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Being from Egypt, we are taught from a young age that the hieroglyphics were the beginning of almost everything.

Egyptians became the first civilization to use hieroglyphics to spread information about medical outbreaks and diseases which is now termed Telehealth and Telemedicine.

The surgery in ancient Egyptian was so advanced that surgeons used various instruments similar to what we use today such as the scalpel, forceps, and scissors, splints were made of pieces of wood padded with plant fibers.

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Kichloo, A., Albosta, M., Dettloff, K., Wani, F., El-Amir, Z., Singh, J., Aljadah, M., Chakinala, R. C., Kanugula, A. K., Solanki, S., & Chugh, S. (2020). Telemedicine, the current COVID-19 pandemic and the future: A narrative review and perspectives moving forward in the USA. Family Medicine and Community Health, 8(3). https://doi.org/10.1136/fmch-2020-000530

Shaver, Julia. (2022, April 25). The State of Telehealth Before and After the COVID-19 Pandemic. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9035352/#:~:text=Telemedicine%20was%20underused%20and%20understudied,rapid%20increase%20in%20telemedicine%20consultation.

HRSA. (2023, August 31). Telehealth policy changes after the COVID-19 public health emergency. https://telehealth.hhs.gov/providers/telehealth-policy/policy-changes-after-the-covid-19-public-health-emergency

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The ancient Egyptians were known to use smoke signals to warn nearby villages of sickness near by.

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The use of telemedicine has been rapidly increasing from 2010 to 2017, and the use of doctors/service providers that connect with patients through the use of video and other platforms has increased from 35% to 76%.

Insurance companies have reported that patient claims for telemedicine have increased by 53%. Because of the effectiveness of telemedicine, providers, and physicians can be sought out by patients who have difficulties getting to the doctor's offices.

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For more than 100s of years: clinicians, health services providers, APRNs, and others have been participating in the use of telecommunications to improve the health care system. All of these efforts are to improve patient care as it can become difficult for many reasons.

Telemedicine is the use of electronic information and communications technologies to provide and support health care when distance separates the participants.

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The utilization of telemedicine has had positive impacts in the public health emergency beyond facilitating triage, including allowing the rapid deployment of large numbers of healthcare providers and the providing of services when local hospitals and healthcare centers are unable to meet demand.

Telemedicine has been a means of providing healthcare information not only to infected people but also to non-infected people during the COVID pandemic.

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CONVENIENCE

More than 70% of patients prefer telemedicine rather than in-person appointments. Not only does this provide convenience for all patients, but also it helps those who live in remote locations which makes it hard access to proper patient care.

SAVES TIME

Patients can participate in a Telehealth visit from anywhere in the world using a mobile device, computer, tablet, or laptop.

This service creates ease for those who would normally have to travel long distances for appointments. Patients sometimes have to wait over an hour to see the doctor. Telehealth helps to reduce wait times in the waiting room.

COST-EFFECTIVE OPTIONS

These services significantly reduce healthcare service costs for patients, especially low-income families.

IMPROVED ACCESS TO CARE

Patients who face physical challenges to see a doctor now have the ability to seek care through virtual visits. Patients who have physical disabilities, the elderly with no transportation, and busy patients who have little room in their schedules.

TELEMEDICINE CAN LEAD TO IMPROVED HEALTHCARE QUALITY

White Coat syndrome is true for a lot of patients who may be too embarrassed to speak about what is wrong regarding their health issues. With telemedicine, patients have the ability to take an appointment in the comfort of their home.

When it is easier for doctors to speak with patients and remotely track their health with monitoring systems, they can work to identify problems as they develop.

A study by the American Journal of Medical Care found that patients who participate in telemedicine visits experience lower levels of depression, anxiety, and stress, and have 38% fewer hospital admins

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IN-PERSON VISITS CAN BE NECESSARY TO DIAGNOSE

Physical exams are impossible over the phone, which may be necessary for the diagnosis or treatment of a patient. COVID-19 test requires a nose and throat swab, so you must go to the doctor physically.

SECURITY CONCERNS

With the relaxation of telemedicine requirements due to the COVID-19 pandemic, hacking into telemedicine systems to steal personal healthcare information may be a cause for concern.

LIMITED TECHNOLOGICAL ACCESS

Not everyone has the same access to technology that makes telemedicine accessible. The elderly, minorities, mentally disabled patients, and low-income families may not always have access to the technology needed for a virtual visit.

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"Telehealth represented less than 1% of the total healthcare volume in the United States before the COVID-19 pandemic, and more than half of physicians used Telehealth for the first time in the pandemic’s first few months."

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Telehealth represented less than 1% of the total health care volume in the United States prior to the COVID-19 pandemic, and more than half of physicians used telehealth for the first time in the pandemic's first few months.

Subsequent research shows physicians have overwhelmingly responded positively to its implementation.

85% indicated that telehealth increased timeliness of care.

75% said telehealth allowed them to deliver high-quality care.

More than 70% were motivated to increase telehealth use.

That last statistic is particularly exciting to Meg Barron, the AMA's vice president of digital health innovations.

"Telehealth is here to stay," she said. "It's not whether telehealth will be offered, but how best to offer telehealth services as we move toward what we're terming digitally enabled care-which is not just hybrid care, but more so fully integrated in-person and virtual care based on clinical appropriateness."

Barron discussed the implementation of telehealth and its future in a recent episode of " AMA Moving Medicine."

Understanding telehealth's value

Physicians are not the only ones who responded positively to the presence of telehealth. Patients also found added value in having a digital opportunity to connect and interact with their care team.

"We know that both patients and physicians want telehealth to continue," Barron said, "and also that they want the option and convenience and access of that virtual care modality to stay in place, in addition to in-person care."

Recognizing that increased interest, the AMA developed a new framework to measure the comprehensive value of virtual care. The goal was to understand how to optimize virtual care beyond just a return-on-investment perspective, but also for patient, physician and caregiver satisfaction, patient access, and health equity.

The "Return on Health" framework consists of six value streams that demonstrate ways virtual care models can generate value. Each value stream has specific metrics that can be used to measure the value of virtual care programs.

The six value streams include:

Clinical outcomes, quality and safety.

Access to care.

Patient, family and caregiver experience.

Clinician experience.

Financial and operational impact.

Health equity.

The framework can be used by physicians, health care organizations, payers and policymakers. Care providers can use it to develop and evaluate new models for care, and payers and policymakers can use it to support long-term fair and equitable payment for clinicians to sustain virtual care services.

Meanwhile, the AMA Telehealth Immersion Program guides physicians, practices and health systems as they work to optimize and sustain telehealth in their organization.

"This is a series of educational modules that focus on moving beyond adoption [and] really optimizing telehealth in your own practice environment," Barron said.

The Telehealth Immersion Program, part of the AMA STEPS Forward™ Innovation Academy, provides clinical best practices, virtual care expansion opportunities, and how to successfully scale and sustain telehealth in practice. Included in the program is a series of webinars, peer-to-peer learning opportunities, virtual discussions, and additional on-demand resources.

The Telehealth Immersion Program's first 2022 event, " Developing Digital Empathy & The Virtual Physical Exam," takes place Jan. 26. Register now.

" AMA Moving Medicine" highlights innovation and the emerging issues that impact physicians and public health today. You can catch every episode by subscribing to the AMA's YouTube channel or the audio-only podcast version, which also features educational presentations and in-depth discussions.

Essential Tools & Resources

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In 2022, moving beyond telehealth to digitally enabled care

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Telehealth represented less than 1% of the total health care volume in the United States prior to the COVID-19 pandemic, and more than half of physicians used telehealth for the first time in the pandemic's first few months. Subsequent research shows physicians have overwhelmingly responded positively to its implementation.

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The CMS has recently expanded access to Medicare telemedicine. This expansion has allowed healthcare services to continue while preventing the spread of the virus. During the COVID-19 pandemic, all Medicare beneficiaries across the USA can receive Medicare telemedicine care at the same rate as in-person healthcare visits. Telemedicine may be offered to new or established patients by clinicians, and a broad range of clinicians may provide services through telemedicine.