Telemedicine Before, During, and After COVID-19

Undoubtedly, telemedicine existed before the COVID-19 pandemic, albeit on a small scale. However, the utilization of telemedicine increased tremendously because the pandemic necessitated a series of measures to reduce the spread of infection, including lockdowns, quarantines, and social distancing (Nitiema, 2022). The outbreak renewed interest in telemedicine from different players in the health care sector. Telehealth and telemedicine vary in definitions across authors. Telehealth refers to a set of services and activities provided by health care personnel to their patients with the help of telecommunication technologies (Nitiema, 2022). Telehealth exists primarily to provide clinical health care and professional health administration from a distance, which explains why telehealth entails collaboration among healthcare workers (Nitiema, 2022). Telemedicine is a subset of telehealth and entails diagnosing and treating patients using telecommunication technologies (Nitiema, 2022). Telemedicine offers several healthcare advantages, but until recently, it was vastly underutilized.

Telemedicine Before COVID-19

The utilization of telemedicine has grown steadily over the last two decades. Before the onset of COVID-19, telemedicine and its availability in health systems varied greatly (Kaundinya & Agrawal, 2021). Telemedicine applies to healthcare services offered to patients covered under Medicare, Medicaid, and private carriers (Kaundinya & Agrawal, 2021). The scope of coverage, however, remained heterogeneous. Under telemedicine, Medicare patients only receive care from a provider from an officially identified distant site approved as an originating care site (Kaundinya & Agrawal, 2021). Other states require a pre-existing relationship between the patient and the provider before the onset of any telemedicine care (Kaundinya & Agrawal, 2021). Telemedicine failed to receive significant traction due to several bottlenecks determining its utilization. Twenty states had parity laws affecting telemedicine and in-person care in the United States.

Telemedicine remained underutilized in rural areas more than in urban areas before COVID-19. The people in the rural areas operated under a stereotype that telemedicine costs more than in-person care (Kaundinya & Agrawal, 2021). The Western parts of the United States registered significant numbers in its utilization of telemedicine before COVID-19, compared to the Northeast (Kaundinya & Agrawal, 2021). The utilization of telemedicine also concentrated on a single demographic, involving young adults aged between 18 and 24 years (Kaundinya & Agrawal, 2021). senior citizens remained the demographic that least utilized telemedicine (Kaundinya & Agrawal, 2021). In general, telemedicine as a healthcare subset remained unknown in many parts of the country, at least before the onset of the current pandemic. A significant lack of awareness persisted in rural areas compared to urban areas.

Telemedicine exists in three overarching care areas: asynchronous video, synchronous video, and remote patient monitoring. In a synchronous video, patients and the healthcare giver engage in real-time conversation virtually (Kaundinya & Agrawal, 2021).

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