Telemedicine: Challenges

There are a multitude of barriers regarding telemedicine and telehealth. Reimbursement is an obstacle that many scientists have pointed out. Many technology companies are not fully aware of the healthcare market and only participate because of the potential financial gains. There are around 90 million people in managed care systems, but there is ample evidence that managed care organizations use telemedicine to control costs. Fears that telemedicine will allow providers to abuse the healthcare system or overuse it result in numerous restrictions. Private insurance companies are not always able to cover telemedicine services, making it difficult for healthcare providers to receive reimbursement for telehealth services.

Other types of restrictions involving telemedicine include more limited opportunities for physical examinations and face-to-face interactions. Due to virtual interactions, physicians do not have to see the patient in person, which can negatively impact the effectiveness of the consultation, as physical examinations are beneficial and sometimes required for an accurate diagnosis. Additionally, telemedicine increases the risk of technical problems such as equipment failure. Implementing multiple technologies simultaneously can create a large amount of data that must be maintained, consuming significant time. How reliable and valid the data is also poses a risk. If large flows of data remain unsorted or unmaintained, physicians are more likely to incorrectly diagnose a patient based on that data. Unreliability can be caused by various reasons. In remote areas, inadequate bandwidth for the transfer of information can lead to data being transmitted incorrectly.

Telemedicine is also limited in other ways. It can only be utilized to its fullest extent if all areas have access to tablets, computers, and smartphones. However, this is not the case, and many people are not able to obtain knowledge about the internet and suffer from computer illiteracy. Older adults who did not grow up with technology may find adjusting to telemedicine more challenging than younger or middle-aged people. Those with disabilities struggle with telemedicine as well. Eighty-one percent of people without disabilities own a form of computer, while only 62% of adults with disabilities have access to technology. Only 26% of Americans with disabilities have high-speed internet, compared to 44% of Americans without disabilities. This affects the effectiveness of telemedicine, as video-based services may be difficult to access and many devices are not customized to meet the needs of those with disabilities.

Furthermore, concerns about privacy have been brought to attention. There is an obvious lack of knowledge among workers about privacy when it comes to using medical equipment. Healthcare workers must have sufficient training and competence to manage patients using telemedicine. Backups and guidelines regarding data ownership and cybersecurity must also be implemented to protect the personal information of patients.

References: 

Board on Health Care Services, Institute of Medicine. Challenges in Telehealth [Internet]. Nih.gov. National Academies Press (US); 2012. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207146/ 

Ansarian M, Baharlouei Z. Applications and challenges of telemedicine: Privacy-Preservation as a case study. Archives of Iranian Medicine [Internet]. 2023 Nov 1;26(11):654–61. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10864944/ 

Monisha M. Challenges in Telemedicine and Their Potential Solutions [Internet]. DrCare247. 2023. Available from: https://www.drcare247.com/telemedicine/challenges-in-telemedicine-and-their-potential-solutions/ 

ADA and Telehealth Challenges Faced by People with Disabilities Accessing Telehealth Services < Southeast ADA Center [Internet]. Southeast ADA Center. Available from: https://adasoutheast.org/resources/ada-and-telehealth-challenges-faced-by-people-with-disabilities-accessing-telehealth-services/