Telemedicine in Pandemic Times

Introduction

Since March 2020, the SARS-CoV-2 virus catapulted healthcare providers and patients into rapid descent towards an alternative form of healthcare to accommodate the restrictions and mandates put in place to increase safety and maintain health status (Mallah et al., 2021). The impact of social distancing and “shutdowns” spurred a flurry of concern from healthcare providers and maintaining their financial status and from patients preventing viral infection while maintaining their health. One could hypothesize that the pandemic catapulted the concept of telemedicine, also less commonly known as virtual health and telehealth; it is here to stay.

Over the past 70 years, telemedicine has transformed from a simple phone call for consultative purposes to the United States Medicare reimbursed platform of the 21^st century. The intersecting of technology and healthcare has developed a novice framework for accessing healthcare delivery networks across the globe resulting in further assessment effecting the quality of care and accepting of the virtual visits lacking the human connection and contact. The foundation of telemedicine has transformed from telephonic and video conferencing to cloud platforms originated from electronic medical records (EMR) allowing interprofessional collaboration for better patient care and outcomes. As health technology develops, evaluations and total quality management (TQM) lack resulting in potential legal challenges, such legal challenges are derived from policy changes, reimbursement, clinical reassurance, informed healthcare plan acceptance, problem identification, and programs for improvement.

The diversity of telemedicine and healthcare applications are broader across research, educational, administrative, and global health that create a thread within patient care. Modifications may be needed within the clinical and non-clinical aspects of the shared system to maintain access and affordability, specifically in rural health. The idea that telemedicine is efficient and attractive to healthcare providers attracts the attention as an alternative healthcare delivery platform, but may foil into economic prospects from declining hospital utilization. This is especially true with the number of institutions closing in the rural areas or acquired through healthcare system mergers.

The scope of telemedicine in the ever-changing healthcare system is far from standardization and integration across the spectrum of delivery as a result of underdeveloped telecommunication infrastructure, industry investments, and the development of innovative consumer electronics. The obstacles of sustainability, standardization, and integration contribute to the uncertainties related to reimbursement, liabilities, and licensure. Many states have independent rulings and legislation addressing the role and definition of telemedicine and additional definitions of what is acceptable, in some cases requiring it to be similar to in-person care. For example, the governor of Pennsylvania vetoed all forms of telemedicine such as voice mail, email, online questionnaires, and others, except those identical to in-person care. Furthermore, the professional state boards are inclined to play a role in the regulatory status of telemedicine at the state level. The lack of consistency and determination of substandard of care may result in litigation and licensure suspension.

The pandemic has reinvented the uniform acknowledgement of telemedicine, the goals and benefits of virtual health, and the role it has played in patient care. It has been developed in a way that overcomes geographical obstacles, enhanced clinical support and patient safety, reduced healthcare costs, and improved logistical access across many socioeconomic classes and populations.