Introduction
In recent years, the healthcare landscape has undergone a remarkable transformation due to technological advancements. One area that has experienced significant growth and potential is telemedicine. Telemedicine, alternatively referred to as telehealth, provides a convenient and easily accessible means for patients to receive medical care from a distance, effectively managing chronic conditions like asthma. With its ability to bridge the gap between patients and healthcare providers, telemedicine is revolutionizing asthma care and improving the quality of life for millions of individuals worldwide.
The Rise of Telemedicine:
Asthma, a chronic respiratory condition affecting millions globally, requires regular monitoring, medication adjustments, and close collaboration between patients and healthcare providers. Traditionally, this has involved frequent doctor visits, which can be time-consuming, costly, and burdensome, particularly for individuals in remote or underserved areas. However, telemedicine has emerged as a game-changer, providing a viable alternative for asthma management.
What Is Facilitated vs. Non-Facilitated Virtual Asthma Visits?
Two types of telemedicine visits related to asthma are facilitated and non-facilitated. In facilitated visits, a third party, such as a nurse, accompanies the patient during the session with the doctor. This can occur in a clinic, hospital, or the patient's home. The facilitator's presence is essential for gathering the patient's background information, including medical history, social history, and family history. The facilitator may also perform various tasks such as measuring vital signs, conducting lung function tests like spirometry, and administering tests like blood pressure measurements and auscultation with a stethoscope.
During the COVID-19 pandemic, most appointments have been non-facilitated, meaning the patient communicates with their doctor alone, typically through phone or videoconference from their home.
Before a non-facilitated asthma visit, a doctor usually orders a lung function test called plethysmography. This test requires the patient to attend a medical facility with the necessary equipment. The procedure involves sitting in an airtight room and breathing into a mouthpiece under the guidance of a technician. The plethysmography test typically lasts about an hour. Once this test is completed, the remaining part of the asthma appointment can be conducted virtually.
Non Facilitated appointments may also be conducted solely for check-ins, without the need for lung function testing beforehand.
What Are the Benefits of Telemedicine in Asthma Care?
Telemedicine offers several benefits for asthma care, enhancing patients' management and overall experience. The followings are some key advantages:
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Accessibility: Telemedicine eliminates geographic barriers, making healthcare accessible to individuals in remote or underserved areas. With the implementation of telemedicine, patients are relieved from the need to undertake extensive travel to visit a specialist or asthma clinic. Patients can save time and minimize transportation expenses by receiving care in the convenience of their own homes.
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Reduced Exposure to Infections: Telemedicine has become especially valuable during the COVID-19 pandemic, as it minimizes the risk of exposure to infectious diseases. Patients can receive care without visiting crowded healthcare facilities, reducing their chances of contracting respiratory infections, including COVID-19.
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Cost Savings: Telemedicine can reduce healthcare costs associated with asthma management. By eliminating frequent in-person visits, patients can significantly reduce costs related to transportation, parking fees, and potential work absences. Moreover, telemedicine reduces the economic burden on healthcare systems by optimizing resource allocation.
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Virtual Visit: Virtual visits allow patients to connect remotely with their healthcare providers. These telehealth appointments enable individuals to conveniently check in with their providers, whether it's for prescription refills, follow-ups after recent meetings, or general check-ins. By utilizing telehealth, providers can extend access to care in a convenient and hassle-free manner for the patient. Additionally, virtual visits improve care continuity by facilitating more frequent interactions between patients and providers.
Symptoms Surveys by Virtual Consultation:
Patients can use their telehealth tablet to respond to vital symptom-related questions that provide valuable insights into their condition. The healthcare provider receives these responses in real time, allowing them to intervene and adjust the treatment plan accordingly. Here are some examples of questions, as provided by the American Lung Association:
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How often does one encounter asthma symptoms throughout the day, such as coughing, wheezing, chest tightness, or shortness of breath?
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Do one experience asthma symptoms, such as coughing, wheezing, chest tightness, or shortness of breath, upon waking up at night?
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How often does one utilize the quick-relief or rescue inhaler within a specific time frame (for example., Albuterol medication) to alleviate asthma symptoms?
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Do one face challenges in performing regular activities, such as walking, climbing stairs, carrying out daily chores, or engaging in physical activities with children?
These questions serve as valuable indicators of the patient's asthma status and help the provider gauge the effectiveness of the current treatment plan.
Biometric Monitoring and Other Devices:
The utilization of electronic respiratory monitors is becoming more prevalent in assisting asthma patients and optimizing their asthma management.
Several examples of such devices are:
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Bluetooth Spirometer: This device enables asthma patients to assess their lung function and monitor lung symptoms conveniently. Individuals can track their lung health by measuring critical respiratory parameters and detecting any changes or decline in part.
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Smart Inhalers: These inhalers feature integrated electronics within their mouthpieces, accurately counting the number of drug doses dispensed. By providing real-time data on medication usage, smart inhalers assist patients in adhering to their prescribed treatment plans and ensuring they receive the appropriate dosage.
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Wearables for Asthma Prediction and Prevention: Wearable devices with advanced sensors and algorithms can predict and prevent asthma attacks. By continuously monitoring vital signs and environmental factors, these wearables provide early warnings, empowering patients to take proactive measures and avoid triggers that could lead to asthma exacerbations.
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Pulse Oximeter: A pulse oximeter assesses the severity of acute asthma episodes. Measuring blood oxygen levels helps healthcare providers gauge the extent of respiratory distress during an asthma attack and determine the appropriate interventions.
Medication Reminders:
The treatment plan for individuals with asthma varies based on the severity of their condition and how well their disease is managed. However, all asthma patients need to follow their prescribed medication regimen consistently.
Medication adherence plays a vital role in asthma management, and using medication reminders can enhance commitment by assisting patients in establishing a routine for taking their medication. By employing such reminders, healthcare providers can promptly identify if a patient has missed a dose and proactively communicate with them to ensure they resume their treatment as prescribed.
What Is the Future of Telemedicine for Asthma Patients?
Telemedicine services experienced a surge in the United States during the COVID-19 lockdowns. However, a STAT report states telemedicine visits significantly declined by the summer of 2020. Patient preferences and providers' choices likely contribute to this shift. A study conducted in New York found that most patients (97 %) were satisfied with virtual visits. However, some still preferred in-person evaluations for personal interaction, physical examination, or skin tests. The study did not specify the reasons for incomplete assessments by physicians.
Conclusion
Telemedicine has emerged as a transformative tool in asthma care, offering accessibility, convenience, and cost savings for patients. It eliminates geographical barriers, provides flexibility in scheduling appointments, and reduces exposure to infections, especially during the COVID-19 pandemic. While patient satisfaction with virtual visits is high, preferences for in-person evaluations and specific diagnostic procedures still exist.
