Although telehealth can be said to have started with the rise of the telephone – a 1879 article in The Lancet discusses using the telephone to cut down on office visits (Board on Health Care Services & Institute of Medicine, 2012) – it is clear that its rise has been aided by recent improvements in technology such as high-speed internet and personal computers with video cameras. What’s more, it works. A 2006 study by DC Harper found “telemedicine consultations to be equally effective as in-person visits and reported high satisfaction levels” (Langkamp, McManus, & Blakemore, 2014, p. 110). Telehealth works especially well with children, particularly those with issues whose treatment is underserved in rural communities, such as mental health. Twenty percent of kids have mental health issues, but those in rural areas are twenty percent less likely to have ever had a mental health visit (Hebbale, Feuston, & Bushehri, 2015). People in need of ongoing medical treatment or therapy, such as handling behavioral issues, speech problems or developmental disabilities are disproportionately children, making them ideal candidates for telehealth (Langkamp et al., 2014).
Telehealth is also likely to save money. Langkamp et al. (2014) writes that benefits included “reduced travel costs,” and Hebbale et al. (2015) suggests that even when parents do not have high-speed internet access necessary for consultations, local schools can offer a portal to telehealth. Clearly too, the immediacy of telehealth results in reduced time in planning, scheduling and travel, meaning that some illnesses can be handled at an earlier, less expensive stage of treatment. Additionally, this allows for subspecialists to be found directly, rather than through unproductive, costly searches for appropriate local care, which may not even exist.
This convenience is mirrored in other ways. Hebbale et al. (2015) mentions the lessoning of lost school and work days for telehealth patients. Virtual visits may result in better treatment outcomes, resulting in a lower frequency of follow-up visits and greater satisfaction. Several studies describe “children and adolescents with severe anxiety and autism as being more engaged during a telepsychiatry visit than they often are during a traditional in-person psychiatry visit” (Langkamp et al., 2014, p. 110). Specialists can have a larger geographic patient reach, without leaving their offices. Other studies report that nurses claimed that “unscheduled virtual visits . . . were rated by the nurses as providing more information than a telephone call . . .” (Cady, Kelly, & Finkelstein, 2008, p. 176).
Aside from the obvious saving of time by not requiring long-distance travel, even in areas with a lack of internet infrastructure, it is possible for telehealth to save time and trouble for parents, with added benefits. As mentioned above, schools can be a nexus for telehealth. According to a Federal Communications source cited in Hebbale et al. (2015), as of 2017, all public schools in the country were required to meet a standard internet connectivity of 100 Mbps, making appointments during school hours possible, with the additional advantage of the presence of a school nurse. Parents do not need to leave work, and kids miss less – if any – school.
For all these reasons and more, telehealth is now on the increase. Aside from the ordinary concerns of cost, access and convenience, telehealth is making proper healthcare for children more likely, allowing for better diagnosis, increased likelihood of intervention, and improved health. In the future, we will see an increase of low-cost telehealth providers, greater use by parents and children in need and an understanding of treatments that work best in this context.
Board on Health Care Services, & Institute of Medicine. (2012, November 20). The Evolution of Telehealth: Where Have We Been and Where Are We Going? Retrieved April 29, 2018, from https://www.ncbi.nlm.nih.gov/books/NBK207141/
Cady, R., Kelly, A., & Finkelstein, S. (2008). Home telehealth for children with special health-care needs. Journal of Telemedicine and Telecare, 14(4), 173–177.
Hebbale, C., Feuston, J., & Bushehri, Y. (2015). Increasing Pediatric Mental Health Care Access in Rural Communities via Telehealth in Schools.
Langkamp, D. L., McManus, M. D., & Blakemore, S. D. (2014). Telemedicine for Children with Developmental Disabilities: A More Effective Clinical Process Than Office-Based Care. Telemedicine and E-Health, 21(2), 110–114.