July 15, 2020

COVID-19 developments: telehealth and (what else?) standards


A few thoughts as we continue to deal with the novel coronavirus (COVID-19):

  • Telehealth is increasing, which – on balance – is a good thing.
    • The technology has existed for some time to expand the view of what a “doctor visit” looks like. It’s unfortunate that it took a pandemic to put it in widespread practice when it improves accessibility for those patients who have transportation or other mobility issues all the time.
    • Additionally, there are many cases (pre- and post-COVID) when sick people should stay home: A practitioner can diagnose the common cold just as well via an app as she can in person. The advantage of the former is that the sick person isn’t exposing the cold virus to otherwise-healthy people who may be at the doctor’s office.
  • At the same time, it feels like the healthcare/healthcare IT community didn’t dream much to expand what telehealth could be.

    Instead, it feels a lot like the first electronic health records that essentially did little more than create PDFs: digital faxes. And so yeah, we don’t have to get dressed to drive to the doctor’s office but the interaction is very similar to an in-person visit. (One upside: No weigh-in!)

    Are patients better-informed? Are there still time constraints? Has telehealth lightened the work burden for providers?

    Perhaps we will move to make telehealth a more robust experience that includes a pre-visit orientation/survey (to ensure patients can ask the questions they want to ask, which sometimes – perhaps often – get forgotten in the usually hurried interaction of an appointment); automated, relevant follow-up for patients; and integrated post-appointment help to ease practitioners’ work load. (And maybe practice groups/hospitals will come to see telehealth as a complement – rather than a competitor – to the rest of their services: one hang-up that likely slowed widespread implementation.)

  • Finally, there has been some concern about fixing “security issues” being blamed on the “rush” to get telehealth online during the COVID-related quarantine. There’s a lot to unpack in all that if one cares to do so.

    What stands out to us, however, is the notion that this is another concrete, real-world example of why standards are so necessary in healthcare IT. Security issues arise when developers have to guess about interoperability issues among and within systems.

    Standards won’t fix everything, to be clear, but man. They sure can prevent a lot of unnecessary, and probably really predictable, headaches that otherwise will arise in an ever-evolving world.

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