Let’s talk Telehealth, our Health and Planet Health
Welcome to the future! Telehealth: where connectivity has no bounds and the support comes to you in abundance. This progressive modality is supporting people all around the world with mental health and medical assistance in the comfort of their own homes. Telehealth provides for prompt delivery, accessibility and presents lower costs (Kichloo et al., 2020; Gajarawala & Pelkowski, 2021; McElroy, Day, & Becevic, 2020). As a result of telehealth, Gajarawala & Pelkowski (2021) found a reduction in hospital visits which alleviated health care worker stress and promoted patient centered care. Imagine adopting the hybrid approach and only those that require in-person support entering the medical system. In reducing in-person care, health care worker are able to provide purposeful and humanistic care to those in need. Most of us have experienced emergency room and or walk-in clinic health care professionals that can come across short and unkind; the medical system can do this to us. Hence, the advocacy in embracing this hybrid approach: in-person when necessary and through telehealth otherwise. With that being the case, remote communities, too, are able to access care and be supported promptly with such advantageous advancements (Kichloo, A. et al., 2020; Hoffman, 2020; Gajarawala & Pelkowski, 2021). Finally, tolerating the COVID-19 pandemic, Hoffman (2020) shares that telehealth would have further aided in enlisting retired doctors that may have been willing to support clients during this time. You see, telecommunication and telehealth have proven to play a vital role in our future with respect to our health and that of our planet.
What is Telehealth? Telehealth is a way for health professionals to connect with and provide services to their clientele by utilizing telecommunication technology (for example, video and telephone) (Gajarawala & Pelkowski, 2021), and telemedicine is a medical support program through telehealth (Hoffman, 2020). Telehealth has been a form of communication for decades (Hoffman, 2020). I worked for an Employee and Family Assistance Program (EFAP) from 2011 to 2016, which is an organization that offers counselling support along with other resources through various service delivery options. We utilized e-counselling (e-mails and texts messages), telephone counselling as well as in-person counselling. Clientele would provide their reactions to such modalities; those that lived in remote areas, unable to obtain childcare, working long hours and or were discouraged from seeking services due to stigma, were glad such modalities were possible. The EFAP presented a large body of research in support of this change in connection and communication to promote telehealth services (i.e. telephone counselling and e-counselling). This research endorsed that e-counselling and telephone counselling are just as effective as in-person counselling. Moreover, the EFAP would not only cut costs by reducing in-person connections but also service clients promptly and efficiently all around the world.
COVID-19 has signaled the need for health professionals to connect with an overwhelming amount of clientele, whether it be medical or psychological. There was no choice but to switch to a hybrid approach but with reduced in-person connections and increased medical care through telehealth, we managed to maintain the safety of our clients yet continued to provide essential services. Though my colleagues and I are experiencing clientele that resist telehealth support. This unfortunately prolongs connection to care and may further harm one’s health should support not be sought immediately or in a timely manner. Although I understand the struggle as we are creatures of habit, we are all being forced to evolve with the times.
Let’s explore what’s been happening since the pandemic: Most professionals have been able to connect with their clientele through telecommunication services such as Zoom, Microsoft Teams, Skype, Cliniko and even iMessage. I personally have experienced psychiatrists (Fraser Health), general practitioners (clinics around the lower mainland), therapists (Chilliwack Counselling), occupational therapists (ICBC) and physiotherapists connect through such tools to provide support akin to meeting in-person. I am aware that not all services can be supported through telehealth, as there are a few barriers. For instance, physical exams, blood tests, and those requiring medical equipment support. Nonetheless, the entire world has adopted support via telecommunications (Gajarawala & Pelkowski, 2021). Many communities, rural included, have internet access and the world has done an impeccable job in advancing such capabilities (Hoffman, 2020). I have traveled 53 countries and have gone to islands, rural towns, and found that most people have access to internet and technology such as smartphones, which supports telecommunication across all bodies of water. For example, I watched a video of a doctor sharing that during the pandemic, he was supporting clients in India as well as the United States, through telehealth, of course. This provides relief to countries that have larger populations requiring support. Furthermore, health care systems are working on evolving: meeting a client in their home or a nearby green space (ecotherapy); this is called an outreach visit (one of my roles as a Fraser Health clinician). This way of connecting supports a reduction in wait times, provides for stronger rapport building with health care professionals and reduces stigma. Thus, I am quite grateful for such advances in technology and organizations that have expanded ways of supporting their clientele.
Now, there are logistics that require attention such as cybersecurity, privacy and confidentiality, liability, licensing, training for professionals, and policies (Kichloo, A. et al., 2020; Hoffman, 2020; McElroy et al., 2020); Gajarawala & Pelkowski (2021) further mention considering fraud and abuse, as well. Moreover, the laws differ from country to country and state to state (Kichloo, A. et al., 2020). At this time, I believe it is the role of the therapist and other health professionals to cover as much as they possibly can to reduce harm to clientele. The client, too, has a choice and may refuse such methods of care, opting instead for traditional options. The evolution of this hybrid approach is important and thus, further time and resources are required to produce telecommunication, telehealth and telemedicine systems that are managed appropriately in all respects (Kichloo, A. et al., 2020).
Professionals are aware that a hybrid approach to care will be necessary and this has been demonstrated by the recent floods in the province of British Columbia (BC) and other natural disasters seen in countries all around the world, as well as with the COVID-19 pandemic. Though, telecommunication, telehealth, and telemedicine have been around for years, now more than ever we are provided with the momentum toward reconsidering such modalities. What is more, at this time, BC has placed a limit on how much gasoline one may purchase to fuel their vehicles and therefore travel, which is necessary as there are limited resources coming in to the province; and fewer vehicles on the roads ultimately supports the health of our planet. Further, due to large amounts of flooding there have been road closures, school closures and quarantine orders, our mental and physical health have been affected. We have not entered such realms of existing and this should not be ignored. Most of us have never experienced a pandemic, restrictions in where we can travel, and who we can see. The added fear and stress from that mentioned above, along with pre-existing psychological and medical concerns increases risk of further health deterioration.
Our health is imperative during these dire times, but are people reaching out and getting the support they need? As previously mentioned, one may not be able to travel to work, to their counselling and other medical appointments. Will one wait post pandemic to receive counselling support? Will one wait until the infrastructure from natural disasters is reconstructed to receive medical assistance? Through professional and client feedback, from those accessing telehealth, as well as studies being published on this matter, we are becoming aware that the hybrid approach (whether it be for employment or medical purposes) positively supports our family life and general well-being. This is where mental health professional come into play – supporting families and communities in this new world. And with greater reason, we are coming to learn that our planet requires us to act – to reduce waste, recycle, plant trees, conserve water, consume sustainable foods and put pressure on our governing bodies so that we can do our share in saving our planet. In advocating for telehealth/telecommunications we promote our health and the health of our planet and together we can make a difference and be well doing so. I hope that the collection of data and personal accounts above encourage those requiring assistance to reach out, to be open to a new world, to be healthy, mind, body and spirit for oneself and one’s community.
Resources
This is a great article that interviewed climate scientist, Simon Donner:
The link below provides information and much more (i.e. case studies) on how we must work with our planet not against it:
https://www.goingcircularfilm.com/
This link provides further information/data on telehealth:
https://cadth.ca/sites/default/files/pdf/telehealth_bundle.pdf
References
Gajarawala, S. N. & Pelkowski, J. N. (2021). Telehealth benefits and barriers. The Journal for Nurse Practitioners 17(2), P218-221. doi:https://doi.org/10.1016/j.nurpra.2020.09.013
Hoffman, D. A. (2020). Increasing access to care: telehealth during COVID-19. Journal of Law and the Biosciences, 7(1). lsaa043, https://doi.org/10.1093/jlb/lsaa043
Kichloo, A., Albosta, M., Dettloff, K., Wani, F., El-Amir, Z., Singh, J., Aljadah, M., Chakinala, R. C., Kanugula, A. K., Solanki, S., & Chugh, S. (2020). Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA. Family medicine and community health, 8(3), e000530. https://doi.org/10.1136/fmch-2020-000530
McElroy, J. A., Day, T. M., & Becevic, M. (2020). The Influence of Telehealth for Better Health Across Communities. Preventing chronic disease, 17, E64. https://doi.org/10.5888/pcd17.200254
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