What is Telemedicine and Telehealth?

As practitioners of health and wellness it is our prerogative to explore the best and most efficient means to provide care for our clients. As we enter the new year of 2020, it is a great time to review the landscape of the developing technologies in therapy markets. Among the most promising of these is that of telemedicine, which refers to technologies which enable or facilitate remote clinical care of patients. This technology often takes the form of one-on-one video chat where patients can meet face to face with their care provider from the comfort of their own home, while also allowing for the exchange of biological data that would traditionally have been limited to lab work such as blood pressure, cortisol levels, etc.

As the average person becomes more accustomed to the conveniences of advancing technology, experts expect telemedicine to become more crucial to medical practices as technology evolves. According to recent research from the market intelligence company Transparency Market Research, the global telehealth market will reach $19.5 billion in value by 2025. This makes it one of the fastest growing sectors of the medical tech industry.

The distinction between telemedicine and telehealth is a subtle one. The difference between the two is the technology distinguished by the clinical care of telemedicine compared to telehealth’s broad spectrum of non-clinical care such as fitness training or mental wellness coaching. In the same way, teletherapy refers to the specific act of conducting therapy through telemedicine technology. Because the clinical nature of therapy in licensed private practice falls under the category of telemedicine and teletherapy respectively, these two markets will be the main focus of this article outside of considerations which take into account the industry as a whole.

Why Should You Incorporate Telemedicine into Your Practice?

Aside from the encouraging market forecasts enumerated above, a primary motivation to consider is the increasing population of individuals who will greatly benefit from the increased efficiencies and conveniences of telemedicine technology. As generation x enters advanced age, there will be an increasing need for geriatric care which takes into account the ease of use in technology they have come to expect over the past several decades. Two thirds of healthcare IT executives report that telemedicine technology will contribute to more efficient functionality and greater growth in 2020 as they target this population.

In his book, “Building Your Ideal Private Practice: A Guide for Therapists and Other Healing Professionals,” Dr. Lynn Grodzki describes the decline of traditional therapeutic systems of care since their golden age 25 years ago when practitioners had fewer limitations placed on private practice, and patients had fewer barriers to entry in attaining care. Similarly, barriers to patients receiving insurance reimbursements and the mounting paperwork required of practitioners is driving the rapid expansion of telehealth markets.

6 of the Most Impactful Offerings of Telemedicine

Low Barrier of Entry:

For a patient to come in to a care provider’s office actually requires quite a few steps. Beyond needing to secure the specific time in their personal schedule, they must physically travel to the office where they will usually end up waiting in the office for their turn to be seen.
While this has been traditionally unavoidable, experts expect that this fact is largely responsible for the shockingly low number of sessions attended by clients--with client’s typically attending an average of one appointment before ceasing therapy. Instead of having to travel to a new and unfamiliar place or having to wait in a waiting room where anxiety can build, telemedicine technology allows for patients to undergo therapy from the comfort of their own home.

Privacy:

As any therapist knows, the comfort and privacy of clients is a crucial antecedent for the success of the session. Especially in the instance of more traumatized clients or therapy sessions of a more sensitive variety, conducting a session within the client’s own home can act as the reassurance that they need.

Timeliness:

One of the great frustrations of private practice is that the tardiness of a single client can throw off the entire day. If you throw in the untimeliness of several clients, the problems can easily compound upon each other and become the bane of our work day. With telemedicine technologies there are no waiting rooms or travel times. While there are certainly new constraints to consider, for the most part teletherapy will be a major time saver for you and your private practice.

Access for the Disabled:

Perhaps one of the most meaningful opportunities for teletherapy is for disabled populations, who would have traditionally found it incredibly hard to make an office visit. By essentially opening up therapies for a previously untapped population, teletherapy represents one of the most impactful developments in the industry over the past 20 years.

Session Flexibility:

Depending on the goals of your private practice, teletherapy can open up new options for you and your client alike. Often times the clients who need therapy the most are those who are either unwilling or unable to stick to a set schedule. The ease of conducting digital sessions can open the door to emergency sessions or rescheduled without all the difficulties that come with rescheduling physical appointments.

Safety:

As healthcare professionals we never enjoy the consideration that our client might provide a danger to themselves or to others. Unfortunately it is a reality that is of particular relevance to those of us in private practice. While it may seem that teletherapy might only increase the safety of the therapist, in fact, it improves the safety of both individuals due to the implicit mechanisms of deescalation within remote communication. Often times it is the physical presence or interaction with a particularly vulnerable client that precedes a behavioral outburst that is unlikely to endanger the client as anyone else.

What Does the Data Say?

Several research studies from the Telemental Health Institute have demonstrated that telehealth therapy options are equivalent to face-to-face care in a diverse range of settings, meaning that it is by all reasonable accounts a reasonable alternative. Similarly a study covered the observation that even in telehealth therapy which did not employ video, asynchronous internet messaging was able to achieve impressive results. This indicates a growing inclination for therapy to be conducted over a period of time through long term messaging, rather than the traditional system of therapy by session. This might be particularly beneficial for client populations that have some aversion to physical appearances or visual stimuli.

Another study from the Journal of American College Health showed, however, that digital therapy options might function to open up clients up to a face-to-face preference. Thus practitioners with a preference for one therapy format over another should still see the advantage of each format acting as a primer for patients to gain a better understanding of their own preferences respectively.

Potential Limitations of Telemedicine

Clinical psychologist, Nina Barlevy, PsyD, describes the potential difficulties of digital therapy options through video or instant messenger technology. She points out that many practitioners who have become accustomed to traditional face-to-face meetings might find difficulty in analyzing the client due to the limitations of video feed. Specifically she mentions that it might be difficult to notice the micro indicators of voice tonality, facial expression, or body language.

She worries that the limitations in teletherapy conducted over internet messaging might even be an inhibitor in client therapy. "I'm such a people person, so it was tough for me to feel a real connection when I was just messaging with people," she says. "Plus a lot of people just stopped responding, and I felt like there wasn't enough time to really build a relationship. It actually turned out to be more difficult than I imagined."

This consideration parallels a larger concern in many professionals that the reliance on telemedicine technology will result in a deficit of skills, which had previously been developed through the one-on-one interactions of traditional therapy. Many practicing therapists report that their expertise came from interacting with patients on a deeper level. Summed up in a question: while telemedicine may be more convenient for the client, will healthcare practitioners pay the price in some other way?

Competition in the Telemedicine Market

Another potential limitation of the telemedicine market is that convenience of geolocation has historically been one of the deciding elements in competing healthcare practices. If convenience of location takes a backseat then clients might be funneled towards the same practices who can afford the most robust digital marketing budgets. This is another point at which there might be a generational divide, as private practices with an emphasis on face-to-face interactions and ‘marketing by local reputation’ might lag behind.

An actionable tip here is to get a jumpstart on your competition and survey the land of practitioners in your area. Take the time to review the medical practices of your field in select cities and explore which practices are set to remain a face-to-face facility and which are set to develop telemedicine capabilities. Along these lines it may also be beneficial for practitioners to explore shifting their own healthcare into the telemedicine market, so that they can experience it themselves from the client angle.

Author's Bio: 

Jerry Bomhoff is a psychologist specializing in the intersection between technology and psychology. He enjoys long hikes into forested regions, and cataloguing cephalopods on outdoor excursions.