Telemedicine might be the new normal for now
As part of the preventive measures against further infection from COVID-19, the Department of Health (DOH) recently launched telemedicine services to all residents of Metro Manila. Apart from protecting patients who are prone to get the virus, this initiative encourages everyone to stay at home without compromising their physical and mental well-being. But what does telemedicine mean, what scope of services does it offer, and how is it different from a face-to-face consultation?
Telemedicine, in its literal sense, refers to the remote consultation, diagnosis, and treatment being offered by healthcare providers to their patients through the use of telecommunications technology. It’s like going to your doctor’s appointment every month but done from the comfort of your home through SMS, landline and mobile calls, and digital platforms such as audio and video conferencing apps. It can be available for free or with payment, depending on the setup agreed upon between the physician and the patient. It is more convenient and accessible, allowing both parties to set a schedule without worrying about the dangers of being outdoors, especially during these trying times.
To ensure that they follow the patient’s right about data privacy, recognized telemedicine providers by DOH are registered with the National Privacy Commission. Prescriptions and medical records are also made digital, allowing doctors to send the documents online. And even after the enhanced community quarantine, chances are, this option might become the new normal especially for senior citizens, children, pregnant women, and PWD patients.
We spoke to Dr. Kenneth Ross Javate, a psychiatrist, to ask about his thoughts about telemedicine. After leaving for further training in the UK in 2018, he used the method to continue working with some of his patients. “While there was an initial adjustment period from seeing each other physically, it was surprisingly easy to adapt to since I and many of my patients had already been using video calls to communicate with friends and family already,” he said. And now, even with the ECQ running, it allowed him to monitor more of his patients especially the ones who returned to their provinces.
As a child and adolescent psychiatrist, teletherapy helped him to see more of his patients, including their facial expressions. “Rapport is very important in establishing the therapeutic relationship in psychiatry, and it’s quite challenging to do that if both persons are wearing masks and goggles or face shields as mandated by safety requirements,” he shared. Obstacles, however, are inevitable with consultations backed up with tech. Several of his online meetings had been hampered mostly with connection issues due to the country’s limited bandwidth.
After all, telemedicine won’t work without mutual trust and respect for both parties. Everything should be set clear on paper. Physicians highly encourage their patients to sign a consent form, detailing the confidentiality of the information to be disclosed on the chosen platform as well as the schedule.
First, you’ll need to have a piece of decent equipment. Although it is ideal to use a laptop, PC, or tablet for a bigger display, you may use your Android or iOS smartphone installed with decent video chat apps available for free such as Viber, Zoom, Google Duo, and Messenger. Make sure you’re in a room with good lighting, have headphones or earphones plugged, a stable WiFi connection, and a good webcam in case your desktop doesn’t have one.
I’ve experienced telemedicine a year ago when my psychiatrist went abroad. So, when the first wave of quarantine announcements happened, and when he asked me if I’m game to continue my therapy virtually, I did not hesitate to say yes. In my case, a disclaimer section is added to my consent form since teletherapy may have a different experience from face-to-face therapy. The experience was quite assuring yet weird. For one, it could make you feel a bit incomplete. For someone who’s been on therapy for years, it felt like not seeing your best friend for a long time. It contributed more to my frustration with my crappy WiFi connection which causes occasional lags and audio delay. There were a few occasions that we both had to turn off our cameras because of technical glitches. But when he started to ask a series of questions as soon as my connection went good, l felt a huge relief. The relief turned into lucidity when I heard his voice and gave some realizations to ponder on. Amidst uncertainty and growing fear for my future, knowing that someone was on the other line gave me a morale boost.
Patient as ever, he listened to my rambles. Our usual hourly session increased by 30 minutes, thanks to my inconsistent Internet provider. Nevertheless, my virtual conversation with my psychiatrist went well. He arranged and sent my ePrescription via email and ensured the security and confidentiality of our telemedicine session. Like a good friend that he is, he also offered face-to-face appointments to other patients once the ECQ is lifted.
With the help of technology and digital tools, I was able to prioritize my mental health despite the pandemic. However, telemedicine might not work for everyone. First, patients who are not tech-savvy might feel overwhelmed and discouraged. Aside from technical difficulties that internet subscribers could encounter, there are still areas in the country with no internet connection. Not everyone could also afford to buy even a smartphone, most especially with our current economic situation.
Should the government want to promote telemedicine as an alternative, it would need to implement feasible programs under DOH that would cater to the needs of the patient and the healthcare providers. Possible solutions may include coordination with the hospitals and partnerships with private companies and telcos. For Dr. Javate, working towards providing affordable and reliable internet connections in both urban and rural areas should also be considered. “A teleconsultation is an important option that should be considered because there are many situations, aside from COVID-19, in which this can be helpful, especially given how many doctors are concentrated in highly urbanized communities, which can be hard to access for the populace. “
How about you, have you experienced telemedicine? Share it with us down below!