travel medicine telehealth

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• Section 2 - Prioritizing Care for Resource-Limited Travelers
• Section 2 - Perspectives : Risk Management Issues in Travel Medicine

Telemedicine

Cdc yellow book 2024.

Author(s): Taylan Bozkurt, José F. Flórez-Arango, Matt Levi, Scott Norton

Benefits of Telemedicine

Conducting a remote pretravel consultation, when a traveler is abroad, legal issues: privacy & security, technology issues, reimbursement.

Telemedicine means “practicing medicine at a distance,” but in common usage it refers to providing diagnostic and therapeutic services via electronic transfer of medical information. Telemedicine encounters can be as simple as patients asking providers health-related questions via the telephone or secure email or as complex as real-time monitoring of the health of astronauts at the International Space Station.

Many analyses of telemedicine programs focus on cost savings for medical organizations or on the benefits provided to distinct population subsets such as underserved urban populations or populations for whom transportation is difficult (e.g., patients in nursing homes, correctional facilities, remote areas). Few analyses have looked at total costs across the entire health care system.

Benefits of telemedicine include expanding access to specialty care, expediting delivery of care (minimizing wait times), and providing opportunities to confirm or obviate the need for someone to see a provider in person—an advantage for individuals or populations for whom an in-person visit is impractical, inconvenient, arduous, or costly.

Telemedicine has several unique uses for the practice of travel medicine. For instance, telemedicine can be used as an alternative to the in-person pretravel consultation. Moreover, travelers can use telemedicine to maintain continuity of care for existing conditions, enabling them to travel farther and longer by extending the interval between in-person visits. Notably, travelers who develop acute illnesses or injuries, have exacerbations of existing conditions, experience high-risk exposures, or need to seek medical advice while abroad can use telemedicine platforms to discuss issues with a trusted provider.

Travel health providers also benefit from using telemedicine. When a traveler seeks medical care in the country they are visiting, the local provider can use telemedicine to obtain additional information from the patient’s regular providers or health records. Clinicians who conduct posttravel evaluations can obtain prompt consultative support when travelers present with unusual clinical findings.

Telemedicine provides a convenient way to deliver pretravel consultations with the same elements as an in-person visit. Providers should continue to follow the same professional standards used during in-person consultations, including adherence to a code of ethics, security and privacy practices, and clinical guidelines. What can and cannot be done in a remote consultation varies by state; clinicians should check with their state’s medical board about any restrictions. Furthermore, the policies and practices of telehealth programs underwent major changes during the coronavirus disease 2019 (COVID-19) pandemic and will continue to change; providers will need to remain current with what is and is not permissible. A valuable resource on telemedicine, including requirements by state, is  prognoCIS [PDF], and many additional online resources related to telemedicine standards, guidelines, and practice are available ( Table 2-14 ).

Medical practices should provide patients with a resource that outlines the expectations and outcomes of telemedicine before they schedule a consultation, including the limitations of a remote consultation. For example, the ability to conduct a complete physical examination is limited, but current technology can help replicate a near in-person quality of inspection, auscultation, palpation, and various other core elements of a physical examination. Intake information, including medical history, prior medical records, and diagnostic information can all be requested from patients and made available to providers in advance of the consultation. Encourage patients to set up and test their connections to the telemedicine software or equipment before the encounter.

At the time of the consultation, establish informed consent with the patient and ensure that the patient is in an appropriate care setting. Depending on state regulations, a patient might need to be in a location where the provider is licensed to practice medicine at the time of the consultation (see Legal Issues: Privacy & Security , later in this chapter). Depending on circumstances, a telepresenter (e.g., another health care provider or translator) might need to be with the patient to assist with the intake and exam.

Table 2-14 Online telemedicine resources

Prescribing medications & vaccines.

Depending on state and country-specific regulations, medications and vaccines can be prescribed during a telemedicine encounter. Where applicable, pharmacies or other allied health care providers can receive certain prescriptions electronically or over the phone, and eligible providers can dispense the medications or administer vaccines.

Yellow fever vaccine is available only at designated yellow fever vaccine clinics, and travelers might need to schedule a separate visit to receive it. For medications (e.g., malaria prophylaxis) and vaccines not routinely stocked at a local pharmacy, the traveler should allow time for the pharmacy to order them.

US-based health care providers, regardless of their level of expertise in travel medicine, might be asked to provide a consultation for someone traveling outside the United States. The provider’s willingness, comfort, and ability to provide a remote consultation under these circumstances will vary with the type of question or nature of the problem, their ability to charge for services, the technical quality of the communication, and perhaps the time of day. Providers must remember that the same security and privacy practices apply during a telemedicine consult as in a conventional, in-person, domestic consultation.

The Centers for Disease Control and Prevention (CDC) does not endorse procuring medication or filling prescriptions abroad because of the risk for counterfeit drugs (see Sec. 6, Ch. 3, . . .perspectives: Avoiding Poorly Regulated Medicines & Medical Products During Travel ). In an emergency, however, such as when a traveler’s medication is lost or stolen, a provider might be able to help locate local, reputable sources for replacement.

US Federal Law & International Law

Telemedicine consultations must comply with state and federal privacy and security laws, including the Health Insurance Portability and Accountability Act (HIPAA). In addition, providers should investigate specific legal requirements of the country where the traveler is located; some countries have strict requirements related to the transfer of personal health data, and even a patient’s written consent might not be sufficient to allow this.

Communicating with patients abroad deserves a careful assessment of data and protection laws relative to the originating (i.e., overseas) location, type of service, and means of electronic transmission. Providers must ensure that the technology and video software chosen to conduct remote pretravel consultations and telemedicine encounters, whether store-and-forward (asynchronous) or live interactive video (synchronous), is HIPAA-compliant and meets the privacy and data security requirements of the countries involved. Although encryption is not specifically addressed under HIPAA, ensuring technology is encrypted will help providers safeguard patient health information.

Providers should communicate with at-home patients via an established patient portal or other HIPAA-compliant method. In urgent or unexpected situations, however, patients often will communicate via their personal email accounts, many of which are not encrypted. Remember that no data storage system or transmission of data over the internet, or any other public network, is guaranteed to be secure.

US State Laws & Regulations

In the United States, each state has its own telemedicine laws and regulations, most of which address reimbursement issues (e.g., informing providers and insurance carriers which telemedicine services are reimbursed) but not the practice of telemedicine. Therefore, providers must perform due diligence to ensure that they conduct telemedicine encounters in accordance with the laws and regulations applicable in their local jurisdiction.

In response to the COVID-19 pandemic, some states modified licensure requirements to support cross-state telemedicine. Providers should check with the Federation of State Medical Boards to ensure they are following all state and federal policies (see  Table 2-14 ). Without appropriate licensing, some states do not permit providers to practice telemedicine or to prescribe certain medications across state lines. Therefore, travel medicine clinics and providers must carefully read medical board regulations before embarking on telemedicine consults across state lines. No state prohibits the practice of telemedicine across state lines, but many do require providers to have required licensure. For example, a provider living in State A conducting a telemedicine encounter with a patient in State B would need to be licensed in both states. The standards for maintaining privacy and security during an international telemedicine consult are the same as for domestic consults.

In addition, providers—particularly solo practitioners or those not part of a larger health care network or system—should explore whether a business associate agreement or contract is needed. When working with international partners (e.g., companies based outside the country in which the provider practices), additional legal issues can arise and should be considered.

Providers should consider the bandwidth and connectivity needed for live interactive video telemedicine encounters. Connectivity can be inadequate in some places, and website accessibility can be made difficult because of internal firewalls. Mobile hotspots can be used in some situations in lieu of dial-up or Ethernet connections.

Some telemedicine vendors have optimized software to work in low-bandwidth settings; others have focused on markets where high-bandwidth networks are more widely available. Providers should have their technology vendor provide information about minimum bandwidth requirements that they can review with patients to ensure a seamless telemedicine encounter. Although not required, providers also should recommend that patients use private, secure connections and avoid using public Wi-Fi such as that available in hotels, internet cafes, and airports, because these connections can pose privacy and security risks.

Much like reimbursement for face-to-face encounters, providers need to ensure that their clinic meets certain legal requirements and payer guidelines. In the United States, the pretravel consultation might not be reimbursed by health insurance companies, so a telemedicine practice might be primarily fee-for-service. If corporate personnel are traveling for work and their companies are paying for the associated health care they receive, providers should make certain the company permits their employees to engage in telemedicine and will reimburse for this service.

Box 2-16 Photographs in telemedicine: advice for travelers

One of the most common ways that travelers use telemedicine is by sending photographs of travel-associated rashes and minor injuries to their home providers with implicit requests for a diagnosis and for treatment recommendations. Nowadays, most such photos are digital images taken with smart phones. Although the cameras on smart phones are seemingly simple to use, travel medicine providers often find these photographs blurry (due to poor focusing, motion artifact, or improper depth of field), poorly lit, or marred by distracting objects in the foreground or background. Even with well-focused, well-lit photographs, discerning which body part is being shown or which lesion is the one in question can be difficult. The following recommendations can help travelers take more useful, information-laden photographs.

Pictures Should Show

• Distribution (i.e., the parts of the body that are involved)
• Configuration and arrangement of lesions with respect to one another (grouping)
• A primary lesion (e.g., an undamaged blister)
• Lesions with secondary changes (e.g., an open or eroded blister)

Mark The Lesion

• If several lesions are present, or if the lesion is subtle, indicate the specific lesion using a marking pen or (for digital images) editing software.

Use Good Lighting

• Take pictures in a well-lit room, or outdoors in a shaded area.

Take Several Pictures

• An orientation view should show the entire body or affected body part; the location of the lesion should be obvious in the picture.
• A mid-distance view should center on the lesion and show an anatomical landmark (e.g., belly button, armpit) for orientation and size.
• A close-up view can be physically close (under 18”) using the camera’s macro function or from farther away if using a zoom lens.
• Take pictures both straight-on and from different angles.
• Make sure the lesion is in the center of the picture; the lesion should fill most of frame but also include some normal skin around it.
• Include a scale/size comparison in the picture (use either a ruler or measuring tape or a standard object like a pencil, paper clip, or US coin).
• Show the normal opposite side for comparison (e.g., a swollen elbow and the uninvolved elbow).
• For lesions on the head, neck, and face, remove jewelry; and for hair problems, focus on scalp.
• Take as many pictures as necessary; send sharply focused, well-lit photos only; blurry pictures are not helpful, even if they are 5MB.

The following authors contributed to the previous version of this chapter: Taylan Bozkurt, Jose F. Flórez-Arango, Matt Levi

Bibliography

Kennedy KM, Flaherty GT. Medico-legal risk, clinical negligence and the practice of travel medicine. J Travel Med. 2016;23(5).

Rokosh RS, Lewis II WC, Chaikof EL, Kavraki LE. 2021. How should we prepare for the post-pandemic world of telehealth and digital medicine? NAM Perspect. Washington, DC: National Academy of Medicine; 2021. Available from: https://nam.edu/how-should-we-prepare-for-the-post-pandemic-world-of-telehealth-and-digital-medicine/ .

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Telehealth: Technology meets health care

See how technology can improve your health care.

How many times have you heard it said that the internet has changed modern life? Indeed, it's likely changed how you stay in touch with family and friends and buy goods and services. And it's probably even changed how you search for information about health problems.

Several telehealth tools are offered to help you manage your health care and receive the services you need. During the coronavirus disease 2019 (COVID-19) pandemic, many people used telehealth. People often still use it. Find out more about telehealth.

What is telehealth?

Telehealth is the use of digital information and communication technologies to access health care services remotely and manage your health care. Technologies can include computers and mobile devices, such as tablets and smartphones. This may be technology you use from home. Or a nurse or other health care professional may provide telehealth from a medical office or mobile van, such as in rural areas. Telehealth can also be technology that your health care provider uses to improve or support health care services.

The goals of telehealth, sometimes called e-health or m-health (mobile health), include the following:

• Make health care easier to get for people who live in communities that are remote or in the country.
• Keep you and others safe if you have an infectious disease such as COVID-19.
• Offer primary care for many conditions.
• Make services more easily offered or handy for people who have limited ability to move, time or transportation.
• Offer access to medical specialists.
• Improve communication and coordination of care among health care team members and a person getting care.
• Offer advice for self-management of health care.

Many people found telehealth helpful during the COVID-19 pandemic and still use it. Telehealth is being used more often.

Here are many examples of telehealth services that may be helpful for your health care.

Virtual visits

Some clinics may use telemedicine to offer remote care. For example, clinics may offer virtual visits. These can allow you to see a health care provider, mental health counselor or a nurse via online video or phone chats.

Virtual visits can offer care in many conditions such as migraines, skin conditions, diabetes, depression, anxiety, colds, coughs and COVID-19. These visits allow you to get care from a provider when you don't need or can't get an in-person visit.

Before your visit, your health care team may send you information or forms to fill out online and return to them. They may also make sure you have the technology you need. They'll check to see if you need to update or install any software or apps too. And they can tell you how to sign on and join the video chat for your visit. Also, the health care team can explain how to use the microphone, camera and text chat. If needed, ask a family member to help you set up the technology you need.

You only need a smartphone, tablet or computer with internet access to join the virtual visit. You can find a comfortable, quiet, private spot to sit during your visit. Your provider also meets from a private place.

Other options

Some people may use web or phone-based services for medical care or advice. When you log into a web-based service or call a service that offers primary or urgent care, you're guided through many questions. The provider or nurse practitioner can prescribe drugs. Or they may suggest home care tips or more medical care.

While these services are handy, they have drawbacks:

• Treatment may not be coordinated with your regular provider.
• Important details from your medical history may not be considered.
• The computer-driven model used to make decisions may not be right for you if you have a complex medical history.
• The service doesn't easily allow for you to make decisions with your provider about treatments.

Remote monitoring

Many technologies allow your provider or health care team to check your health remotely. These technologies include:

• Web-based or mobile apps for uploading data to your provider or health care team. For example, if you have diabetes, you may upload food logs, blood sugar levels and drugs that a nurse checks.
• Devices that measure and wirelessly send data, such as blood pressure, blood sugar and oxygen levels.
• Wearable devices that automatically record and send data. For example, the devices may record data such as heart rate, blood sugar, how you walk, your posture, tremors, physical activity or your sleep.
• Home monitoring devices for older people or people with dementia that can find changes in daily activities such as falls.
• Devices that send notifications to remind you to do exercises or take drugs.

Providers talking to providers

Providers can also use technology to give people better care. For example, in a virtual consultation, primary care providers can get input from specialists in other locations when they have questions about your diagnosis or treatment.

The primary care provider sends exam notes, history, test results, X-rays or other images to the specialist to review. The specialist may answer by email. Or they may do a virtual visit with you at your provider's office. They may also ask for a face-to-face meeting.

In some cases, a nurse or other health care professional may use technology to provide care from a medical office, clinic or mobile van in a rural area. They may call a specialist or provider at a medical clinic to do a remote consult.

These virtual consultations may prevent unnecessary in-person referrals to a specialist. They may also cut wait times for you to see a specialist. And they may remove the need for you to travel to a specialist.

Patient portal

Your primary care clinic may have an online patient portal. These portals offer a safer way of contacting your provider instead of email. A portal provides a safe online tool to do the following:

• Message your provider or a nurse.
• Ask for prescription refills.
• Review test results and summaries of earlier visits.
• Schedule visits or ask for appointment reminders for preventive care.

If your provider is in a large health care system, the portal may also provide one point of contact for any specialists you may see.

Personal health apps

Many apps have been made to help people better organize their medical information in one secure place. These digital tools may help you:

• Store personal health information.
• Record vital signs.
• Calculate and track your calories.
• Schedule reminders for taking drugs.
• Record physical activity such as your daily step count.
• Personal health records

An electronic personal health record system (PHR system) is a collection of information about your health that you control and maintain. A PHR app is easy for you to see anytime via a web-enabled device, such as your computer, laptop, tablet or smartphone. A PHR also allows you to review your lab results, X-rays and notes from your provider. Your provider may give this to other providers with permission.

In an emergency, a personal health record can quickly give emergency staff vital information. For example, it can show your current conditions, drugs, drug allergies and your provider's contact details.

The potential of telehealth

Technology has the potential to improve the quality of health care. And technology can make it easier for more people to get health care.

Telehealth may offer ways to make health care more efficient, better coordinated and closer to home. You can go to a virtual visit anywhere — such as at home or in your car. And you don't need to travel to go to a virtual visit.

Telehealth can be useful so you can stay home if you're sick or if it's hard for you to travel. And you can use telehealth if you live far from a medical center. And many people have been able to keep distance from others at home and still receive care during the COVID-19 pandemic. And providers can diagnose and treat COVID-19 remotely.

Virtual visits can also provide you with the choice to meet with specialists who don't live where you do.

The limitations of telehealth

Telehealth has potential for better coordinated care. But it also runs the risk of gaps in care, overuse of medical care, inappropriate drug use or unnecessary care. Providers can't do a physical exam in-person, which can affect a diagnosis.

The potential benefits of telehealth services may be limited by other factors, such as costs. Insurance reimbursement for telehealth can vary by state and type of insurance in the U.S. But insurance keeps expanding for telehealth services in the U.S. And during the COVID-19 pandemic, insurance restrictions changed for a period of time. Check with your insurance company to see which providers have virtual visits covered by insurance.

Also, some people who need improved access to care may be limited because of not having internet access or a mobile device. People without internet access may be able to access telehealth services by using wireless internet offered at public places. For example, libraries or community centers may offer wireless internet for virtual visits that can take place in private rooms.

Sometimes technology doesn't work well. It's important to have a plan with your provider to call them by phone if there is an issue with the virtual visit.

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• Telehealth. National Institute of Biomedical Imaging and Bioengineering. https://www.nibib.nih.gov/science-education/science-topics/telehealth. Accessed May 6, 2022.
• What is telehealth? Telehealth.HHS.gov. https://telehealth.hhs.gov/patients/understanding-telehealth/. Accessed May 6, 2022.
• Ong MK, et al. Telemedicine for adults. https://www.uptodate.com/contents/search. Accessed May 5, 2022.
• Doraiswamy S, et al. Use of telehealth during the COVID-19 pandemic: Scoping review. Journal of Medical Internet Research. 2020; doi:10.2196/24087.
• Brotman JJ, et al. Providing outpatient telehealth services in the United States: Before and during coronavirus disease 2019. Chest Reviews. 2021; doi:10.1016/j.chest.2020.11.020.
• Telehealth: Defining 21st century care. The American Telemedicine Association. https://www.americantelemed.org/resource/why-telemedicine/. Accessed May 6, 2022.
• Mahtta D, et al. Promises and perils of telehealth in the current era. Current Cardiology Reports. 2021; doi:10.1007/s11886-021-01544-w.
• AskMayoExpert. COVID-19: Outpatient management. Mayo Clinic; 2021.
• Tapuria A, et al. Impact of patient access to their electronic health record: Systematic review. 2021; doi:10.1080/17538157.2021.1879810.
• Takahashi PY (expert opinion). Mayo Clinic. May 9, 2022.

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Telemedicine for healthcare: Capabilities, features, barriers, and applications

Abid haleem.

a Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India

Mohd Javaid

Ravi pratap singh.

b Department of Industrial and Production Engineering, Dr B R Ambedkar National Institute of Technology, Jalandhar, Punjab, India

Rajiv Suman

c Department of Industrial & Production Engineering, G.B. Pant University of Agriculture & Technology, Pantnagar, Uttarakhand, India

Regular hospital visits can be expensive, particularly in rural areas, due to travel costs. In the era of the Covid-19 Pandemic, where physical interaction becomes risky, people prefer telemedicine. Fortunately, medical visits can be reduced when telemedicine services are used through video conferencing or other virtual technologies. Thus, telemedicine saves both the patient's and the health care provider time and the cost of the treatment. Furthermore, due to its fast and advantageous characteristics, it can streamline the workflow of hospitals and clinics. This disruptive technology would make it easier to monitor discharged patients and manage their recovery. As a result, it is sufficient to state that telemedicine can create a win-win situation. This paper aims to explore the significant capabilities, features with treatment workflow, and barriers to the adoption of telemedicine in Healthcare. The paper identifies seventeen significant applications of telemedicine in Healthcare. Telemedicine is described as a medical practitioner to diagnose and treat patients in a remote area. Using health apps for scheduled follow-up visits makes doctors and patients more effective and improves the probability of follow-up, reducing missing appointments and optimising patient outcomes. Patients should have an accurate medical history and show the doctor any prominent rashes, bruises, or other signs that need attention through the excellent quality audio-video system. Further, practitioners need file management and a payment gateway system. Telemedicine technologies allow patients and doctors both to review the treatment process. However, this technology supplements physical consultation and is in no way a substitute for a physical consultation. Today this technology is a safe choice for patients who cannot go to the doctor or sit at home, especially during a pandemic.

1. Introduction

Advanced technologies with quality network services enable individuals to improve healthcare delivery and make it available to more and more people. Telemedicine is a more beneficial technology that can make it easier for people to get preventive treatment and help their long-term health. It is particularly true for those who face financial or regional causes to receiving quality treatment. Telehealth has the potential to make health care more effective, organised, and available. The research on this area is still in its early stages, but it is expanding. For example, the telephone-based care and telemonitoring of vital signs in persons with heart disease decreased the risk of mortality and hospitalisation and increased quality of life. There are several compelling reasons for people to get a diagnosis or recovery plan. This can make patients feel assured that they are receiving the best quality treatment. Telemedicine is an excellent choice for treating mental health issues. It eliminates some of the causes that prevent patients from receiving this critical form of treatment [ [1] , [2] , [3] ].

Telemedicine enables patients to receive medical attention at the convenience of both doctor and him, and at the same time, he is safe. This may imply that a person does not need to take time off from work or arrange childcare. Going to the doctor's office entails sitting in close quarters with others can cause infection. This is especially risky for people who have chronic medical problems or a weakened immune system. It prevents the possibility of contracting an infection at the doctor's hospital. Telemedicine service providers could have lower overhead rates. Clinicians may find that telemedicine supplementing their income by allowing them to take care of more patients. When caregivers see patients online, they are not exposed to the infections that the patient may bring. The patient may be happy with their physician if they do not have to fly to the office or wait for treatment or get infected from the hospital [ 4 , 5 ].

Telemedicine has improved the capacity of healthcare providers to take care of many people without physically being there. Furthermore, now that it has proved its worth, it will be around for a long time. Although introductory video conferencing brought many providers to telehealth, the new wave of telemedicine technologies would have much more to offer. For example, during a patient, clinicians can use natural language processing to take notes automatically. During emergency operations, specialists will weigh in from afar. The knowledge gathered by healthcare instruments may be submitted to an Internet of Things (IoT) cloud platform, where the healthcare provider consolidates it. This information will then be sent to IoT systems used by healthcare providers for patient management. The most recent advancements in telemedicine technologies include Artificial Intelligence (AI) to help physicians function more effectively. This technology keeps patients updated with wearables and other remote patient tracking resources and even uses robots to deliver specialised treatment to areas it has never been before [ [6] , [7] , [8] ].

Telemedicine technology holds great promise for patients in remote areas. The most significant effect is provided in various countries where healthcare facilities are both scarce and unavailable. To ensure an accurate medical history, all patients and doctors must have sufficient hardware and software security in place. Some clinics can provide virtual appointments with a doctor through online video conferencing. When an in-person visit is not required or necessary, these appointments enable them to continue receiving treatment from a usual doctor. Web-based visits with a doctor or nurse practitioner are another form of interactive appointment. As part of their health care offerings, several major corporations have access to automated doctor's offices. On the other hand, a nursing call centre is staffed by nurses who use a question-and-answer format to offer advice for at-home treatment [ [9] , [10] , [11] ].

This technology allows people to take blood pressure medicine, refill medications, and recall their appointments. In addition, patients can describe their symptoms to doctors by email, take a series of self-tests, and enrol in step-by-step training services tailored to their specific condition. For all scenarios, electronic health technology makes chronic illness control easier by simply placing care monitoring apps and smartphones in the hands of patients [ 12 , 13 ]. This article briefs about telemedicine and its need in Healthcare. Significant capabilities, features, barriers, and applications are discussed briefly.

1.1. What is telemedicine?

Telemedicine is a health-related service with the help of telecommunicating and electronic information technologies. It refers to the whole collection of deliverables designed to enable patients and their physicians or healthcare providers. It has a wide range of uses, including online patient consultations, remote control, telehealth nursing, and remote physical and psychiatry rehabilitation. It allows better health care choices, increases emergency service quality and performance, reduces time in making a diagnosis, and saves costs for both doctors and patients by optimising clinical procedures and reducing travel expenses to hospitals [ 14 , 15 ].

Telemedicine has increased access to high-quality healthcare facilities. Patients will now get more customised clinical services. They can also meet the best medical providers simply by using video application software, consultations can be taken from afar, and clinicians have better-suited tools for networking, data storage, report management, and leveraging on each other's specific skills. This improves the quality of medical practice, allowing doctors to spend less time on rural assignments and providing more care to patients. Telemedicine also enables private healthcare specialists to practise and will enhance the patient experience. Patients will no longer have to stand in long queues, and physicians will be able to access patient information more conveniently and efficiently with electronic files and eliminating overall wait times. Furthermore, remote appointments allow doctors to devote less time to each patient, allowing them to treat a more significant number of patients [ 15 , 16 ].

1.2. Why healthcare system needs telemedicine?

Rising healthcare costs and a need for better treatment are motivating more hospitals to investigate the benefits of telemedicine. They want improved contact between physicians and far-off patients and better usage of healthcare facilities. Here telemedicine also promotes better connectivity, which has resulted in fewer hospital re-admissions and patients entirely adhering to their prescription care plans. Telemedicine's increased contact advantage extends to doctor-to-doctor communication as well. Doctors may use telemedicine to build support networks to exchange their skills and provide better healthcare services. Telemedicine is a way of delivering medical treatment over the internet, usually through video chat. This technology has several advantages for both patients and healthcare providers. Though there are still technical hurdles and critics, telemedicine can supplement and enhance the overall patient experience [ [17] , [18] , [19] ].

2. Capabilities and features of telemedicine when used in healthcare management system

The concept of telemedicine and associated services have now been well established and proven for societal help. Fig. 1 reflects the various features and facilities offered by the telemedicine concept, specifically for the healthcare domain. It provides chronic health management, prescription compliance, remote services, care-for-all under critical and severe cases, etc., which ultimately enable this methodology to support the healthcare and medical care sphere. In addition, a series of tele-wearables heals up the patients and keeps them updating about their health status in a unique way [ 20 , 21 ].

Various capabilities & features of telemedicine for healthcare domain.

Telemedicine is an innovative technology, and many call it disruptive innovation. Thus, to cater to a distant patient, telemedicine employs a range of electronic communications media, ranging from teleconferencing to image-sharing to remote patient surveillance. Doctors may also use automation to offer quality treatment to their patients. They need to develop better IT support systems and learn a new way of file management. For example, a virtual appointment encourages primary care physicians to receive advice from experts when they have concerns about the illness or treatment. Exam reports, history, medical findings, X-rays, or other images are sent to the expert for examination to the doctor. The specialist can answer electronically, set up a virtual meeting with the doctor. These virtual consultations can eliminate the need for unnecessary in-person referrals to specialists, reduce wait times for specialist feedback, and eliminate the need for unnecessary travel. Telemedicine strategies are more useful where a doctor can see the patient, identify a disease, and chart the experience [ [22] , [23] , [24] , [25] ].

An electronic personal health record system uses health records that can monitor and preserve. We can use a web-enabled device, such as a desktop or smartphone, at any time. A personal health report will quickly provide essential details to emergency responders in an emergency, such as diagnoses, prescriptions, substance preferences, and the doctor's contact information. The applications of this technology have been developed to assist customers with properly organising their medical records in one safe location. Recovery programmes must establish targets for effectively improving patient behaviour, which is getting more uncomplicated due to mobile health technologies. It allows patients to count calories, record vital signs, record exercise, and control prescription doses and schedules. Aside from diabetes, telemedicine's idea of patient self-management can be extended to other long-term chronic disorders such as hypertension and a host of digestive diseases [ [26] , [27] , [28] ].

Telemedicine solutions will significantly assist doctors. However, when combined with Artificial Intelligence (AI), it can become even more effective. It can simplify basic tasks by reducing doctor workloads and increasing job satisfaction. The application relay data in a timely and high-quality manner to ensure that an appointment runs smoothly. It would enable doctors to do a more rigorous review of a patient's health and inspections for any abnormalities. Patients are encouraged to see a doctor's open (available) time slots, as well as their upcoming appointments and the ability to reschedule them. Healthcare analytics is often used to interact with the gathered data and view it from a user interface. In the long term, store and forward approaches imply improved time and cost utilisation. Telemonitoring is based on various electronic technologies that transmit patient statistics directly to a healthcare provider's analytical interface [ 29 , 30 ].

This technology has proved valuable and essential in a variety of capacities within the telehealth and medical industries. It is notably revolutionising surgeries, medical training, and schooling. Once the doctor has approved the desired appointment, the patient should obtain confirmation. Internal records, such as reviews, changes, and critical hospital alerts, can be included in their profiles. Physicians can be able to make meetings using schedules as well. Scheduling, and rescheduling, are the standard features of modern telemedicine applications. When physicians are informed of an appointment, they can access the patient's medical record and other details as needed in order to have an appropriate consultation and diagnosis [ 31 , 32 ].

Virtual Reality (VR) systems have transformed communication applications in telemedicine devices, making them more immersive. In virtual reality, doctors and their teams can now watch a 3D monitor when performing surgical procedures. By using video conferencing, physicians and even surgeons will work on people that are thousands of miles away. This enables even intercontinental medical teams to collaborate and hold video meetings on complex and urgent situations. The telehealth platform might use VR to simulate the patient's data and a graphical environment with video conferencing to streamline communication with a doctor. This method is also helpful in rural or isolated regions, and it is critical for providing patients with local Healthcare. In rural areas, this ensures increased trust in the local healthcare system. This tool means more funding for local health services for a remote patient's population. In addition, this technology can allow all patients to remain with family and friends [ [33] , [34] , [35] ].

3. The treatment work flow process as being used in telemedicine care

Fig. 2 is showing a line-way representation of the workflow for attempting telemedicine culture-based treatment in healthcare services. It provides an ultra-edge type facility and attention at every step during its implementation. It all starts with the patient's entry or detailed information, further followed by the telehealth supportive care unit. This step is further associated with the setting up of the doctoral assistant to the patient and then after the diagnosis and appropriate treatment offered to the person under utmost care [ 36 , 37 ].

Work flow treatment process through telemedicine support.

Telemedicine and other technology improve clinical and administrative operations by telecommunication. It is a multifaceted technique that provides emergency care in both critical and non-critical situations. In general, it is used to treat patients who are suffering from chronic diseases. On the other hand, a hospital with an appropriate ambulance crew or other personnel can compensate for telemedicine. Furthermore, additional functions such as the patient's treatment history, diagrams of treatment dynamics, and e-prescriptions can be added to the telemedicine solution.

Furthermore, doctors can easily continue to call patients for follow-ups or findings following an appointment. Therefore, text messages are essential because they enable the doctor to speak directly and quickly without another appointment. In addition, data and medications can be exchanged between offices by physicians [ [38] , [39] , [40] ].

In the current situation, healthcare surveillance is vital to maintain the quality of Healthcare. With the implementation of digital health tracking technologies and services, there are smart connectivity systems. This technology opens the door for direct patient control to provide much greater insight into patients with simple video conferencing. The doctor's catalogue saves both patient's and healthcare provider's time. It improves the precision of the doctor-patient treatment procedure. The appointment scheduling function keeps doctors informed of the status of their appointments. Until communicating with a patient, doctors may review scheduling requests and patient profiles. This shows the patient queue and allows to filter of patient profiling. The doctor can now easily postpone appointments at any time in case of an emergency. Data protection is often ensured by cloud-based medical record-keeping of telemedicine data with patient information and captured video consultation [ [41] , [42] , [43] ].

There is an easy sharing of medical records with any clinician specialising in treating a specific patient's disease, even a patient's caregiver who needs the information for insurance purposes. Patients can ask questions about their symptoms by communicating with their doctors via teleconference. Photographs and video consultations are replacing In-person evaluations. Telemedicine application software companies use app connectivity and cloud technologies to allow real-time collaboration and remote patient diagnosis. It saves time for both patients and physicians by monitoring health progress and inspecting when necessary. The telehealth app ensures seamless patient record collection and consolidation in a single location. It helps pharmacies, customers, and prescribing physicians by delivering healthcare services more quickly. With an e-prescription feature, doctors can create and deliver prescriptions with lesser errors. It would help to save time while also improving connectivity and customer satisfaction [ [44] , [45] , [46] , [47] ].

Telemedicine solutions for Healthcare improve the quality of treatment for both patients and doctors. Today, telemedicine app growth is increasing as the demand for mobile telemedicine applications grows and will continue to expand. It also enables doctors to view documents on the prescription insurance form and provide all information in electronically connected pharmacies. The ability to pay medical bills from mobile should be a must of every telemedicine app. The ability for patients to rate and compare their doctors is an essential feature of any telemedicine app. Patient feedback is regarded as an essential part of quality management and professional development. Furthermore, it will assist many new patients in locating the specialist doctor that is ideally suited to their needs [ 48 , 49 ].

Telemedicine applications have the potential to speed up the treatment of a variety of medical conditions. It is more successful when a person gets medication from a professional doctor who provides detailed knowledge about their symptoms. Telemedicine is a method of maintaining continuous contact with patients and healthcare providers. It has expanded access to healthcare facilities through the use of advanced technologies and services. Telemedicine provides any hospital or treatment centre with immediate access to medical professionals, consultants, and additional education and statistics. It is the fastest way to exchange all services with any hospital or clinic in the country. Telemedicine application specifications may be as simple and few simple requirements and some decisions [ 50 , 51 ].

Telemedicine technology can be reduced the requirements through an internet network, a video platform, technical equipment, and probably portable equipment. Healthcare facilities may have extensive services, which can perform telemedicine visits using a scaled-back variant of the same equipment. The assistance required to run a telemedicine programme is just as necessary as the hardware decisions. Any software requires a qualified computer and technical assistance to run correctly. Depending on resources, physicians access the needs at all times. The support team will be able to ensure consistent and safe internet access. In addition, it assists with logistical and technological issues that could arise during a clinic day to avoid patient treatment interruptions [ [52] , [53] , [54] ].

Telemedicine provides a great deal among healthcare professionals. Healthcare organisations incorporate telemedicine in medical offices and skilled nursing hospitals to deliver more effective services. Technologies combined with telemedicine software, such as electronic medical records, AI diagnosis, and medical streaming applications, can help physicians diagnose and manage patients more effectively. This enables physicians to track patients in real-time and modify care plans. Using telemedicine, doctors can treat more patients without adding more employees or expanding their office rooms. However, several physicians and patients, mostly older adults, are having difficulty adjusting to telemedicine [ 55 , 56 ].

4. Barriers for the adoption of telemedicine practices in making healthcare services effective

Fig. 3 exemplifies the several fences that came across the successful implementation of telemedicine care to support the healthcare units and patients for their utmost care. There are very typical and usual barriers needed to be taken care of while looking to apply telehealth-related practices for Healthcare and its allied domains. The things must be very free from any kind of privacy loss, confidentiality revealing, fraud & abuse, inaccurate solutions, etc. as any of these issues may become a reason for anyone's discouragement, or the case may become complex as far as health sediments are concerned [ [57] , [58] , [59] ].

Frequent barriers in supporting healthcare through telemedicine.

Telemedicine and other telehealth monitoring methods may assist patients and physicians in managing severe health problems such as diabetes and asthma. Providers will also track patients at home after being discharged from the hospital or recovering from an accident. Patients' mismanagement is a significant source of anxiety for physicians. Although advancements in medicine have made it easier to use technology, device outages occur from time to time. Healthcare systems that are considering adopting telemedicine technologies meet with industry experts. They have a host of realistic options for practitioners interested in incorporating telemedicine into their clinics, making the integration smoother [ 60 , 61 ].

This telemedicine method helps physicians exchange patient details with another doctor who is located in another country. A primary care practitioner will now exchange patient history and medical details with a doctor without being in the same room. Systems can relay data over large distances between systems, allowing one practitioner to know what another has already done. As a result, there is less duplication in monitoring and fewer cases of inadequate drug management. A physician can collect and exchange information with their patient using patient portals. Medical devices can transmit vital signs and other data to physicians, allowing them to make treatment changes. Patients can now send biometric data to their clinicians through wearables or remote monitoring devices such as pulsometers or blood pressure cuffs. It can access patient information from a dashboard or clinical decision support system, compile data, and display patient status in near-real-time [ [62] , [63] , [64] ].

Telemedicine helps patients to exchange information over long distances and become a game-changer. Healthcare records such as imaging photographs, blood analysis, and other data may be exchanged in real-time for proper patient evaluation. Overcrowding in emergency departments can be eliminated using telemedicine by making patients first consult with a remote physician via video chat. Healthcare networks that have implemented telemedicine technologies will testify that it takes a significant amount of time and resources. Practice administrators, clinicians, doctors, and others must understand how to use the device to achieve benefits. While telemedicine is initially costly, healthcare facilities can have a good return on investment over time due to more patients and fewer employees. Using this technology, physicians can evaluate a patient's medical background, administer clinical examinations, and more [ [65] , [66] , [67] ].

There are now telemedicine options available that enable patients from the convenience of their own homes. It is beneficial for those who use the services of a physician but do not have the means to travel thousands of miles or wait a long time. High-risk children will be seen by a doctor at another hospital in seconds by merely sharing the footage. This also reduces the need for babies to be moved to a different hospital, which is expensive and time-consuming. Patients who formerly had little access to health care facilities will now see a specialist without leaving their homes. Disease transmission is minimised when people with infectious illnesses do not reveal themselves to those in cramped waiting rooms. Individuals will also book consultations during job breaks or even after hours [ [68] , [69] , [70] ].

Telemedicine creates a new technology-assisted level of treatment by further connecting patients with their caregivers, access to physicians and experts, and encouraging both patients and providers to escape high-risk environments. Patients with drug abuse can be treated with different telemedicine methods. Overall, the cost of treatment is lower, resulting in cost savings. The cost savings would become more apparent as technology advances. When it comes to care and diagnosis, telemedicine is fantastic for physicians and patients. It can serve as an excellent support system. This form of telemedicine technology is handy for healthcare professionals for appropriate medication and care of the patient. Telemedicine can save money for both the individual seeking treatment and the provider when opposed to conventional care. In order to proper treatment, the healthcare provider would have telemedicine facilities on-site [ 71 , 72 ].

Telemedicine technology allows for continuous patient care. This will promote proper self-care and help diagnoses. AI-enabled telemedicine services will automatically interpret patient data and assist physicians in responding rapidly to new technologies. Providers will be able to treat more patients by the use of telemedicine technologies. Visits can be reduced in length, and hospitals can be reduced in size. Access to tele–urgent treatment has the potential to minimise emergency room visits. It enables experts to collaborate on cases in rural hospitals. These exchanges live streams with remote specialists who can have on-screen consultation. Telemedicine is the remote transmission of medical information from one location to another. This is done in order to improve a person's fitness. Getting an appointment with a primary care doctor or a specialist can be challenging. This remote network is actively gathering and transmitting data to other healthcare organisations for analysis. This technology allows mental health practises to see more patients while maintaining a high degree of medical care. This results in greater profitability and better time control. Parents will now stop taking their sick child out of the house to visit a doctor [ [73] , [74] , [75] ].

Telemonitoring is the use of technologies to transfer medical data from people in various geographical areas. This type of monitoring allows physicians and primary caregivers to track patients through electronic equipment. Telemonitoring systems also allow patients to be cared for at home. This lowers hospital visits and gives them greater control over their illness treatment. Patients at far-out locations cannot fly to hospitals or patients without access to affordable healthcare benefits from telemedicine. Acting with other healthcare workers daily can be incredibly time-consuming and is one of their daily tasks. Radiologists may collect high-quality photographs and obtain input from anywhere using telemedicine. They no longer need to be in the exact location as the provider sending over the images, allowing for a more efficient operation. Mental health practises, likely one of the most common specialities for telemedicine, and offer therapy sessions from anywhere [ [76] , [77] , [78] ].

5. Telemedicine in healthcare: significant application areas

Telemedicine technology has access to various treatment options, including primary care consultations, psychotherapy, physical therapy, and many more. It provides treatment through the use of wireless technologies such as laptops and smartphones. In most cases, video conferencing is used in telemedicine. Some services, on the other hand, choose to provide treatment through email or phone messages. Often patients use telemedicine in conjunction with their primary care physician. This technology is helpful where a patient must maintain physical distance or is unable to visit a healthcare centre. It allows practices to sell extended or weekend hours without incurring the cost of having the office open. This also makes practices more attractive to the growing number of patients who insist on telemedicine as a primary care provider choice [ [79] , [80] , [81] ]. It is a cost-effective and easy way to assist people with severe illnesses in managing their disease, being involved in their treatment, and preventing complications from worsening. Table 1 gives the significant applications of telemedicine for Healthcare.

Table 1

Telemedicine applications areas for the Healthcare sector.

Various innovative technologies are used in the field of engineering. Healthcare and their associated field [ [146] , [147] , [148] , [149] ]. These are helpful to solves various problems related to design, manufacturing and to create sustainable environment [ [150] , [151] , [152] ]. Telemedicine is often used to link doctors operating with a patient in one place while experts are in another to help them through telecommunication. This is highly beneficial to remote or difficult-to-reach areas where experts are not readily accessible. It is used to perform remote visits at a lesser cost and time. The advent of the internet age brought about significant improvements in the practice of telemedicine. The emergence of this smart technology is capable of high-quality video streaming paved the way for remote Healthcare to be delivered to patients in their households, offices, or assisted living centres as an alternative to in-person appointments for both primary and specialist care. Many people say that telemedicine has existed in some way or another since the telephone was invented. One can send images instead of data over the handset. Telemedicine is also an accepted component of the way Healthcare is provided in various countries. It has a surprising number of applications, which allows patients to plan a follow-up appointment by video, improves consistency with aftercare visit guidelines and reduces the pressure on both patients and doctors [ [153] , [154] , [155] ].

Modern mobile health apps support telemedicine and bind an interactive clinical interface to software. Treatment of patients with minor diseases, exchanging data investigation information, or imaging findings are examples of noncritical events. Patients can also buy drugs and get prescriptions from a dedicated app. Close coordination with payment gateways. Here analyses and information transmission take place in real-time. These telemedicine systems are often integrated; as a result, it allows patients and physicians to easily collaborate via a single app to chat and exchange data. It can be easily collected direct patient data and forwarding it to the appropriate doctor. This evidence may be a transcript of an appointment or a test report saved in an Electronic Health Record system folder. In addition, it allows doctors to interpret data once it has been collected [ [156] , [157] , [158] ].

Telemedicine makes extensive use of confidential medical records. It is used for capturing, preserving, and distributing data, which helps to consider essential criteria in this area. Telemedicine is a website that allows one to chat with a doctor remotely [ [159] , [160] , [161] ]. Mobile applications serve as a connection between the device and the hospital's internal infrastructure. Dedicated modules can submit warnings, research notes, and data visualisations to assist clinical decisions. This programme uses a remote control to care for people with severe and chronic conditions. Any patient admitted to the hospital and held under care during surgery takes up a precious bed. Home health Telemedicine collects vital signs, has video conferencing services, and can sound alarms at a nurse's station [ [162] , [163] , [164] , [165] ].

6. Discussion on the findings

Telemedicine allows doctors and patients to communicate directly through audio and video conferencing. During the call, and even before the doctor can see the ill person's health records. Telemedicine is a branch of health information technology that entails using technologies to provide clinical Healthcare over safe video and audio connections. This also allows for online treatment of sick people. Via telemedicine, a sick person can communicate with a doctor at any time and from any location through a secure audio and video call, and the sick person can even exchange records and photographs. Telemedicine technologies can be cost-effective and convenient if correctly oriented and conducted. During the Covid-19, it has become quite popular, and creative applications are being developed to increase health outcomes, reduce costs, and ensure that each patient receives the high-quality treatment they deserve.

Telemedicine use emerging networking systems, application software for communication & file management, advanced devices such as computers and mobile devices to view and control health care facilities to view our medical reports, appointments, order prescription refills, payment or contact doctor can be used as an online patient portal. Forward-thinking school partners with doctors to perform school-based remote visits. The provider may measure the severity of the situation and provide parents instructions or reassurance. Telemedicine technology has also been seen to successfully hold residents in assisted living facilities out of the hospital. On-call physicians may use telemedicine to perform a remote visit to decide if hospitalisation is needed at remotely located clinics. Several telehealth options are now becoming available to assist in managing health care and receiving treatments.

Telemedicine, a prominent example of IoT in Healthcare, should ideally be user-friendly, accessible, and adaptable. Computer hardware should have a simplified design factor that is appealing to both patients and healthcare practitioners. In addition, the system should be simple to incorporate into the current healthcare systems. Another factor to remember is the instruction that consumers would need to run smoothly for the system. Healthcare organisations should use the power of IoT to create robust, cost-effective, and accessible telemedicine applications. These healthcare systems track the user's vitals and record data over time. Some of these instruments can also forecast impending diseases depending on the user's general health. The aim of deploying an IoT-powered system is not limited to patient surveillance. For example, hospitals can mount IoT sensors on wheelchairs, nebulisers, defibrillators, and other medical equipment to allow for real-time tracking. This method may also be used to monitor the position of medical personnel involved with the hospital.

Telemedicine is now used in medical areas such as dermatology, mental health, medicine, and cardiology to deliver improved treatment to populations underserved by doctors and clinics. It is often thought to be a way to minimise significantly the expense of treating health problems such as asthma, diabetes, and sleep apnea, which benefit from continuous observation of a patient's condition. Telemedicine technology in recovery tackles these problems in various areas, including performing cognitive or psychiatric assessments, leading group counselling meetings, supplying patients with internet services, and remotely observing patients. For example, this technology will help people recover from lung disease by undergoing video therapy sessions and supervised physical recovery at a local satellite site. Cardiovascular disease is the primary cause of death worldwide. However, many incidents can be avoided with the aid of drug therapies or social/lifestyle changes.

Telehealth may be making health more affordable and, as a result, growing Healthcare's importance and getting immediate treatment for patients. However, people must fly thousands of miles around the globe or continents to get affordable Healthcare. Several applications that have been created for health-related purposes have ensured that this hurdle is removed. Telemedicine service makes it much easier to have a video medical appointment with any doctor in the shortest amount of time. Patients can be able to customise their needs, venue and allow compatibility with current patient records. They can make personalised meetings and physicians who can collect vital details prior to the meeting. Furthermore, it allows various algorithms to view pertinent information on the home screen. For example, a search engine with complex filter algorithms would allow patients to choose several filters that can operate.

Telemedicine applications associate patients with doctors who consult them via video chat. The doctors available depends on the software by using the number of physicians who have registered with it. Any telehealth applications will also help to treat illnesses like diabetes, high cholesterol, or addiction. The apps will also send prescriptions to pre-selected pharmacies, allowing them to pick up medications conveniently. Telemedicine provides expert medical advice, diagnosis, recovery plans, and medications. The doctors can receive advanced training through internet consultations. Telehealth applications are entirely modern technology used for patient care and rapidly changing Healthcare and its effectiveness. It supports technologically-inspired health care systems.

7. Limitations of telemedicine in healthcare

Telemedicine, when compared to conventional treatment approaches, has lots of possible drawbacks to using telemedicine. It is no substitute for the conventional healthcare system; it compliments the healthcare system for minimal functions. There is a serious issue of hacking patient's medical data, especially if the patient connects to telemedicine from a public network or an unencrypted channel. When a person requires emergency care, this technology can cause the medication to be delayed, mainly because a doctor cannot deliver life-saving care or laboratory tests remotely. State rules differ, and physicians will be unable to practise medicine across state boundaries based on the state in which they are licenced and the state in which the patient resides. Clinicians must also ensure that the telemedicine service they use is safe and severe and compliant with privacy laws.

During telemedicine sessions, providers must focus on patient self-reports and necessitate physicians asking further questions to get a complete patient history. If a patient fails to report an important symptom that should have been detected during in-person care, medication could be jeopardised. One of the most significant drawbacks being a lack of availability and affordability. It can be costly for the supplier to set up and manage. Though a valuable and worthwhile facility, telemedicine can be prohibitively expensive for smaller healthcare facilities. Poor communication will also make it impossible to provide reliable care.

8. Future of telemedicine in the healthcare sector

In the future, patients will book an appointment with the doctor of their choice after completing a quick and straightforward registration process. Instead of typing, patients will upload medical history, verification documents, medical reports and past prescriptions. The patient interface is a proper function that allows the doctor to create an urgent care plan. It displays an outline of the patient's physical and personal records, assisting the doctor in deciding. Local healthcare resources can be quickly mobilised to offer both emergent and non-emergent services. This will allow clinicians to concentrate on high-demand, complicated cases in person rather than low-level cases that could be handled remotely. In the future, emergency departments to use video consultations to triage their patients, non-emergency situations are discharged earlier. As a result, there is less emergency diversion and improved patient conditions. Several healthcare organisations are adopting telemedicine application software to prepare for the future. It connected cardiologists with patients who came to the rural facility for care. They will also shorten the time required for follow-up appointments and complement the regular system. Remote patient management has arisen as the next major cause for virtual Healthcare, and this challenge is generating significant opportunities for many businesses.

9. Conclusion

Telemedicine is a valuable technology in linking clinicians with patients to ensure they make long-term lifestyle changes. It has significant benefits for medical office staff. This many times eliminates the burden of patient check-in and concentrates on higher-value tasks. With online visit capability, clinicians may care for their patients while still potentially assisting other affected practices. This also reduces distance limitations by exchanging information about a diagnosis, care, and disease prevention between the doctor and the patient through electronic means. The most extensive telemedicine application can get health coverage closer to people who live in rural areas where quality treatment is otherwise impossible to access. In recent years, this technology has been shown to increase the quality of healthcare facilities by allowing the exchange of information across many distant areas. It expands access to underserved areas, making it easier for them to schedule and hold appointments. People with reduced mobility get doctors' opinions and prescriptions which they need more quickly. Medicine and testing and procedures they have to manage at their place. Telemedicine minimises the doctors' & patient travel around the globe and changes each sick person's life, ensuring that each sick person receives the appropriate health treatment.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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dvm360® product report: Remote pet play device, plus rabbit and guinea pig treats, and more

Here's our regular rundown of new and notable veterinary products

Photo courtesy of Enabot.

Remote pet play device

Enabot, a company specializing in at-home robots, has launched ROLA PetPal, new technology for pet owners to use remotely. The ROLA PetPal allows owners to play with their pet even when they are not home. The device has high-definition cameras, remote-controlled mobility, automatic recharging, and artificial intelligence-enabled pet recognition. ROLA PetPal can be equipped with a play stick, a laser game, and rolling balls to entertain pets. It features 2-way voice communication to allow owners to talk through the device’s speaker and for pets to make noise back once they are trained to hit the call button on their own.

Photo courtesy of Canine Companions.

Technological collar for service dogs

The CanineAlert Device, developed by Canine Companions, is worn by the service dog and wirelessly connected to the human wearer. The device tracks vital signs such as heart rate and alerts the service dog via vibration of irregularities. Canine Companions service dogs are already trained to detect changes in their human; however, this new device will ensure no issues go undetected and earlier intervention can support a faster recovery.

Photo courtesy of Earth Animal.

Plant-based dry food

Earth Animal offers a new plant-based dog food, Wisdom Air-Dried From the Seed Recipe. The commercial diet’s formula includes lentil protein, quinoa, sunflower seed protein, alfalfa juice concentrate protein, and potato protein and has a 28% protein content, which exceeds the standards of the Association of American Feed Control Officials for complete and balanced nutrition. This dry food is marketed for dogs of all breeds and sizes.

Photo courtesy of Small Pet Select.

Rabbit and guinea pig treats

New Healthy Snackers treats from Small Pet Select are specifically designed for rabbits and guinea pigs and have no sugar, salt, or additives. The treats come in 5 flavors: apple, banana, pear blueberry, pumpkin, and carrot pineapple. These high-fiber treats incorporate timothy hay and fruit to improve healthy gut bacteria.

Ultrasound system for veterinary imaging

Esaote North America has launched the MyLab FOX

Updates in cannabis and integrative medicine in 2022

Angela Ardolino is a holistic pet expert specializing in cannabis products who has been caring for animals for over 20 years

First ever green and violet laser

Erchonia introduces a new laser for the veterinary market

What you need to know about GFI #256 and the changing landscape of compounding medicine

Marcy Bliss, CEO of Wedgewood Pharmacy, talks GFI #256 compliance and how drug compounding has changed over time

New digital prescription software

Wag! introduces a new digital tool for veterinary clinics: Furscription

Cancer test launches within US and European veterinary clinics

Nu. Q Vet Cancer Test is now available through Antech

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What can be treated through telehealth?

Telehealth can be used to treat a wide range of health conditions.

On this page:

What types of care can i get through telehealth.

Telehealth lets you take care of your health in different ways, like:

• Talking to someone about your feelings or problems with issues like alcohol or drugs
• Checking results from lab test or x-rays
• Checking on common problems like headaches or infections
• Looking at skin problems
• Managing your medicines
• Getting help for common sicknesses like colds or an upset stomach
• Checking in with your provider after surgery
• Doing physical or occupational therapy
• Using remote patient monitoring tools to track your health

Talk to your health care provider to see if telehealth is a good fit for you.

By bus [ edit ]

The central bus station of Perm is on Shosse Kosmonavtov opposite the central market. There are daily buses to/from Ekaterinburg , Kazan , Izhevsk , Chelyabinsk , and many cities in Perm Krai .

By car [ edit ]

Although Perm lies on the "Siberian Trakt", the main motorway from Moscow to Siberia, the local roads are of poor quality, similar to most of Russia.

By boat [ edit ]

Perm is accessible through its Kama river port. Passenger transportation is limited to recreational cruises to Chaikovsky, Kazan , Moscow , St. Petersburg and Volgograd . Cruise companies tend to sell return tickets only.

Buy [ edit ]

With the city quickly developing, new shopping malls appear everywhere. Definitely worth seeing is the always crowded Central Bazaar, with uncountable kiosks and market stands, as well as huge market halls. The bazaar is located opposite the central bus station, at the very beginning of Kosmonavtov avenue. Perm also has a Chinese market, with mostly clothing being sold.

• Semya (Family) Shopping Mall , Revolution street, 13 . 10:00-midnight . Includes a cinema and plenty of entertainment for children.  
• Iceberg , Popova street, 16 . 10:00-21:00 . 60 stores with clothing, electronics and a beauty salon.  
• Tczemlyanika (Wild Strawberry) , Parkovy avenue, 17 . 10:00-21:00 . A large discount centre.  

Eat [ edit ]

There is plenty of Russian, Georgian, Azeri, and Uzbek food in Perm.

Mid-range [ edit ]

• Grill-Tavern Montenegro , Maksima Gorkogo, 28 . Excellent meat restaurant - cooked in a variety of methods.  

Splurge [ edit ]

• Karin Restaurant @ Hilton Garden Inn , 45 B Mira Street . High-end fusion cuisine.  

Connect [ edit ]

Stay safe [ edit ].

Reckless drivers are probably the biggest safety threat. Pickpocketing is common in the crowded public transport and in the Central and Chinese Bazars. Occasional drunkards may be somewhat annoying but rarely pose any menace. It is wise to stay out of city parks, Balatovo Park, during the night.

Cope [ edit ]

Be prepared for cold weather from November to March. Despite cold temperatures outside, nearly all indoor spaces and public transportation are well heated.

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How much is the cheapest flight to Perm?

Prices were available within the past 7 days and start at for one-way flights and $641 for round trip, for the period specified. Prices and availability are subject to change. Additional terms apply.

Find Your Flights to Perm PEE

Cheap flights to Perm ( PEE)

Get started finding a cheap flight to Perm on Expedia by either choosing a deal on this page or entering into the search bar your travel dates, origin airport, and whether you want roundtrip or one-way airfare. You can filter for flexibility, number of stops, airline, and departure/arrival times to find the best flight for you.

We recommend using the ‘Flexible Dates’ calendar at the top of the page to see the price of plane tickets on the surrounding dates. This allows you to pick the cheapest days to fly if your trip allows flexibility and score cheap flight deals to Perm.

Roundtrip prices range from $641 - $749, and one-ways to Perm start as low as .

Be aware that choosing a non-stop flight can sometimes be more expensive while saving you time. And routes with connections may be available at a cheaper rate.

Airlines that fly to Perm ( PEE)

You have several options for which airline you choose to travel with to Perm. There are 9 airlines flying into PEE: S7 Airlines. 

Cheap plane tickets may be available from different airlines at different times and with unique terms. It’s best to understand the details of each airline’s offer before judging its value.

For example, if you plan to check a bag or bring a carry-on, check whether the cheap airfare deal includes a baggage allowance. If not, verify whether the baggage fee is higher than the difference of other airline plane ticket deals offering free checked/carry-on baggage in exchange for a slightly higher airfare. 

Additionally, your preferred frequent flyer membership programs may influence your choice of cheap airline. Expedia allows you to enter your membership numbers during checkout to earn points from your airline and Expedia Rewards—all while getting a great deal and planning all your travel in one online platform.

Find the best deals

At Expedia, we source many flight deals from multiple providers, so you can easily find the best deals that are right for you. A great strategy for getting the best deals can be to make sure you book and travel at the optimal times. Airfare to Perm (PEE) varies throughout the year based on seasonal demand. You’ll see the lowest rates for roundtrips to PEE in June and in for one-ways.

Cancellation & flexibility

To change or cancel eligible flights, go to ‘My Trips’ and navigate to your itinerary. If you booked within the last 24-hours, you might be able to cancel your flight for free. Learn more about flight changes or cancellations from our customer service portal . Some plane tickets are available with no change fees, which you can filter for during your search.

Frequently asked questions

• Air travel can be easy if you take the right gear. Firstly, you’ll need toiletry items, such as deodorant and a toothbrush, a fresh set of clothes and a magazine or two. Secondly, make room in your carry-on bag for your phone and charger, any daily medications and maybe a quality neck pillow as well. Lastly, and most importantly, don’t forget to bring your passport, travel docs and your credit cards.
• Pack all your full-sized bottles of shampoo and hair gel in your checked luggage. Any liquids in your carry-on bag larger than 3.4 ounces (100 milliliters) will be confiscated by authorities. Sharp objects, like your trusty pocket knife, and dangerous goods which are explosive or flammable, such as aerosol cans, flares and poisons, are also prohibited.
• Your aim here is to make yourself as comfortable as you can. Layer yourself up in natural-fiber clothing and bring a pullover in case it gets cool in the cabin. Opt for roomy, flat shoes as it’s possible that your feet and ankles will swell during the journey. Leave the stilettos and hiking boots in your main luggage.
• Most travelers are aware of DVT (deep vein thrombosis), a blood clot condition caused by long periods of sitting. There’s lots you can do to lower your risk. Wear a pair of compression socks, stay hydrated and keep your legs and feet moving. Walk the aisles of the cabin or perform some stretches in your seat.
• Be sure to keep your ID and travel documents handy. They’ll be the first things you’ll be asked to show at security.
• The X-ray machine comes next. Empty your pockets and remove anything metal that is likely to set off the alarm. This includes things like earphones or headphones, as well as heavy coats or jackets. They’ll all need to go on the X-ray conveyor belt.
• All your electronic devices, including your laptop and phone, will also need to be scanned.
• Don’t forget to remove liquids and gels from your carry-on luggage. They often need to be sent through the X-ray scanner separately. Each item should be no larger than 3.4 ounces (100 milliliters) and everything must fit in a quart-size (one liter), clear zip-close bag.
• There’s a chance you’ll be asked to remove your shoes for scanning, so wearing slip-on shoes is always a wise idea.
• Sharp items are not allowed on board. They’ll be confiscated at security, so put them in your checked bags.

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