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Telemedicine for healthcare: Capabilities, features, barriers,
and applications
Abid Haleem
a
, Mohd Javaid
a
,
*
, Ravi Pratap Singh
b
, Rajiv Suman
c
a
Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
b
Department of Industrial and Production Engineering, Dr B R Ambedkar National Institute of Technology, Jalandhar, Punjab, India
c
Department of Industrial &Production Engineering, G.B. Pant University of Agriculture &Technology, Pantnagar, Uttarakhand, India
ARTICLE INFO
Keywords:
Healthcare
Remote treatment
Telemedicine
Virtual appointment
ABSTRACT
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. Further-
more, 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 in-
dividuals 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 [1–3].
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
* Corresponding author.
E-mail addresses: ahaleem@jmi.ac.in (A. Haleem), mjavaid@jmi.ac.in (M. Javaid), singhrp@nitj.ac.in (R.P. Singh), raje.suman@gmail.com (R. Suman).
Production and hosting by Elsevier
Contents lists available at ScienceDirect
Sensors International
journal homepage: www.keaipublishing.com/en/journals/sensors-international
https://doi.org/10.1016/j.sintl.2021.100117
Received 17 June 2021; Received in revised form 18 July 2021; Accepted 19 July 2021
Available online 24 July 2021
2666-3511/©2021 The Authors. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/).
Sensors International 2 (2021) 100117
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 op-
erations, 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 in-
formation 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 func-
tion 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
[6–8].
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 ac-
curate 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 interac-
tive 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 [9–11].
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 con-
dition. 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 tele-
communicating 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 hos-
pitals [14,15].
Telemedicine has increased access to high-quality healthcare facil-
ities. 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 assign-
ments 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 ex-
change 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 hur-
dles and critics, telemedicine can supplement and enhance the overall
patient experience [17–19].
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].
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 teleconfer-
encing 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 manage-
ment. 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 unnec-
essary 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 [22–25].
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
A. Haleem et al. Sensors International 2 (2021) 100117
2
uncomplicated due to mobile health technologies. It allows patients to
count calories, record vital signs, record exercise, and control prescrip-
tion 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 [26–28].
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 appoint-
ments 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 technolo-
gies 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 appro-
priate consultation and diagnosis [31,32].
Virtual Reality (VR) systems have transformed communication ap-
plications 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 commu-
nication 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 pa-
tient's population. In addition, this technology can allow all patients to
remain with family and friends [33–35].
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 in-
formation, 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].
Telemedicine and other technology improve clinical and adminis-
trative 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 telemedi-
cine 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 [38–40].
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 appoint-
ment 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 post-
pone appointments at any time in case of an emergency. Data protection
is often ensured by cloud-based medical record-keeping of telemedicine
Fig. 1. Various capabilities &features of telemedicine for healthcare domain.
A. Haleem et al. Sensors International 2 (2021) 100117
3
data with patient information and captured video consultation [41–43].
There is an easy sharing of medical records with any clinician spe-
cialising 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 physi-
cians by monitoring health progress and inspecting when necessary. The
telehealth app ensures seamless patient record collection and consoli-
dation in a single location. It helps pharmacies, customers, and pre-
scribing 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 con-
nectivity and customer satisfaction [44–47].
Telemedicine solutions for Healthcare improve the quality of treat-
ment 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 man-
agement 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 treat-
ment 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 main-
taining 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 treat-
ment 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 prob-
ably portable equipment. Healthcare facilities may have extensive ser-
vices, 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 [52–54].
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 re-
cords, AI diagnosis, and medical streaming applications, can help phy-
sicians 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 em-
ployees or expanding their office rooms. However, several physicians and
patients, mostly older adults, are having difficulty adjusting to tele-
medicine [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 [57–59].
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. Pa-
tients' mismanagement is a significant source of anxiety for physicians.
Fig. 2. Work flow treatment process through telemedicine support.
A. Haleem et al. Sensors International 2 (2021) 100117
4
Although advancements in medicine have made it easier to use tech-
nology, 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 moni-
toring 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 bio-
metric 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 [62–64].
Telemedicine helps patients to exchange information over long dis-
tances 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 de-
partments 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, clini-
cians, doctors, and others must understand how to use the device to
achieve benefits. While telemedicine is initially costly, healthcare facil-
ities 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 [65–67].
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 in-
fectious illnesses do not reveal themselves to those in cramped waiting
rooms. Individuals will also book consultations during job breaks or even
after hours [68–70].
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 technol-
ogy 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. Tele-
medicine 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 ex-
changes live streams with remote specialists who can have on-screen
consultation. Telemedicine is the remote transmission of medical infor-
mation 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 prof-
itability and better time control. Parents will now stop taking their sick
child out of the house to visit a doctor [73–75].
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 tele-
medicine. 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 tele-
medicine. 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 tele-
medicine, and offer therapy sessions from anywhere [76–78].
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 tech-
nologies such as laptops and smartphones. In most cases, video confer-
encing 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 pa-
tients who insist on telemedicine as a primary care provider choice
[79–81]. It is a cost-effective and easy way to assist people with severe
Fig. 3. Frequent barriers in supporting healthcare through telemedicine.
A. Haleem et al. Sensors International 2 (2021) 100117
5
illnesses in managing their disease, being involved in their treatment,
and preventing complications from worsening. Table 1 gives the signif-
icant applications of telemedicine for Healthcare.
Various innovative technologies are used in the field of engineering.
Healthcare and their associated field [146–149]. These are helpful to
solves various problems related to design, manufacturing and to create
sustainable environment [150–152]. 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 acces-
sible. 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 pa-
tients to plan a follow-up appointment by video, improves consistency
with aftercare visit guidelines and reduces the pressure on both patients
and doctors [153–155].
Modern mobile health apps support telemedicine and bind an inter-
active 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 al-
lows 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 [156–158].
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 [159–161]. Mobile applica-
tions 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
[162–165].
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 appli-
cations are being developed to increase health outcomes, reduce costs,
and ensure that each patient receives the high-quality treatment they
deserve.
Table 1
Telemedicine applications areas for the Healthcare sector.
S
No
Applications Description References
1 Telehealth Technological advancements and
healthcare creativity have
considerably expanded their
applicability. With the
implementation of this technology in
Healthcare, clinicians, researchers,
lab staff, and doctors may also use
the concept of telehealth. It is now
time for hospital systems, medical
groups, suppliers and to incorporate
telemedicine into their medical
services. In addition, many
organisations want to collaborate
with a telemedicine provider to ease
the process and deployment.
Telemedicine is performed by using
a telemedicine device, which
includes a computer and handheld
medical equipment. Physicians also
use high-resolution imaging cameras
to give accurate diagnostic
photographs to experts.
[82–85]
2 Facilitate service to
disabled patients
Telemedicine facilitates access to
services for a patient having
disabilities. It also increases access
for other groups, such as the elderly,
the culturally isolated, and the
incarcerated. Telemedicine can aid
in the treatment of a variety of
medical conditions. It is effective
when an individual receives medical
attention from a competent provider
who gives detailed information
about their symptoms. According to
some reports, patients who use
telemedicine spend less time in the
hospital, saving money.
Additionally, less travel time could
imply lesser secondary expenditures
such as petrol.
[86–89]
3 Remote treatment Remote treatment can be done
virtually, which have been found a
successful way to keep people out of
the hospital. Patients who wish to
see a provider with highly
specialised experience of a specific
illness will do so without driving
long distances and video visits. Each
specialist's knowledge and skills can
be used to the best use. Healthcare
can be a competitive sport at times,
with primary care and specialist
physicians collaborating to ensure
the best possible health result for the
patient. Telemedicine facilitates this
by allowing all clinicians to
communicate with the patient and
each other through a safe remote
link.
[90–93]
4 Treatments of school-
going children
Telemedicine can play an essential
role in the treatment of our rapidly
ageing population. When a child
becomes ill at school, they can see a
school nurse or be picked up by their
parents and taken to an urgent care
facility and mostly inconvenient and
perhaps needless. The forward-
thinking schools can partner with
doctors to perform video tours from
the classroom. The provider may
decide what action is required and
provide parents with guidance or
reassurance. It has also been shown
[94–97]
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A. Haleem et al. Sensors International 2 (2021) 100117
6
Table 1 (continued )
S
No
Applications Description References
that having on-call doctors
accessible overnight and on
weekends will help keep patients
who live in assisted living facilities
out of the hospital.
5 Effective for disorders
not requiring lab
examination
Telemedicine is effective for any
disorder that does not necessitate
laboratory examinations or a
physical exam. This technology also
provides continuing treatment, such
as psychotherapy. During the
COVID-19 pandemic, a patient who
lives long distances away from a
primary care centre can also achieve
better treatment. The patient who is
unable to transport themselves,
providers can broaden the list of
conditions they are willing to
handle. For example, a doctor might
use telemedicine to administer
antibiotics for a possible infection.
[98–101]
6 Doctor's appointment
virtually
In this age of social distancing,
millions of people look forward to
virtual doctor appointments.
Telemedicine has improved
medication management, patient
quality of life, and reduced
healthcare costs. Telemedicine app
growth is now a key target for
healthcare providers who want to
deliver healthcare services to
patients online and remotely. This
technology creates suitable
telemedicine applications for doctors
and patients. In addition, patients
find it dependable and
straightforward when minimal
specifics are combined with a robust
authentication mechanism.
[102–105]
7 Enhance overall
healthcare system
performance
Telehealth refers to a wide variety of
technology and facilities used to
provide patient care and enhance the
overall performance of the
healthcare system. Telemedicine
encompasses a greater range of
online healthcare facilities. In
addition to healthcare care, it is
applied to remote non-clinical
services such as provider
recruitment, administrative
meetings, and continuing medical
education. Telemedicine uses mobile
messaging and assistive tools to
deliver health care to people who
cannot see a doctor physically. This
technology is also suitable for follow-
up appointments, chronic illness
treatment, expert consultation, drug
management, and various other
health resources that can be accessed
remotely through secure video and
audio connections.
[106–108]
8 Improve patient
coordination
Telemedicine has the potential to
improve patient coordination and
better healthcare services. Treatment
shortages, overuse of medical care,
inadequate drug use, and
unnecessary or overlapping care may
also result from fragmented care.
The patient can quickly pay the
nominal charges of telehealth
services. This service can be
provided to patient comfortably
which improve patient's
coordination with the doctor.
[109–111]
Table 1 (continued )
S
No
Applications Description References
Patients benefit from fewer days
away from work, fewer travel costs
or time, less overlap with the child or
elder care duties, privacy, and no
proximity to potentially infectious
patients.
9 Minimise travelling of
patients
Telehealth would drastically
decrease the amount of time
available for appointments. Patients
will no longer have to waste hours
travelling to or waiting in a hospital.
Now, they will be able to make an
appointment online and then
navigate to their meeting with the
app. Furthermore, Healthcare can be
more affordable than ever before. A
patient can be able to meet with a
doctor from the safety of their own
homes. It may also help those who
need emergency medical attention.
Doctors who can view on-demand
necessitate the use of an internal
database of built-in queries. Fast and
straightforward access can also be
provided by a variety of application
programming interfaces and
facilities.
[112–115]
10 Teledentistry This technology enhances dental
care, allowing dentists to obtain
teeth, dentures, and other dentistry
parts photographs or other related
evidence to evaluate and transfer it
to another practitioner for
examination. The critical advantage
of telemedicine in dentistry is to
exchange records among dentists
and dental specialists to decide if a
particular treatment is required.
Specialists may also assist dentists in
identifying problem areas and
recommending prevention steps to
patients to stop expensive and
complex procedures. Like other
telemedicine applications, this
partnership benefits people in
remote or underserved areas who
may not usually have access to
medical specialists.
[116–119]
11 Better service for
clinician and patient
Telemedicine provides rapid growth,
which offers many benefits to both
clinicians and patients. The
paramount need for any healthcare
provider is to have better patient
services, which telemedicine systems
will achieve while still assisting
physicians to refine and improve
their private practice. As a result,
developing medical video
conferencing applications in some
kind of medical institution is critical
in order to make better medicine.
The gap barrier is a well-known
cause in the healthcare sector using
telemedicine technology. This is due
to the seriousness of the global
shortage of skilled healthcare
providers. This shortage of doctors
can be easily fulfilled by using this
technology.
[120–123]
12 Digital health
monitoring
Telemedicine systems with digital
health monitoring capabilities,
combined with artificial intelligence
and machine learning, will provide
more accurate diagnoses and
treatment recommendations. Using
[124–126]
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A. Haleem et al. Sensors International 2 (2021) 100117
7
Telemedicine use emerging networking systems, application software
for communication &file management, advanced devices such as com-
puters and mobile devices to view and control health care facilities to
view our medical reports, appointments, order prescription refills, pay-
ment 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,
Table 1 (continued )
S
No
Applications Description References
video conferencing tools and
machine learning technologies with
the help of each patient's case will
enable refining the algorithm to
provide a better diagnosis for each
one. Telemedicine is the method of
connecting physicians in one area
with patients in another using
networking devices. Appointment,
review, and photography transcript
applications provide an alternative
to in-person sessions. It allows
doctors and patients to be safe in a
pandemic and expand the medical
services digitally.
13 Skincare Patients can communicate with their
dermatologist through telemedicine
by using a smartphone, tablet, or
computer. Dermatologists may
evaluate patients suffering from
psoriasis, bedsores, eczema, and
other conditions using high-
resolution photographs and film.
This is particularly useful for patients
who are confined to their homes.
Dermatologists can safely and
reliably identify and treat skincare
disorders using telemedicine
technologies. Furthermore, it
prevents a patient from going to a
doctor, but it also lets them keep
their integrity. Telemedicine will
help the doctor to communicate
more effectively. Any healthcare
providers have electronic patient
management services in place.
[127–130]
14 Track patient for
medication
Telemedicine technology allows
providers and other healthcare
personnel to track when and how
their patients take their medication.
Physicians will now track their
patients' welfare over long distances
using high-tech medical equipment.
This technology enables information
such as pulse rhythm, blood
pressure, glucose levels, and more by
transmitting data from one system to
another. Since older adults are more
likely to fail to take their
prescriptions, so telemedicine may
help in this regard.
[131–135]
15 Secure patient from
infectious disease
Telemedicine helps everyone live in
a safe world. For example, patients
suffering from the flu or a cold
should consult with their doctor
without taking germs into the
workplace. When providing
guidance and tracking patient
success, providers are well secured
from infectious diseases. This
encompassing solution incorporates
robust network security capabilities
as well as managed access rights
management. This can help to secure
patient information shared over
telemedicine devices. It is also a way
to reduce the number of emergency
department visits.
[136–139]
16 Cost-effective When compared to conventional
ways of healthcare administration,
telemedicine is a more cost-effective
approach. This is valid since
physicians and patients do not need
to travel each time; they need to see
a doctor or patient. In addition,
[140–142]
Table 1 (continued )
S
No
Applications Description References
video consultations are typically less
expensive than in-person
consultations, saving money on
travel and hospital setup costs.
Furthermore, making the online
booking as well as video
conferencing included in healthcare
solution saves money. This is
particularly useful in areas where
patients may find it challenging to
get to a hospital for medical care.
Another thing that telemedicine is
doing is expanding the medical
industry's frontiers. This field's
studies, science, and growth are now
made more available. With the
assistance of video conferencing
streamlines, medical students'
schooling and preparation are now
more realistic.
17 Reduce face to face
meeting
Telemedicine has several functional
applications. In certain situations,
face-to-face meetings are
unavoidable, which can be easily
sort-out by using this technology.
This offers its own set of advantages
that increase the hospital's overall
operability. On the other hand,
telemedicine allows healthcare
providers to monitor several patients
simultaneously without leaving the
hospital. There are appointments
and supervision through
telemedicine, which helps relieve
overcrowding in emergency
departments and care for patients in
more critical conditions. Hospitals
can exchange medical details for
offering care even more quickly with
the aid of telemedicine. Finally, it
provides treatment for patients who
need supervision contributes to a
reduction in overall health risk.
[143–145]
A. Haleem et al. Sensors International 2 (2021) 100117
8
hospitals can mount IoT sensors on wheelchairs, nebulisers, de-
fibrillators, 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 prob-
lems 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 meet-
ings, 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 compat-
ibility with current patient records. They can make personalised meet-
ings 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 con-
sult 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 conve-
niently. Telemedicine provides expert medical advice, diagnosis, recov-
ery 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 Health-
care and its effectiveness. It supports technologically-inspired health care
systems.
7. Limitations of telemedicine in healthcare
Telemedicine, when compared to conventional treatment ap-
proaches, 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 medica-
tion 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 symp-
tom 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, verifi-
cation 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 consulta-
tions to triage their patients, non-emergency situations are discharged
earlier. As a result, there is less emergency diversion and improved pa-
tient conditions. Several healthcare organisations are adopting tele-
medicine 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 pa-
tients 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 preven-
tion 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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