The accelerated use of telemedicine during the COVID-19 pandemic has been critical to keep patients and providers connected. However, with the rapid adoption of this technology, issues with privacy and security, documentation requirements, and information integrity have arisen. AHIMA has revised its Telehealth Toolkit (first published) in 2017 to aid organizations addressing these vital components of their telehealth programs. Contributors from across the globe have provided valuable insights to produce this timely resource.  

AHIMA International recently sat down with health information professionals from around the world to hear their perspective on this monumental shift in telemedicine. Read below for highlights of a conversation with Jordi Piera Jiménez, Director of the Digital Health Strategy Office at Catalan Health Service; Linda Renn, RHIT, CHPS, CCS, CPC, COC, CHTS – TR, Vice President, HIM Professional Services at STAT Solutions, Inc. & Professional Outsourcing, Inc; and Dwayne Richards, Victoria Branch Convenor, at the Health Information Management Association of Australia (HIMAA).  

Jordi, as COVID-19 has accelerated the adoption of telemedicine, what benefits have you seen? 

The enormous deployment of telemedicine solutions during the COVID-19 pandemic has had two direct benefits. First, we have been able to protect health centers and facilities from unnecessary visits, thus avoiding possible infections. Second, we have been able to guarantee the continuity of care that otherwise would have not been possible due to the different lockdowns.  

In the long term, I foresee as an indirect benefit through the removal of many of the barriers that were preventing the deployment of telemedicine solutions. The pandemic has helped to remove barriers and has helped telehealth gain acceptance from both healthcare professionals and patients. 

Linda, tell us about your experience with the benefits of telemedicine adoption over the past year.  

COVID-19 has accelerated the adoption of telemedicine across the board. The benefits have been numerous. Telemedicine can serve as a first responder and lifeline during emergencies and disasters. It has improved the continuity of care, patient education, and timely treatment.  

Telemedicine has provided continuing medical education opportunities for special seminars with targeted groups in remote/rural locations. Also, veterans of recent wars benefit from clinical trial research, and patients can have improved interactions with physicians and other providers for disease education and management. 

Dwayne, share with us the telemedicine approaches in Australia. What challenges and benefits are being experienced? 

Telemedicine has been in use for many years in Australia, particularly in remote and rural areas where medical expertise is not always readily available. In recent years, services have been expanded to provide remote monitoring of patients. In remote areas of Western Australia, the benefits of telehealth are numerous for Aboriginal patients who may not cope well culturally with the enormous travel required to attend specialist services thousands of kilometers away.  Challenges to telemedicine in Australia include difficulties with network services, interruptions in transmission, and remote locations where the patient might not have a clinical support person during the call.  The benefits, however, outweigh the negatives, as very ill people do not have to travel to receive care.  

During COVID-19, many healthcare professionals in suburban and city areas initiated remote telemedicine services. Initially this service was available to all Australians, however in the last six months this scope was narrowed to ensure that the patient already had an existing relationship with the provider before accessing telemedicine services with them. There was also a push for general practitioners to move to electronic prescriptions where adoption had lagged in Australia. Community mental health services developed rapid telehealth response to the COVID crisis that saw many of our psychiatrists unable to travel to our regional area or from other states of Australia.  A further extension of telehealth in Australia was the virtual ward to provide care to COVID-19 patients. Many services, including health departments scrambled to implement this service when normally it would take years to set up, in a matter of a week or two.  

The revised Telehealth Toolkit details the key factors for telemedicine adoption and requirements. Linda, what challenges have you seen in meeting these key factors? 

In my home state of Florida, one of the key barriers of early adoption was a regulation regarding physician licensure requirements to provide healthcare services in our state. The Florida Health Information Management Association (FHIMA) worked through this issue with the Florida Hospital Association and the Florida Medical Association to resolve it quickly. Additional challenges in America include increasing healthcare cybersecurity intrusions, including ransomware, and the issues these threats pose for telemedicine adoption and requirements. Along with this, increasing medical identity theft is a threat, the requirements on the privacy and security of protected health information are important. 

 Another issue is lack of access to broadband. It’s important to recognize the barriers posed by America’s digital divide. Digital deserts affect care coordination and case management communications among individuals and covered entities, so what would appear to be noncompliance by the covered entity may be the result of this. 

Jordi, how do you think this toolkit will benefit those working in health information?  

Health information professionals will be able to benefit from a toolkit that summarizes, guides and provides up-to-date resources for the implementation of telemedicine solutions in routine care. In that sense, the toolkit comes as a very handy easy-to-use guideline that will help anyone who is thinking about deploying a telemedicine project. 

Dwayne, what does the future hold for telemedicine adoption? 

Now that patients and providers have experienced the benefits, telehealth adoption will continue to progress at a new pace not seen before. Telemedicine also increases the possibility for advancements in the collection of data and integrity of databases. This data will present new opportunities for research and advancement that will progress our society across the world in ways not seen before.  The world will continue to benefit enormously from telemedicine adoption, particularly in remote and inaccessible areas. The advances in AI will also further develop such areas as remote monitoring and guidance of clinically suitable options.  

Jordi, what do you see as the future for telemedicine adoption? What's next? 

The digital transformation of the health sector will transform healthcare as we know it. The first industrial sectors that embraced the digital transformation were those where it was relatively easy to transform their products into digital, including media, music, film, etc. The sectors that are still in the process of this industrial revolution are those where the physical dimension will always have a relevance and healthcare is obviously one of those. Healthcare professionals won't be replaced, but enhanced thanks to the technologies of digital transformation. By providing healthcare professionals the resources, tools and skills they need to keep up with advancing technology, we are ensuring relevant, accurate, and complete data and care for the future.  

AHIMA International thanks Jordi, Linda and Dwayne for sharing their experience and perspective on telemedicine. For more information on the AHIMA Telemedicine Toolkit and to get your copy, visit AHIMA.org. 

Jordi Piera Jiménez, Director of the Digital Health Strategy Office at Catalan Health Service

Linda Renn,  RHIT, CHPS, CCS, CPC, COC, CHTS – TR, Vice President, HIM Professional Services at STAT Solutions, Inc. & Professional Outsourcing, Inc

Dwayne Richards, Victoria Branch Convenor, at the Health Information Management Association of Australia (HIMAA)