Introduction to the U.S. Health Care System
April 5, 2022
The sustainability of the health care system is a significant concern for many countries, in particular developing nations. The health care costs to individual patients and hospitals are often immense, with the number of patients assigned per hospital and per physician growing exponentially (Snoswell et al., 2020). Furthermore, persons living in remote rural areas experience a major barrier to accessing primary and specialized health care that can have a negative impact on their health and well-being. With the rapid technological development and more people gaining access to the Internet, Telehealth systems can be implemented to mitigate the lack of access to care as well as financial barriers to it. It can be argued that Telehealth can lead to minimized health care costs, improved health care results, and enhanced patient outreach.
Telehealth is a means of providing long-distance health care with the use of technology. It can be defined as the use of telecommunications, including video and phone conferencing technologies and email, to deliver health care, information, and education to patients (Gajarawala & Pelkowski, 2021). In addition, patient monitoring can be performed with the use of telehealth systems. The use of Telehealth services expanded substantially during the COVID-19 pandemic due to the measures imposed to prevent the further spread of the disease (Gajarawala & Pelkowski, 2021). Telehealth can be implemented to ensure access to health care for persons living in remote areas in developing countries, improve patient outreach and outcomes, and decrease health care costs.
Research suggests that the implementation of Telehealth systems for the treatment and monitoring of patients can significantly reduce health care costs. According to Snoswell et al. (2020), cost-minimization, cost-effectiveness, and cost-utility analyses of Telehealth implementation illustrate 53%, 50%, and 32% cost reduction to the health care system, respectively. The decrease in costs to the health system is attributed primarily to a reduced number of health system-funded travel made by either clinicians or patients (Snoswell et al., 2020). Moreover, increased access to care for disadvantaged and remote populations can translate into reductions in secondary care use due to productivity gains and conversion of travel time to clinical time (Snoswell et al., 2020). It should be noted that utilization of Telehealth can lead to increased revenue for medical facilities. Thus, in 2020, Medicare Advantage offered Telehealth services coverage, resulting in a rise in profits for hospitals (Park et al., 2020). Therefore, the utilization of Telehealth in developing nations can lead to a decrease in health care costs.
Telehealth is positively correlated with improved patient outreach, specifically to communities and individuals experiencing geographical and other barriers to health care. Research indicates that utilization of telecommunication systems is linked with improved access to health care, enhanced continuity and efficiency of care experienced by patients (Moss et al., 2020). Furthermore, Telehealth allows patients easier access to second opinions on their symptoms and conditions. It can lead to persons being more willing to consult with a physician online or via phone if they are unable or unwilling to leave their homes and travel to a medical facility. Thus, Telehealth implementation can be highly beneficial for patient outreach.
Furthermore, it can be argued that improved health care results can be expected with better patient outreach. Snoswell et al. (2020) note that remote care and Telehealth interventions within the cardiovascular, neurology, pulmonary, obstetrics, and intensive care disciplines is not associated with a rise in mortality rates. Telehealth is associated with greater safety of care, high-quality care being provided to the patients, and diminished health care inequalities (Almuslim & AlDossary, 2022). In addition, Telehealth was found to be positively correlated with medical staff training and interprofessional consults that can lead to improved quality of care received by the patients (Datta et al., 2020; Moss et al., 2020). Moreover, research conducted by Moss et al. (2020) indicates that health care efficiency is viewed as a benefit of Telehealth use by patients. However, further research is required to assess the impact of Telehealth implementation on health care results and patient outcomes.
It should be noted that health care provided via telecommunication systems is associated with certain disadvantages. Thus, Telehealth utilization raises concerns over patient privacy and protection of medical records (Almuslim & AlDossary, 2022). Remote consultations limit physicians’ ability to perform physical examinations and diagnose patients and translate into misdiagnosis and malpractice liability concerns (Gajarawala & Pelkowski, 2021). Fraud, patient abuse, and the inability to establish an efficient provider-patient relationship can be considered disadvantages to Telehealth (Gajarawala & Pelkowski, 2021). Overall, remote health care can be viewed as a detriment both to patients and physicians.
In summary, Telehealth implementation can be highly beneficial but presents certain disadvantages to the health care system. Remote care being offered to patients can lead to decreased costs to the health care system due to travel time being converted into clinical time. Moreover, Telehealth diminishes health care inequalities, specifically for disadvantaged and remote rural communities. In addition, safety and quality of care, as well as patient outreach and outcomes, are positively correlated with Telehealth. Nevertheless, further research on health care results and outcomes associated with Telehealth use is needed. The interplay between Telehealth-related increased revenue and decreased costs also presents a potential avenue for future research.
Almuslim, H., & AlDossary, S. (2022). Models of incorporating Telehealth into obstetric care during the COVID-19 pandemic, its benefits and barriers: A scoping review. Telemedicine and e-Health, 28(1), 24–38. https://doi.org/10.1089/tmj.2020.0553
Datta, N., Derenne, J., Sanders, M., & Lock, J. (2020). Telehealth transition in a comprehensive care unit for eating disorders: Challenges and long-term benefits. International Journal of Eating Disorders, 53(11), 1774–1779. https://doi.org/10.31234/osf.io/hrbs4
Gajarawala, S. N., & Pelkowski, J. N. (2021). Telehealth benefits and barriers. The Journal for Nurse Practitioners, 17(2), 218–221. https://doi.org/10.1016/j.nurpra.2020.09.013
Moss, H. E., Lai, K. E., & Ko, M. W. (2020). Survey of Telehealth adoption by neuro-ophthalmologists during the COVID-19 pandemic: Benefits, barriers, and utility. Journal of Neuro-Ophthalmology, 40(3), 346–355. https://doi.org/10.1097/wno.0000000000001051
Park, S., Langellier, B. A., & Burke, R. E. (2020). Telehealth benefits offered by Medicare Advantage plans in 2020. Medical Care, 59(1), 53–57. https://doi.org/10.1097/mlr.0000000000001408
Snoswell, C. L., Taylor, M. L., Comans, T. A., Smith, A. C., Gray, L. C., & Caffery, L. J. (2020). Determining if Telehealth can reduce health system costs: Scoping review. Journal of Medical Internet Research, 22(10), 1–22. https://doi.org/10.2196/17298