The Rise of Telemedicine in Healthcare Training

 

June Trinos, PharmD 

PGY1 Pharmacy Resident 

Suburban Hospital – Johns Hopkins Medicine

               The ongoing COVID-19 global pandemic has permeated itself into our lives and has changed how we act in every aspect of our personal and public lives. Classrooms across the United States have certainly felt the impact of the pandemic and this includes healthcare education. In addition to lectures, most healthcare students also rely on hands-on training as a part of the traditional curriculum. Many healthcare programs require lab practicums, internships, and even job shadowing or rotations to practice real-life situations.¹ Now, this particular aspect of hands-on training is limited at most pharmacy schools as rotations off site and abilities labs become more limited, requiring a shift in the curriculum. As students and instructors shift into the world of the online classroom and virtual meetings, there is also a parallel shift in how healthcare is practiced with the increased use of technology. While telemedicine has been around for decades, it appears that many doctor’s offices and patients have been slow to accept healthcare technology and remote medicine based on observation.¹ According to data from a software analytics company, Pendo, usage of telemedicine rose about 63% in the third week of March in 2020.¹

             Telemedicine did not gain traction until the development of technology during the early 1970s when NASA partnered with the Papago Nation of southern Arizona. They worked to develop a project that eventually led to the advent of technology that allowed for remote health care to become more accessible.² Now, in the era of social distancing and limited office visits, both patients and healthcare providers are opting to utilize more technology to continue the daily rhythms of patient care.² As virtual visits continue to rise and become more prevalent in our society, students in healthcare must learn to adapt to this trend.  This will require both learning and adapting to new technology and embracing “soft skills” that will prepare students for utilizing telemedicine. In pharmacy school, students are often pressed to memorize new information with every lecture and new skills such as compounding and vaccinating. These are “hard skills” that will allow them to practice pharmacy, however, there must also be an emphasis on the “soft skills” needed to provide excellent care through the virtual route.  This unique set of skills includes clear, effective, and confident communication, maintaining eye contact and positive body language, and learning how to work within a team. Adding exercises such as an telemedicine-based OSCE into an abilities lab course, is a way to integrate telemedicine training, where these skills can be assessed.

             Alongside students, pharmacists can take this opportunity to expand their roles with telepharmacy, or by providing pharmacist care through the “use of telecommunications or other technologies to patients or their agents at distances that are located within U.S jurisdictions.^”4 Opportunities that students may now look into include medication therapy management, chronic disease management, transitions of care, pharmacogenomics, remote dispensing, and ambulatory care.⁴ Through a new phase of virtual learning, students must learn to adapt to the ever-changing landscape of healthcare. With these new “soft skills” and further exposure to new technologies, they will be better equipped to handle the ongoing demands of caring for patients from 6 feet away or more.

 Students and instructors must be equipped with not only a computer and camera for virtual learning, but they must also be able to embrace new technologies. Newly developed apps draw in more capabilities to screen share, allow more users to simultaneously tune in, and find creative ways to allow for a more accessible interface for users (thumbs up and applause emojis for less disruptive responses). However, a major barrier in the current virtual classroom includes inconsistency in users turning their cameras on, which may make it difficult for instructors to gauge how engaged their students are in their lecture or presentation.  Beyond navigating the logistics of technology, students must also learn to develop skills to communicate compassion and empathy, which is not always easy through the screen. As these encounters provide a physical barrier in between students and instructors, it becomes even more important for future healthcare professionals to become self-aware of how they present themselves through non-verbal cues, which can present themselves as interested or not. Despite the ongoing challenges of virtual learning, students are in the unique position to practice other important traits of patient care such as effective communication, learning to adapt and improvise, becoming proficient users of telemedicine. The COVID-19 pandemic has taught healthcare that there must be measures in place to allow healthcare to move forward with telemedicine especially in times of crisis.⁵ And in order to address this need, it all begins with ensuring that health professionals are given the proper training and education to arm themselves with telemedicine competency.⁵

References: 

1. Dennon, Anne. (2020 May 21) The Impact of Coronavirus on Healthcare Education. Best College. Available from: https://www.bestcolleges.com/blog/coronavirus-impact-on-healthcare-education/

2. Board on Health Care Services; Institute of Medicine. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary. Washington (DC): National Academies Press (US); 2012 Nov 20. 3, The Evolution of Telehealth: Where Have We Been and Where Are We Going?Available from: https://www.ncbi.nlm.nih.gov/books/NBK207141/

3. Wheel Health Team. (2019 June 26) The 7 Qualities Top Telehealth Providers Share. Available from: https://www.wheel.com/blog/the-7-qualities-top-telehealth-providers-share/

4. Telehealth. American Pharmacists Association website. pharmacist.com/telehealth.

5. Smith AC, Thomas E, Snoswell CL, et al. Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19). J Telemed Telecare. 2020;26(5):309-313. doi:10.1177/1357633X20916567