Abstract a leading role in the provision of health

AbstractInformation and communication technologies arerevolutionizing the way people communicate with each other. These technologieshave great potential to help adapt contemporary global health problems.Telehealth refers to the incorporation of Information and CommunicationTechnologies in health systems, including medical, academic, administrative,and technical services with the purpose of exchanging information in the fieldof health.

Given that telehealth plays an important role in a leading role inthe provision of health services worldwide, it is increasingly important toknow the extent of this technology in order to develop strategies to reachsuccessful and innovative solutions that lead to a scalable and sustainableprogram. This document defines what telehealth is, as well as describes itsadvantages and disadvantages perceived from different points of view of users,both professionals and patients. Among the many disadvantages including thedigital divide and the excess amount of users, the most concerning issue aboutthis innovation is the doctor-patient confidentiality and the miscommunicationbetween doctors and patients. Even though it does possess these factors, thereare some advantages that do impress making it easier to access patient data andcommunicate with specialists worldwide. The data was obtained from a revised bibliography. Keywords: Telehealth, advantages, disadvantagesTelehealth: Its Effects on Society The modern societyhas found ways to newly impress its member of the community by introducinginnovative technology into a regular lifestyle.

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Telehealth, for example, allowsus to provide health care services at a distance, through the use oftechnology, which makes it possible for us to exchange data to make diagnoses,put treatments, and prevent diseases and accidents. Trying out new advancementsinto societies can potentially cause downfalls because it changes thetraditional ways of medicine: miscommunication between the personaldoctor-patient relationship, and excess amount of users, the digital divideamong communities, larger investment for those in private practice, trainingmight be necessary, and uncertainty of patient information. The biggest concernis that with different formats can compromise the security of information andthe confidentiality of the data that is shared.

For the permanent training ofhealth care professionals and in research activities, this is an innovativeadvancement made in order to improve the health of people and the communitiesin which they live by involving communications from different areas, havingbetter accessibilities with patient data, universalizing patient care, andeasier accessibility for those with chronic conditions or psychotherapy. The main disadvantages found in relation to the use oftelehealth were that this method provides scarce doctor – patient relationship.Patients are concerned about the suitability of the equipment and thereliability of the consultation. Both patients and doctors have reservationsabout the possibilities of demands. There are patients and even healthprofessionals who resist the use of technology. This incident is more common inelderly people, especially because they do not master their management, butwith careful preparation these difficulties can be reduced. Mitzner, Stuck,Hartley, Beer, & Rogers (2017) investigated the criterion of elderly peoplewith mobility impairments about the use of televideo technology.

Although theparticipants perceived that these technologies were useful, they showedconcerns about the lack of security and privacy, that is, concerns about theinvasion or violation of privacy, exposure of personal information, exposure toa computer virus, and the misuse of technology to steal information or incurdamage. Durupt, Bouchy, Christophe, Kivits, & Boivin (2016) addresses thefact that doctors who had been practicing for more than 30 years did not wantto change their conventional exercise mode, due to current technologies such astelemedicine. The lack of time, the deterioration of the doctor-patientrelationship, the loss of the clinical examination, the risk of diagnosticerror are the brakes to the teleconsultation mentioned by the doctorsinterviewed, added to the fear of more work and a loss of autonomy. The authorsays that for doctors the physical encounter between the doctor and his patientis a ritual, and the need to maintain an intimate and confidential contactconstitutes an obstacle for the development of telemedicine. Another concern was that they found them difficult to useand learn as well as an unnecessary excess of users. Gogia et.

al (2016) statesthat telehealth can only provide text, sight and sound. That although they areimportant lines, the management of a problem has to go beyond listening to thepatients’ voices, or treating an image. It also addresses the technicaldifficulties that sometimes interrupts the service, the existence of securityproblems related to patient data, and considers that distance is a barrier toeffective education and training with remote personnel, which represents athreat to the evidence based on practice.

The author considers as a negativeaspect of telehealth that there is a problem of excess of some users, sincepatients feel free to make calls at any time without respecting the establishedschedules. It also addresses the issue of resistance and negativity offered bythe use of telehealth by some health personnel, especially those who have beenworking for many years and do not want to change their routine.Another issue addressed by Gogia et. al (2016) is that thereis a digital divide for a group of people, such as low income, lowtechnological knowledge, low cultural level, elderly, isolated communities,etc., which, paradoxically, they are the people most in need of telehealth benefits.

The author also considers the technical challenges of telehealth, such as theneed for a high performance system for the transmission of information, whichis expensive and technologically demanding. It also discusses the issue ofreliability, casting doubt on whether people who offer telehealth service arereally trained and licensed to practice, which is difficult to assess,especially in phone calls, to know if the person responding is really who wasassigned or an assistant.In addition, doctors who practice in their ownconsultations, express that it requires an investment of time and money tooimportant for a single doctor.

They also express fear of the loss ofinformation, since teleconsultation does not allow to visualize the stagesprior and after the consultation, nor to evaluate the behavior of the patientwith other people present in the consultation, which are steps that constitutethe essence of the practice of general medicine. On the other hand, others believe that the continuous creationof new technologies and methods of work lead to concerns about the short andlong-term consequences of the application of telehealth. It is feared thattechnology will become obsolete, that skills will not be available for itsmanagement, and that training will be necessary. These trainings areindispensable for the successful application of telehealth. Another difficulty encountered was that the quality ofhealth information is uncertain. The fact that a large part of the informationobtained on the Internet does not have regulations that allow us to know if itis being provided with true data is of concern. In addition, theconfidentiality of information obtained from patients can be lost somewhat(Ondiege & Clarke, 2017).

Although this program expresses negative impacts, it alsointroducing important changes into modern societies. It is a new form ofcommunication with patients and professionals from different healthcare areas.For the system, according to Langabeer et.

al (2016), the fundamental advantageis an increase in efficiency through the optimization of healthcare resources,the improvement of demand management, the reduction of hospital stays, thedecrease in repetition of medical acts, and the reduction of travel through thecommunication of professionals and care providers. Telehealth is a benefit tothe economy with the savings of time and costs in transporting the sick, intransporting doctors, and in transporting specialists. Many hope that thecontinuous decline observed in the cost of telecommunication equipment willlead to a positive evolution of the cost-benefit ratio. According to Langabeeret. al (2016), patient care enabled by telehealth is a more cost-effectivealternative than traditional treatment. This could, in turn, allow for themoney saved to be invested in equipment and medicine for those who needsurgeries or have serious illnesses.For professionals, there are a number of advantages, amongwhich are better communication between professionals of the same and differentcare areas, an improvement in the accessibility of patient data, and importanttraining and research resources.

The information of the patient, such as theclinical history, the results of examinations and observations made by thedoctors, is easily transmitted electronically, making use of differentprotocols and technologies such as electronic mail. Digital communicationallows health information to be more complete, updated and accurate. Thanks tothis, health professionals have the possibility to consult specialists withouthaving to travel. It also makes continuing education more affordable since itis a fundamental tool in distance training programs, as well as for theexchange of information and scientific studies. Doctors can attend, forexample, to surgical interventions performed anywhere in the world and even,communicate directly with the surgeon (Durupt, Bouchy, Christophe, Kivits,& Boivin, 2016).For patients, the advantages revolve around greateraccessibility to healthcare resources, greater accessibility to informationabout their problems, a greater comprehensive conception of the patient, and auniversalization of care.

That is, it is possible to provide health services inscenarios in which there is no other alternative than the use of communicationtechnologies. Specialized care is approaching remote areas where there arescarce health resources, avoiding displacements, and improving accessibilityand equity. Bull, Dewar, Malvey, & Szalma (2016) considers that telehealthapplications should be affordable and accessible to all and that engineers andprogrammers should take this into account when designing telehealth systems andapplications. Through telehealth, unnecessary referrals can be avoided, sinceit makes contact between centers and healthcare levels accessible, whichimplies an improvement in the quality of the service. Even in urban areas, itis possible and advantageous to streamline administrative and support processessuch as appointments, sending reports, etc. for greater speed and precision intreatments.

Of nearly 1,500 citations reviewed on telehealth Totten et.al (2016) conducted many investigations reported that telehealth interventionsproduced positive results when used for remote control of the patient, forvarious chronic conditions, and for psychotherapy as part of behavioral health.The most consistent benefit was reported when telehealth is used forcommunication and counseling or remote monitoring in chronic conditions such ascardiovascular and respiratory diseases, with improvements in outcomes such asmortality, quality of life, and reductions in hospital admissions.

According to the reviewed bibliography, some only see theadvantages in the use of telehealth, others only see disadvantages, and mostvalue both. The adverse opinions expressed can be taken as advice towards theimprovement of digital medicine. Regarding the levels of information access, itis important to be detailed and strict about the patient information that willbe shared and by whom.

It would be beneficial to create applications that allowdifferent access to information according to the user. This will ensure thepatient’s information confidentiality. The excess amount of users can be solvedby prioritizing which patients must be digitally attended to based on a quickquestionnaire determining the severity of their call. In addition, there shouldbe benefits for those with low income in order to fairly provide this programto everyone in a community. Although there are some bugs that can be revised ina system like this, there are certain traditional ways that can never bereplaced. Programs like Telehealth are only the beginning to the new up andcoming innovative ideas that could better our lifestyle, but that does not meanthat users and medical professionals will not bump into difficult aspects.