Telehealth Technology: What’s Under the Hood?

Pros

• Video-based virtual doctor visits allow the provision of healthcare services in isolated communities and remote regions where there is no clinician available
• Video chats are a good alternative for home-bound patients
• Video conferences facilitate doctors’ collaboration for remote diagnosis and patient treatment
• Video-based interactions allow primary care physicians to replay patient visits when necessary
• Video calls are convenient for patients who don’t have enough time to visit a doctor in person and or who don’t like to waste time in a waiting room

Cons

• Technology is dependent on the power supply and proper internet connection
• Specialized health data management equipment is necessary
• Technology requires technical training, especially for elderly citizens
• Not all insurance policies cover telemedicine

Examples of Live Video Telehealth Technologies:

• Online video conferencing systems for medical check-ups, therapy sessions, and patient visits
• Patient assessment applications for clinicians, allowing capturing and sharing of medical examination information
• Video systems for group practices
• Patient portals
• Mobile platforms

As a rule, the deployment model used for these solutions is cloud, SaaS, and web technologies as well as via mobile (Android and iOS) applications.

Store-and-forward Telemedicine Systems

Store-and-forward (asynchronous) systems support the collection, recording, and transmission of health data history through a secure electronic communications system to a specialist to evaluate the case or to render a service outside of the live interaction. See CCHP’s micro-documentary Telehealth and Access to Care about possible uses of this service.

The results of Cisco’s Global Customer Experience Report Focused on Health Care show that people’s attitudes toward health data management have shifted significantly and, by making medicare patient-centered, telemedicine has been a major driver of these changes. Today, 70% of consumers feel comfortable communicating with doctors via text, email, and video instead of seeing them in person. And 63% of surveyed respondents say they are satisfied with storing their medical records in the cloud. Transparent and computerized health information management has significantly increased patient engagement, experience, and overall satisfaction from using remote monitoring systems, patient self-service portals, and other health information technologies.

There are distinct advantages to store-and-forward systems, such as improved access to information and better communication between patients and practitioners, but there are also disadvantages due to the fact this technology is still evolving:

Pros

• Healthcare professionals from several hospitals can share information and discuss patient issues as if they were in the same place
• MRIs and X-rays can be transmitted to specialists for a second opinion
• Electronic health records are always accessible
• Compliance with HIPAA laws, which aim to prevent private or secure medical documents from being leaked
• Improved professional education

Cons

• Low-quality records (X-ray and other images) pose a risk of faulty clinical treatment
• Low internet speeds or server problems can make virtual communication impossible
• Store-and-forward systems cannot provide immediate treatment
• Requires a high-quality security module in a software solution

Examples of Store-and-forward Telehealth Solutions:

• Collaborative patient assessment applications for capturing and sharing medical exam information
• Web-based systems for information exchange
• EHR systems
• Mobile applications for uploading data

Remote Patient Monitoring (RPM)

This telehealth modality is widely used for the care of chronically ill patients. Remote patient monitoring (RPM) involves the collection and transmission of patient’s data to a care provider in a separate location for care or support. RPM provides patients with more control and a better understanding of their health conditions, while clinicians using RPM telehealth technologies can address any negative changes in a timely fashion and improve their patients’ quality of life.

According to the Telecare Services Association, telehealth services, when used correctly, can substantially benefit patients. The association’s data shows:

• 15% reduction in visits to A&E (accident and emergency centers);
• 20% reduction in emergency admissions;
• 45% reduction in mortality rates.

Pros

• Extra attention to at-risk patients and early detection of deterioration
• Continuity of care after leaving the hospital and the possibility to adjust prescriptions
• Proactive communication between doctors and patients
• Education and support of patients with chronic illnesses
• Better nurse availability
• Greater patient engagement

Cons

• Special medical devices are necessary for monitoring vital data; monetary investments are needed
• Safe data transmission is still a problem
• More specialists are needed to process and interpret data
• Possible faults with monitoring devices

Examples of Remote Patient Monitoring Solutions:

• Special devices and sensors with embedded cellular chips that transmit biometric data to servers or to the cloud
• Medical devices with short-range sensors that wirelessly connect with a mHealth gateway or hub
• Mobile applications and specialized platforms

Mobile Health (mHealth)

The last but most widespread type of telehealth service is mobile health. Mobile health (or mHealth) means health care and public health practice and education through smart devices and wearable technologies. According to the US Food and Drug Administration (FDA), about 500 million people all over the world are already using personal healthcare apps.

Pros

• Improved data accuracy and access
• Facilitates accurate diagnosis
• Focus on personalized precise medicine and better preventive and predictive functionalities
• Great management for chronic illnesses
• Support for the workflow of clinical practitioners
• Encourages better patient commitment

Cons

• Data security is not always provided
• No unified, formalized systems (for now); no integration with existing IT systems
• Apps must be updated to stay relevant

Examples of mHealth solutions:

• Mobile-enabled connected medical devices
• Mobile wellness apps
• Wearables

It’s clear enough that the growth of mobile device technologies is where the future of medicine lies, and it’s time to use these technologies to reach consumers, i.e. patients.

How to Develop Your Own Telehealth Solutions?

Telehealth solutions not only facilitate the workflow of healthcare services, foster professional and patient education, and increase specialist collaboration, but also allow remote doctors to monetize their assistance. Now is a good time to use telehealth solutions to reach consumers and increase their loyalty.

Software development companies can offer you various solutions, but they will always need your input on:

• Features you need in your solution and business objectives you want to achieve through them;
• User experience and preferred app design;
• Potential regulatory requirements you want your solution to comply with.

Here’re a few examples of how telehealth solutions could be built:

For telehealth and wellness video conferencing apps, the solution could be developed as an add-on to the existing third-party service. It’s possible to embed video chat features in several ways:

• A plug-in for existing cloud solutions like Zoom or Webex is a fast way to get your own video conferencing solution, as your team will build an integration rather than a whole solution from scratch. You will also exploit the IT infrastructure of the third-party vendor, which could be a good cost saver, but the quality and accessibility of your service will be completely dependent on the third party too.
• The advantage of deployment on your own server for video streaming is that despite the additional costs of extra server capacity support you are in full control over the provision of your healthcare services and are able to customize everything according to your needs. The disadvantages are obvious: big initial investments for server configuration and integration, involving several specialists’ work over several months, and, possibly, purchase of a license if a paid solution is chosen.

Store-and-forward solutions can look like cloud databases containing electronic health records of the patients and allowing doctors access to them. Store-and-forward systems are complex, often involving both mobile and desktop versions must meet HIPAA provisions, and require deep customization and integration with various data sources, unified algorithms of collection, aggregation, processing, and analysis.

Remote patient monitoring systems using various portable devices and wearables involve several processes:

• patient data collection through a device and data transfer to a server;
• health data aggregation and visualization in an easy-to-use format;
• optional features such as involving specialists (doctors, consultants, nurses) to give recommendations and instructions, or connection to a clinic’s existing online patient accounts.

How Much Will a Telehealth App Development Cost?

Outsourced development is cheaper than hiring an in-house team and developing the solution in the US or in Europe. But even if you build a cost-efficient team yourself there’s always a question of how versatile the team’s experience would be. With reliable outsourcing or staff augmentation partner, you can be sure that whenever you need an engineer bearing knowledge of a very specific tech stack, they will either offer you one instantly as they have them on the team already or staff much quicker and with less pain than you could do on your own.

The cost of development depends on several factors:

• The complexity of the technological architecture,
• Business and technological risks,
• Building the solution from scratch or dealing with legacy code and refactoring,
• Number of features you want,
• Intended timeline of the project.

In simple words, the faster you need to have the product built, the more people you would need on the team, and the more complex the architecture and features are, the more rare and more expensive tech talents will have to be hired.

It’s wise to invest most in the business analysis phase at this point: get a team of business and system analysts to do the research, validate your product idea with users and stakeholders, develop the system architecture, discover and evaluate risks, define what would be the right team setup and only then provide you with the estimates of the project budget.