The field of Telemedicine is getting a lot of media and trade show attention. I’ve been practicing via telemedicine since 2008. My specialty, Diagnostic Imaging, is uniquely suited to telemedicine, so the field was a naturally early adopter in the healthcare universe. Diagnostic Radiology, for the uninitiated is the interpretation of medical imaging studies. The name “Radiology” is likely derived from “radiation”, as early imaging was performed using X-rays exclusively. Over time, medical imaging has evolved to include sound wave technology (Ultrasound Imaging), Radiofrequency waves and magnetic fields (MRI or Magnetic Resonance Imaging) and atomic nuclear energy (gamma radiation and positron particles). These different methods are used to generate images. These images are no different than other digital data. The static, digital nature of medical images lends them to easy transmission to remote locations to be reviewed, generally via the internet. This is the essence of telemedicine – physicians and other health care professionals providing service remotely, via the internet. In my case, images are generated by a medical scanner in one location, then transmitted to me at another location so I can review and interpret them, and render a diagnosis.
Other types of medical practice is slowly embracing telemedicine. As internet bandwith has become cheaper and more widely available, the opportunity to practice other types of medicine remotely has emerged. The issue, I think, is that most office visits entail some necessary physical contact between patient and physician, generally during the physical examination. For example, the examining doctor will listen to a patient’s heart and lungs with a stethesope, look in the ears with an otoscope, the eyes with an ophthalmoscope, and will palpate the abdomen. The inability to perform these functions remotely is a problem that is being tackled by some very new and innovative companies. But in the meantime, there are some types of medical data that can be supplied to the physician, without the need for direct contact, such as blood pressure, pulse rate, weight – any factor that can be measured and expressed digitally.
This data is the basis of much of the current developing practice of telemedicine. Many “wellness” programs are in development as telemedicine options. The rise in fitness “wearables”, has accelerated this development. There is a race on to develop software and online platforms that collect the data from your fitbit, or you smartwatch, and send it to you doctor or other health care professional. This is an exciting development, as individual’s effort to improve overall health can be quantified and monitored. It’s a big breakthrough.
I find one thing troubling… the new telemedicine technology, at least as applied to wellness programs, is really nothing more than an advanced technological tool. Like any tool, it is only useful if it is used. A tool sitting in a toolbox is useless. That DIY project won’t get done by buying a bunch of new tools, and then putting them in the garage or shed. It will only get done with work…using those tools. I’m concerned that the same issues will arise in using telemedicine for wellness as we have seen with all the gyms, fitness programs, and healthy food options. Initially, a lot of excitement, followed by a rapid drop off in enthusiasm, followed by dropping out of the program.
That’s why I believe one of the most important components of telemedicine is still people. A good coach or mentor whether nearby or online can probably have a bigger impact on wellness than a pile of data. That’s why I think the telemedicine online movement should be focused on mentoring, more than just data collection. I see this evolution as a Coaching opportunity, for those engaged in training and mentoring clients.