The relationship between Hypertension and Telehealth

Introduction

With the advanced technology, various electronic and communication processes have been recently applied in the healthcare services to enhance better service provision to patients. The communication and electronic processes being applied today include telehealth and mobile health (Chowdhury et al., 2018) . Telemedicine mainly refers to the use of medical information transmitted via electronic communications to help in improving healthcare services offered to patients and help in improving their health status. Telehealth involves growing types of application and services and other forms of telecommunication technology (Cottrell et al., 2015) . These include wireless tools, smart, phones, two- way video, email, and phone calls. This essay is going to discuss the importance of telehealth in medicine including how it can be used in the hypertension management.

Telehealth in Medicine

The introduction of telehealth in hospitals and healthcare services occurred approximately 40 years ago. The main goal of using telehealth was an extension of health care services in remote areas (Chowdhury et al., 2018) . Despite challenges such as poor implementation, lack of physician support and even low reimbursement, the usage of telehealth in medicine has really grown. Currently, most medical facilities have adopted the use of telehealth where it has been mainly applied in ongoing operations in hospitals, used in private physician offices, home health agencies and specialty departments. It is also being used by patients at homes or their workplaces (Cottrell et al., 2015) . A recent survey conducted by Hospital Information System (HIS) technologies indicates that the number of patients using telehealth services increased from 350,000 in 2013 to 7 million in 2018.

Telehealth services have positively impacted all branches of medicine by offering a tool for improvement of disease management to patients and healthcare professionals (Cottrell et al., 2015) . Healthcare improvement tools that have really been used include the use of video conferencing for patient consultation, telemonitoring such as remote monitoring of vital signs, a continuation of medical learning online, nursing call centers, a website for patients, and transmission of still images. Telehealth also performs actual delivery of healthcare services to remote areas via health information technology which contains electronic health records and important health information (Harrison & Wild, 2017) . Telehealth is also used for remote data transmission via the use of telemonitoring. The transmission involves both vital parameters such as blood pressure and heart rate and non-vital parameters. These parameters are usually transmitted from the patient’s place of residence to health provider’s office.

One of the most common telemonitoring applications is home blood pressure telemonitoring (HBPT) which monitors blood pressure and stores the patient’s blood pressure readings. The readings are then transmitted to the health professional electronically (Cottrell et al., 2015) . The use of tele- ICU platform has also been adopted by various hospitals in the United States. Tele- ICU platform allows access to intensivists and specialists (Chowdhury et al., 2018) . Tele-ICU helps the ICU staff to have the same access to the vital data about the patient such as lab results and vital signs (Harrison & Wild, 2017) . Application of telehealth in medicine has also been seen in telestroke services. Tele-stroke allows healthcare professionals to identify key symptoms and administer the patients with tissue plasminogen activator (tPA) as early as possible usually within three to four hours of suffering stroke (Cottrell et al., 2015) . Telehealth has also been used for patient rehabilitation conducting online cognitive assessment and offering online therapy sessions (Chowdhury et al., 2018) . Heal professionals have also used cardiovascular disease management programs by allowing patients to access information, ask helpful information and get appropriate feedbacks online or through messages.

Hypertension Management by Telehealth Services

Due to the growing interest in the recent years regarding the possibility of telehealth services potential to reduce the burden of chronic cardiovascular diseases, researchers and health professions have conducted research studies and several pragmatic trials with the goal of finding how telemedicine is effective in reducing primary and secondary cardiovascular diseases. The main focus on telemedicine was put on arterial hypertension because of the high burden of suboptimal blood pressure (Chowdhury et al., 2018) . It is approximated that suboptimal costs at least 370 billion US dollars, the amount representing approximately almost 10% of world’s healthcare expenditure. Researchers argue that telemedicine can improve control of blood pressure and reduce the burden that is associated with high costs of optimal blood pressure due to uncontrolled hypertension (Cottrell et al., 2015) . Telemedicine has provided useful tools used for health service delivery to hypertension patients. Telemedicine services also create healthcare network around the hypertension patient.

Availability of internet services and high-speed normal landlines creates easily accessible network for health professionals in hospitals and hypertension patients in the remote areas, it also provides a network between hospitals and community health providers. This help in access to services without the need for expensive technologies (Chowdhury et al., 2018) . Doctors also use live interactive video and store and forward transmission services to transmit diagnostic images, vital sing among others, and patient data that will be useful to primary care physician. This will allow consultation with hypertension patient or consultation with the specialist assisting primary physician in performing diagnosis of hypertension. Doctors also used web-based monitoring centers to monitor blood pressure, adherence to antihypertensive therapy that is conducted at homes, respiratory function, heart rate and other vital signs (Harrison & Wild, 2017) . Web-based monitoring can also be used to provide health care services to hypertension patients at home.

Tools for monitoring blood pressure and other vital signs at home combined with telephone calls by doctors and visiting nurses may be helpful in the remote collection of data. These data collected are then sent to remote diagnostic testing facilities or to home health agency to be interpreted and a feedback is given to the referring physicians (Cottrell et al., 2015) . Web-based e-health patient service sites provide health services directly to hypertension patients. These sites are also used to transmit health information to patients. The online discussion forums on these sites provide a peer and moral support to hypertension patients. Telemedicine also provides physicians responsible for hypertension management with medical education and update.

Benefits of Telehealth

The main benefit of telehealth is providing a long-term and close relationship between patients and health providers. This is achieved by continuous online and telephone consultation between the physician and patients (Chowdhury et al., 2018) . Telehealth services also treat and diagnose stroke faster. Telemedicine allows patients to go through rehab process at home. Telemedicine hypertension management has also helped in reduction of the costs of optimal blood pressure and reduced the risk of heart diseases (Cottrell et al., 2015) . It also encourages diabetics to embrace healthier behavior. A continuous interaction between physician and the diabetic patient has helped doctors’ administer patients’ progress online. Remote access to health services has also ensured improved health provision in rural areas (Harrison & Wild, 2017) . Telehealth has generally helped in reducing health costs incurred by making health services easily accessible to patients.

Challenges in Telehealth

Some of the challenges that have faced implementation of telehealth in medical services include the low reimbursement in medical technology, licensing, failure by health facilities to adopt telemedicine services and complex technology with a huge data flow that cannot be easily maintained (Cottrell et al., 2015) . There is also lack of evidence regarding cost reduction by telemedicine services among other factors.

Conclusion

This study shows that telehealth is a very useful tool in controlling blood pressure. The telemedicine services help in the control of hypertension. Telemedicine services have also been helpful in managing costs of optimal blood pressure. Telemedicine services such as telemonitoring, web-based sites, internet, email and phone calls have been used majorly in controlling hypertension. Services such as transmission of vital data, online provision of health services and online consultations have helped in hypertension management. Telehealth is, therefore, a vital tool in hypertension management.

References

Chowdhury, F. M., Ayala, C., Chang, T., Dalmat, D., Shantharam, S., & Zhang, X. (2018). The effectiveness of Telehealth on Hypertension Management and Control Among Disparate Populations-A Systematic Review and Meta-analysis.

Cottrell, E., Cox, T., O'Connell, P., & Chambers, R. (2015). Patient and professional user experiences of simple telehealth for hypertension, medication reminders and smoking cessation: a service evaluation.  BMJ Open ,  5 (3), e007270.

Harrison, C. E., & Wild, K. (2017). Using telehealth in the management of hypertension.  Nursing Standard (2014+) ,  31 (48), 44.