GLOBALIZATION TECHNOLOGY & SOCIAL CHANGE
WHAT IS TELEMEDICINE?
Telemedicine is a relatively new and innovative way of merging the growing use of technology with the increasing demands of healthcare. Hospitals created new ways to integrate telemedicine in their system in order to reach patients living in rural areas only about fifty years ago. Over the last ten years, its success has lead to complex interconnected services that are not only incorporated in hospitals but also in homes, private physicians offices, and other healthcare facilities. [1] Telemedicine transcends time and distance in order to meet the demands from a global level to the level of the individual.
Source of picture: http://www.ortelehealth.org/content/telemedicine-or-telehealth-definitions
Sourceof video: https://evisit.com/what-is-telemedicine/)
Sourceof video: https://evisit.com/what-is-telemedicine/)
Currently, more than half of the hospitals in the U.S utilize telemedicine programs. People can find it more convenient to do telemedicne in the comfort of their own homes.[2] Alaska, Arkansas, and South Dakota are the states with the highest adoption rates of telemedicine. Alaska ranks first with the highest adoption rate of 75%. Arkansas has a rate of 71%, while South Dakota has 70%.[3] Analysis drawn from the research study, “Global Telemedicine Market Outlook 2020” shows that there will be a growth in telemedicine technologies, including the software and services, and hardware. Telemedicine technologies was initially valued at $17.8 billion in 2014 and is expected to grow at a compound annual growth rate (CAGR) of 18.4% between 2014 and 2020.[4]
PROS OF TELEMEDICINE
Let us take a second to delve deeper into the meaning of '-tele". "-Tele" is of Greek origins meaning “at or over a distant”.[9] So for example, when Alexander Graham Bell patented the telephone in 1876, his intent was to expend distance in order to allow people to communicate far away without physical interaction. In this sense the most pure objective definition of telemedicine is to help people bridge distance in order to access good medical care over a distance. There was an incidence in which a woman in Alaska's Northwest Arctic Borough went into labor. She is 200 miles away from a doctor in the town of Kotzebue. She received live guidance through her delivery from the village's health practitioner who used two-way video and voice technologies. [5] She was also able to engage in family based care at a basic level as she received assistance from family members. The use of telemedicine has significantly increased over the past year allowing more doctor-patient contact through "tele-consultations". [5] Whats radical and powerful about telemedicnine is that using technology enables people to traverse various scales from isolated maladies within an individual all the way out to a global system of doctors who are capable of diagnosing, treating, and offering assistance. Through telemedicine people are able to be physically separate from each other. Source: https://www.softwareadvice.com/resources/telemedicine-benefits-small-practices/ Accessed 12/18/2017
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Source: http://www.trekalaska.com/wrangell-st-elias-national-park/getting-to-mccarthy-alaska Accessed 12/18/2017 CASE STUDY: Although there are subtle differences between the adoption rates of the three states, I will explore the use of telemedicine in Alaska. Alaska is the largest state in the U.S with 1,481,346 sq. km.[5] It has a significant indigenous population with 226 tribes that is dispersed over a large area. Unfortunately, it has a very limited road system and many villages are only accessible by boat or bush planes.[6] The map below shows how distant hospitals. There is a shortage of doctors within these rural areas and medical specialist are quite distant as small town and villages are isolated. Not only is this issue exacerbated by isolation but also by poverty. "Communication with village health aides was originally by high frequency (HF) radio. Satellites brought reliable voice communication in the 1970s. Alaska has now introduced the first permanent upgrade to the voice satellite system, known as the Alaska Federal Health Care Access Network (AFHCAN). This satellite-based system is now the world's most extensive telemedicine network, linking 248 sites, including 158 village health centers."[9] The map below shows how distant hospitals. Source: http://dhss.alaska.gov/ahcc/Documents/meetings/201206/Ferguson%20AFHCAN%20Telehealth%20Presentation.pdf Accessed 12/19/2017
Early Telemedicine in Alaska:
“We went from house to house taking care of the sick… Our tools consisted of a thermometer, a stethoscope, and a blood pressure cuff…. We had no phones… but used the school’s [HF] radio to report [on] our patients. There was no nonsense about confidentiality.” -- Health aide Paula Ayunerak [5] See http://dhss.alaska.gov/ahcc/Documents/meetings/201206/Ferguson%20AFHCAN%20Telehealth%20Presentation.pdf for more details and statistics on the impact of telemedicnie in Alaska. |
DRAW BACKS OF TELEMEDICINE
In one study investigating physician and patient perspectives on telemedicine, more physicians were concerned with the quality of telemedicine technologies. More specifically, doctors listed “suboptimal image clarity, poor or unreliable internet connections, and delays from technical difficulties” as a threat to the success of telemedicine techniques in providing quality patient care. One physician stated, “it works great when it works, but let me tell you, in my clinics, it's more not working than working. And if it is working, the staff doesn't know how to use it” (CITE). This prompts the need for readily available technology support staff to ensure that the telemedicine tools work efficiently. [8]
Another major drawback to telemedicine is the lack of continuity with physicians. Patients are no longer viewed by one consistent doctor but rather by multiple doctors. This doesn't allow doctors to build a relationship with patients. With each visit, doctors are “starting from scratch” drawing on personal accounts of the patients past medical history to make a diagnosis.
The use of video lack of face-to-face interaction during a doctor’s visit. It is harder to develop a mutually beneficial patient-physician relationship when most of the nonverbal signals are lost over telemedicine. Much of these ‘signals’ are taken into account when deciding a diagnosis. While the use of telemedicine allows doctors to reach underserved communities, it is nearly impossible to give a holistic diagnosis from a video recording. Lack of physical contact with the patient during an examination can lead to misdiagnosis and further complications.
Thus, it is important to note the specific parameters of telemedicine. This evidence supports the general benefits of using telemedicine in increasing the access to health care. Telemedicine can lead to a patient being treated less of a whole organism but rather a particular complaint.
With advanced technologies, someone can use a high definition camera at home to show what is going on with a patient within the confines of their home. Normally in a clinic, if someone comes in with a particular concern, a health aid can an overall assessment of the patient in order to screen for everything. Therefore in some ways, the effectiveness of scaling in so deep beyond the individual to a particular malady can lead to a lost in the holistic perspective of healthcare. Telemedicine can be so effective of scaling in to the individual malady to the point that a doctor who can be anywhere in the world and treat a patient that they lose site of the patient level.
Source: https://www.youtube.com/watch?v=ukjzzBZxS9w Accessed 12/19/2017
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From the perspective of this doctor in the video on the left that voluntarily moved into telemedicine, with less face to face contact makes patients more comfortable giving more personal information in details because of this sense of anonymity. The younger generation may feel comfortable communicating online or through a medium rather than in person. There is a potential correlation between cyber bullying and telemedicine. This leads me to make the argument that telemedicine is one of these technologies at the frontier of what might be possible in terms of connecting and crossing distance [tele] as well as crossinfg scale. Telemedincine reveals some of the dangers and shortcomings of globalization in a larger sense. Future research can be delve deeper into the shortcomings of globalization. |
Telemedicine transcends time and distance in order to meet the demands from a global to an individualized level that in-patient visits cannot master efficiently and conveniently. People in rural areas are more reliant on telemedicine for healthcare due to the lack of accessibility. As you see once the issue of not having a physical barrier was addressed, another of barrier of miscommunication can come about of lack of familiarity of the new technologies. For some the lack of face to face interaction allowed them to engage in telemedicine. Telemedince impacts globalization as well as pointing to the other shortcomings.
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METHODS
My research method include case studies, and data collected from research telemedicine companies in the United States and more specifically in Alaska. I also looked at journal articles. |
RESEARCHER: Shantae Spencer
RESOURCES
[2] Iafolla, T. (n.d.). EVisit's Blog. Retrieved December 19, 2017, from http://blog.evisit.com/36-telemedicine-statistics-know
[3] Telehealth takes off in rural areas. (2014, February 12). Retrieved December 19, 2017, from http://www.healthcareitnews.com/news/telehealth-takes-nationwide
[4] Ltd, R. A. (n.d.). Global Telemedicine Market Outlook 2020. Retrieved December 19, 2017, from https://www.researchandmarkets.com/research/qn3csn/global
[5] &[6] https://www.comsoc.org/sites/default/files/hudson-dsp-emea2011-presentation.pdf
[7] Hudson, H. E. (2005, August). Rural telemedicine: lessons from Alaska for developing regions. Retrieved December 17, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/16149892/
[8] Hiratsuka, V., Delafield, R., Starks, H., Ambrose, A. J., & Mau, M. M. (2013). Patient and provider perspectives on using telemedicine for chronic disease management among Native Hawaiian and Alaska Native people. Retrieved December 19, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751232/
[9] http://www.dictionary.com/browse/tele-
RESOURCES
[2] Iafolla, T. (n.d.). EVisit's Blog. Retrieved December 19, 2017, from http://blog.evisit.com/36-telemedicine-statistics-know
[3] Telehealth takes off in rural areas. (2014, February 12). Retrieved December 19, 2017, from http://www.healthcareitnews.com/news/telehealth-takes-nationwide
[4] Ltd, R. A. (n.d.). Global Telemedicine Market Outlook 2020. Retrieved December 19, 2017, from https://www.researchandmarkets.com/research/qn3csn/global
[5] &[6] https://www.comsoc.org/sites/default/files/hudson-dsp-emea2011-presentation.pdf
[7] Hudson, H. E. (2005, August). Rural telemedicine: lessons from Alaska for developing regions. Retrieved December 17, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/16149892/
[8] Hiratsuka, V., Delafield, R., Starks, H., Ambrose, A. J., & Mau, M. M. (2013). Patient and provider perspectives on using telemedicine for chronic disease management among Native Hawaiian and Alaska Native people. Retrieved December 19, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751232/
[9] http://www.dictionary.com/browse/tele-