Patient+Perception+of+Telehealth


 * Patient Perception in Telehealth**

Patient perception of telemedicine is heavily studied, while clinician perception is far less researched. In a study by Abrams and Geier, focusing on prenatal genetic counseling, patients reported that they felt that the telecommunication was just as effective as a face-to-face meeting would have been. Many preferred telehealth because it eliminated their travel time. Some participants felt that telehealth was effective, but they still preferred face-to-face interactions.

A study conducted by Walsh and Coleman with patient’s over 70 overwhelming support telemedicine. The patients had skilled nurses come to their home periodically for assistance. In the study, the patients were given the technology necessary to do some of the nurse’s work themselves. They did some simple medical activities traditionally performed by nurses by themselves, with the supervision of a nurse through telehealth. All patients said they would use telehealth again, and all but one felt that their health had improved because of telehealth. None of them struggled using the medical equipment themselves.

Preexisting trust is one of the most important variables to successful telehealth. If the patient has already established a trusting relationship with their doctor, they are likely to benefit from telehealth. Three aspects of trust are important to patients: careful listening, responsive feedback, and conveyance of understand of the patient's distress and vulnerabilities (Mechanic and Meyer, 2000). All three aspects can be affected by telehealth.

Patients find that telehealth is "emancipatory," in that they do not have to go to the doctors office at odd hours or take off work in order to get answers to simple questions. They also are more likely to ask questions because they are not nervous about taking up the doctor's time (the doctor was given a 3 day frame to respond to messages.) Patients also feel that it is easier to talk about personal problems on the internet rather than face-to-face, so they were more open about their health issues. Mental health patients find telehealth particularly helpful because they are able to send a message when they feel anxious, where as in traditional medicine they are more likely to wait longer to speak to their doctor because they do not want to bother the doctor.

Informal language made patients feel more comfortable with their doctors. Instead of worrying about how to word things in the office, they find that they are able to communicate in a more personal tone, because they are not intimidated by a medical atmosphere. They also find that they have as much time as they need to word their questions appropriately, which ensures that they get the response to the specific question they are asking, as opposed to face-to-face interactions, when sometimes doctors misunderstand poorly worded questions.


 * Guidelines to Evaluating Perceptions of Telehealth**

According to __Telemedicine: A gude to Assessing Telecommunications in Health Care,__ a guide released by the Institute of Medicine, there are five dimensions to consider when evaluating the effectiveness of telemedicine. 1. **Technical Capacity**- Is the technology reliable when it is used through telemedicine, as compared to traditional medicine? 2. **Diagnostic Accuracy**- Does the technology diagnose the patient as accurately as traditional medicine? 3. **Diagnostic Impact**- Is telemedicine enough, or will a face-to-face meeting still be necessary after the diagnosis? 4. **Therapeutic Impact**- Will the technology change therapy for the patient? 5. **Patient Outcome**- Does the technology improve or decline the patient’s final outcome?

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