Impact of Telemedicine on Healthcare Administration.

Running head: IMPACT OF TELEMEDICINE ON HEALTHCARE ADMINISTRATION
IMPACT OF TELEMEDICINE ON HEALTHCARE ADMINISTRATION
Name of the Student:
Name of the University:
Author’s Note:

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Chapter 2: Literature Review
Introduction
Telemedicine is an effective way that supports to alleviate the congestion of hospitals
and improves the utilisation of medical responses. Over the decade, the healthcare industry
has grown immensely due to the convenience and ease offered by the modern and advanced
technologies. However, there persists an issue related to availability and opportuneness of
services for the medical providers and patients. The advancement of SaasS-based solution has
enabled the healthcare organisations to reduce time in travelling and increase the efficiency
level. Thus, it had resulted in various video products, which support collaboration and
conferencing needs (Doolittle & Spaulding, 2017). The features and functionality in a care
episode are similar and is widely used. Despite the change made in the Client Management
System (CMS) in accepting and reimbursing of telemedicine incidents, however,
reimbursement is limited in nature. In some of the organisations, it can be seen that
telemedicine reimbursements are not following a sustainable model. The challenges of
telemedicine prevent the technology to be accessible to patients and healthcare professionals.
The purpose of this section is to critically evaluate the previous and existing studies
conducted by other authors in order to gain an in-depth knowledge of the topic and form a
foundation for conducting the study on a further basis.
Impact of telemedicine on the healthcare sector
According to Wade et al., (2017), telemedicine is the usage of telecommunication
expertise, for example, phones and computers in order to offer clinical services to patients
that are situated far away using long distance. With the help of mails, applications, phone
calls and video chats, the healthcare staffs are able to diagnosis and treat patients without in-
patient visit or travelling. In addition to linking patients with medical providers, it also offers

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a method for healthcare specialists to refer with other specialists and physicians in a critical
case of a patient without the need of leaving the medical settings. As per the opinion of Lilly
et al., (2017), telemedicine has been used for more than a decade in some way or another;
however, with the advancement in the technological field, the telemedicine has begun to
change in the area of healthcare delivery system. As argued by Boxer and Ellimoottil (2019),
telemedicine has supported the providers to effectively involve with the patients; thus,
offering quick and convenient solutions for better healthcare experience. As per the American
Telemedicine Association, there are more than 15 million people had remotely acknowledged
medical care in the year 2015 (Dorsey & Topol, 2016). The patients can show their vital stats
include blood pressure and heart rate in a quick manner with the use of new technologies to
the doctor, and the doctor will able to deliver care for chronic conditions. In addition to this,
telemedicine help in connecting with patients, utilising to connect with doctors in giving
experts and consultations. Due to high internet speed and updated technology, telemedicine
help in reaching around the globe in remote areas. As commented by Nadar et al., (2019),
telemedicine has been able to give practice in a new way. For example, a Virtual Care Centre
is available in Mercy Health Systems where specialists supervise the Intensive Care Units
(ICUs) all the time. The healthcare system has been reported to involve a decrease of 35% in
the length of stay and approximately 30% less deaths as compared to others. As stated by
Law et al., (2019), the fast-growing field of the healthcare sector hold various promising
aspects in solving the challenges faced by both healthcare professionals and patients. It offers
appropriate and easy-to-access care, which, is considered to be the original goal of
telemedicine. With this technology, even small hospitals located in the countryside areas are
able to be specialised and the support of intensive care from specialists located in other areas.
A US Federal law, Health Insurance Portability and Accountability Act of 1996 (HIPAA) that

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sets the standards for privacy and protection of patients’ personal details (Colorafi & Bailey,
2016).
For this reason, the use of HIPAA-compliant, secure and encrypted telemedicine
software can be used for transmission of sensitive data to patients or other healthcare
providers. It helps the stakeholders to reduce the cost of healthcare and save money. As per
the study of Serwe et al., (2017), non-urgent and unnecessary ER visit or check-ups for
diagnosing purpose of simple disorders such as rashes, cold and cough, common flu which
can be eliminated using telemedicine thus, reducing the transportation expenses and cost of
an in-person visit. As per the report of the National Rural Health Association (NRHA), there
are 30 specialists for every 100,000 patients in the rural regions, and thus, the patients
residing on those areas had to travel long distances for accessing the specialists (Iglehart,
2018). With the usage of telemedicine, access to experts improves and widens the population
of the patient for a specialist. Telehealth is an emerging field in healthcare that is considered
as a critical component in resolving the crisis solution. It holds significance as it affects the
issues of the modern healthcare system. Giani and Laffel (2016) opined that the challenging
matters include access to care cost-effective delivery, and distribution of providers is limited
in nature. Therefore, telehealth can change the paradigm of care and allow in improving
access and health outcomes. As stated by Frontino et al., (2016), telehealth increases the
accessibility of healthcare by offering clinical services, emergency and intensive care to
remote patients. It improves the health outcome by diagnosis and treating the patient at an
early basis; thus, reducing the need for costly treatment, it supports ICU care by reducing
complications, mortality rate and hospital stay. In addition to this, it assists in addressing
misdistribution and shortage of healthcare professionals, supporting patients and families,
supporting clinical education programs, improves organisational productivity and
environment as well. According to Paul (2017), telemedicine involves direct-to-consumer

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interaction that encompasses a number of products and services available to date. This is an
area where the investment in health technology has been occurring, and the market is
commercially viable in nature. However, the healthcare system has struggled to convert the
technology into a profitable operation. There was a slow adoption rate toward the model and
attracting new consumers toward the specialised use of medical services led to high cost.
As opined by Chirra et al., (2019), the workflow solutions related to telemedicine
have now being built in the majority of the telehealth apps, and the next generation of
products have begun to appear that incorporates artificial intelligence. Doarn, Latifi and
Hostiuc (2016) opined that these apps help in guiding the patients by asking a series of
questions and answer for the collection of relevant data. This can be done using a bot or
manually that help in interpreting the response obtained. When the patient actually connects
with the provider, most of the legal work is completed. This allows in more efficient and
focused clinical interaction. However, since these are emerging solutions, thus, safety needs
to be maintained in term of exploring the features and the interface with the EMR.
Hooshmand and Yao (2017) stated that the virtual health system is moving in a particular
direction where the physician believes that self-service is a hybrid model and thus, involves
human interaction to a minimum extent. In another study by Mehta et al., (2016), one of the
areas of growth in telemedicine collaboration of providers. This is found to be useful as it
enhances the flow of communication between the physicians and other healthcare
professionals, especially the nursing staffs. The physicians use this technology in order to
strive for expert knowledge that they lack and help in obtaining the guidance of the next
move. One of the most well-known examples, in this case, is tele-stroke in the emergency
room. Some systems utilise a similar approach for connecting the specialists with the primary
care experts specifically for transplantation and oncology departments. The medical
collaboration is more than just video; it includes phone calls, text message and email. Thus,

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many organisations operate in this particular space; however, the challenges involve
significant value that is beyond the capabilities of texting. One of the innovations that are the
requirement in this area is appealing to the hospital's system and help in measuring the
performance of the provider. The fourth factor that is most important in case of telemedicine
is space. As opined by Doarn, Latifi and Hostiuc (2016), it involves a shift in the thought
process about the idea of future that can be treated using telemedicine at the hospital, at
home, in nursing homes and other places. The spaces need to be designed as well as
configured in such a manner that it includes securing cabling, use of necessary equipment
such as high-definition cameras, monitors and speakers, which is used in eICU in modern
times. In the future, it is building space with the concept of the patient requiring care by the
professionals within that space rather than the option of travelling to distant places for the
care (Raymond, Chong & Hyland, 2016). The equipment in nursing homes and hospitals
need to be enabled in such a way that the practitioners can offer bedside care in a more
expediently manner for both patients and provider. In that case, patients do not require to be
transported, and the doctor can see a number of patients without any disruption.
Furthermore, the primary care provider, friend, the family were located elsewhere that
could link with the video consultations; therefore, improving the communication between the
concerned the parties in the patient’s care. The building of the technology within the premise
of the hospital or physician’s office require current fashion. As opined by Anderson et al.,
(2017), the idea of extending the service in the home environment. The people can receive
healthcare services according to the convenience in their place, thus, improving access to
those living the remotes areas. It also helps in reducing the need for requirement of
transportation, therefore, resolving the mobility issue and limited the chance of acquiring
contagious infection through the transmission of pathogens. According to Elliott et al.,
(2017), telemedicine can change the structure, outcomes and procedures within the healthcare

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structure on a worldwide basis. In today’s time, the telemedicine field is extensively
dominated with the efforts in research and development. However, the introduction of new
concept and technology are implemented on a regular basis in the clinical practice. Various
stakeholders such as patient, healthcare providers, third party and the policymakers need to
be informed about the new and emerging inventions that have an impact on the healthcare
delivery system.
In addition to various advantages of telemedicine, a number of challenges are being
observed. As stated by Correia et al., (2017), when a primary care provider is unable to
examine the patient on a first-hand basis, there is a possibility that of missing on certain vital
information that leads to inaccurate diagnosis. In some other conditions, it is not possible to
diagnose a person or direct treatment without an in-person visit. Not all telemedicine services
are covered under private insurance companies or federal programs. In such cases, the cost of
the treatment increases and there is no chance of reimbursement. As per the opinion of Brova
et al., (2018), the clinicians offering telemedicine need to obey the confidentiality and privacy
standards set by the HIPAA. It is often found that online communication is susceptible to
hacking activity, and thus, privacy breach may occur, which involve compromising on the
private information of patients.
Conclusion
From the literature review section, it can be concluded that telemedicine is one of the
emerging fields in the healthcare sector that had revolutionised the way of treating patients all
over the world. It offered an advanced method of diagnosis and treating people from distant
areas; thus, mitigating the issue of shortage of primary care providers as well as geographic
location. Various reasons had led to the growth of the technological advances of telemedicine
that was found beneficial to the entire healthcare system. The existing studies that had been

7IMPACT OF TELEMEDICINE ON HEALTHCARE ADMINISTRATION
reviewed in this section gave a summarised idea of the effect of telemedicine on the
healthcare sector as well as the developmental phases of the technology. However, it did not
focus on the benefits attained by specific departments, for example, health administration in
the healthcare settings. The studies evaluated helped in shedding light to the benefits and
challenges of telemedicine on technical functions. It did not highlight the reasons for the
issues related to its poor acceptance or discontinuation of the system in its infancy stage in
the administrative department of the hospital. Therefore, based on these gaps, further research
will be conducted that will help in bridging the gaps found in the literature review. The
compelling statement states that there are numerous benefits associated with
telemedicine in the healthcare sector, specifically in term of healthcare administration
that needs further research.

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