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Telemedicine in Differing Careers

Morgan Hensch

Honors English

Mrs. Schlichtemeier

February 28, 2025

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In 2020, the COVID-19 pandemic disrupted medical care while insisting on safe

social distancing measures in hospitals and clinics. Telemedicine had been

underutilized and was not given much consideration before the pandemic.

When the pandemic arrived, there was a change towards a more home-like

model. However, with medical systems desperate to find ways to continue

patient care with few face-to-face visits, telemedicine quickly became an

essential tool. Telemedicine expanded from traditional medical consultations

to include other services such as mental health counseling and physical

therapy. Telemedicine allows for numerous diverse elements of care, such as

taking measurements, virtual consultations, information sharing, receiving text

and email reminders, and remote monitoring.

Despite all its success, telemedicine does have challenges. When issues like

technical problems are relatively easy to fix, more complex obstacles, such as

language barriers for those who are non-English speakers, are harder to

improve. Still, over the past few years, telehealth has evolved into a valuable

resource, providing widespread access to healthcare and benefiting a wide

range of patients.

Telemedicine, by a definition given by Dillon, M., et al,. is “the delivery of

healthcare where the patients and healthcare professionals are remote from

one another” ( Dillon 2024). The communication can be performed on various

platforms, such as email, text, phone calls, voicemail, or video chat. It has

become popular due to its convenience and accessibility. Telemedicine is

especially helpful to those who do not require a visit but still require medical

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care. Telemedicine is more convenient and effective in receiving care, making it

a valuable alternative to many. Telemedicine makes possible the diagnosis,

treatment, and management of diseases without requiring the patient to

physically appear in a health facility. The abilities listed by Dillon, M., et al. in

the article “ Exploration of the barriers and facilitators influencing the use of

telehealth for orthotic/prosthetic services in the United States of America”, are

for the remote configuration of prosthetics, clinical specialists, healthcare

during COVID-19, timely convenience, low no-show rate, and the ability to see a

home environment.

As reported by Watson, in association with Harvard Health Watch, 76 percent of

hospitals currently provide remote links between physicians and patients

through telehealth, up from only 35 percent a decade ago. Telemedicine traces

its origins back to the 1970s when it was known as “healing at a distance”. The

initial communication technologies, including the telegraph and the telephone,

played a crucial role in the development of telemedicine. These technologies

were initially used to transmit signals or alert individuals of potential outbreaks

of infectious diseases. Telehealth has continued to increase and is still

expanding its functionality.

In telemedicine, there are various ways through which patients can

communicate with healthcare professionals based on their medical

requirements. Telehealth services are divided into four major categories, each

focusing on various types of care needed. The first one is Real-Time

Consultations, where a patient and a healthcare professional engage in live

video or telephone conversation. Such live interaction allows for real-time

assessment and counseling, which is the benefit of being able to allow the

patient to ask follow-up questions during the consultation. Additionally, video

calls provide healthcare providers with a clearer understanding of the patient's

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home environment, which may help identify potential adjustments to living

space that could improve the patient's overall health and well-being.

Store-and-forward is a type of telehealth where patients send medical data,

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such as images, test results or patient records to their healthcare provider for

later review and analysis. The healthcare provider then contacts the patient,

typically by phone and sometimes email, to discuss the results or findings from

the data and create a plan. This type of telemedicine is very popular for

specialties like dermatology and radiology, where there isn't necessarily a

requirement for real-time interaction between the healthcare provider and the

patient. Instead, the focus here is on reviewing lab results or images to develop

an appropriate diagnosis or treatment plan.

One type of telemedicine, known as Remote Monitoring, is the utilization of

equipment to check vital signs or chronic conditions, such as heart rate, blood

sugar, and blood pressure. These devices collect patient data remotely, allowing

healthcare providers to monitor the patient's health and ensure that the key

metrics remain within the desired range for the patient. This method enables

the provider to continuously track the data and make timely adjustments to

treatment plans or medications as needed to better manage the patients'

conditions. This category specifically targets individuals with heart monitors

and diabetics, allowing both the patient and healthcare providers to monitor

the numbers on a day-to-day basis.

The final telemedicine category is Mobile Health (mHealth), smartphones, apps,

or wearable devices that track health metrics, send reminders for tasks such as

taking medication or changing ports, and enable communication between

patients and healthcare providers when necessary. This method combines

elements of Real-Time Consultation and Remote Monitoring. The category

mHealth allows patients to communicate with their healthcare provider in real

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2
time while also giving providers access to the patient's health data to send

reminders or make adjustments to treatment plans based on the tracked

metrics.

The difficulty of implementing telemedicine varies significantly across different

medical fields. For example, mental health treatments are often simpler to

transition to telemedicine, as many therapy sessions have already shifted to

video calls, making the process more convenient for the patients. This online

format allows individuals to participate in therapy sessions from the comfort

and privacy of their own homes, which can be especially beneficial when

discussing sensitive or difficult topics. Additionally, having sessions via video

call helps maintain privacy, as patients are not required to go to a therapy office

where others may see them.

Looking back at the time of the Coronavirus, organizations for healthcare

around the world made the transition to telehealth to continue helping

patients. With an event as life-changing as the pandemic, there was an uprising

in people with anxiety, depression, and other stress-related mental health

issues. “In 2021, the CDC published results of the Household Pulse Survey, a

self-report online survey, which showed that the percentage of adults who

reported experiencing symptoms related to depression and anxiety disorders

increased from 36.4% to 41.5% between August 2020 and February 2021.”

(Bulkes 2021). According to the same article, mental health workers had been

exploring remote sessions for over six decades before the pandemic.

Researched by the workers at the National Library of Medicine, they concluded

that the effectiveness of therapy sessions was not based on in-person care or

treatment via telehealth, coming to this conclusion by looking at admission and

termination scores.

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Speech-language pathology has also seen success with telehealth, as the

nature of the profession primarily involves speaking and is less physically

interactive. This makes it easier for patients and therapists to achieve positive

outcomes through online sessions. However, some therapists have noted

challenges when it comes to school-based speech therapy, where in-person

interactions may be necessary.

During an interview with a school language-speech pathologist, Claire Boudro

(2025 March 19), she shared her experience with telehealth during COVID-19,

where she conducted therapy sessions via Microsoft Teams. While telehealth is

no longer a frequent part of her practice, she continues to provide virtual

sessions for students in alternative placements, such as private or alternative

schools. She expressed that as a speech pathologist, telehealth presents

unique challenges, particularly when working with students focusing on

articulation ( speech sounds) and social skills.

Boudro believes face-to-face interactions are the most effective way to work on

these skills as they allow for more direct engagement. However, telehealth

requires a great deal of flexibility and creativity. To adapt to this aspect, she has

incorporated online games like Blooket and Kahoot to help reinforce skill

development. A significant drawback, she noted, is the tendency for students to

become distracted by their environment or to face issues with poor internet

access. Additionally, conducting assessments online is not available, which

poses another limitation to telehealth services. Despite these challenges, she

recognizes that telehealth can be a valuable tool for students who are unable to

attend school due to health problems or other alternative placements,

providing an essential service in those circumstances.

In fields like radiology and dermatology, telehealth has been more widely

implemented, particularly through the “store-and-forward” model. In this

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approach, patients can send in images or lab results and receive feedback from

their providers via phone, email, or text, eliminating the need for an in-person

visit. While patients still need to visit a clinic for initial tests and imaging,

consultation and treatment planning can often be handled remotely through

telehealth once the necessary photos and lab results are submitted.

On the downside, telehealth has proven less effective for more physically-

based therapies, particularly in fields like occupational therapy and physical

therapy. These types of therapy often require a high level of interaction between

the patient and therapist, with hands-on assistance being crucial for both the

patient's progress and safety. For telehealth sessions, a caregiver or family

member would need to be present at the home to assist the patient with tasks,

which can limit the overall effectiveness and success of the therapy session.

In physical therapy, telehealth faces additional challenges due to the need for

specialized equipment. Many therapy sessions rely on specific tools and

exercise equipment, which are often unavailable at home. Without access to

these resources, the patient's progress may be hindered, making it harder to

achieve the desired outcome through remote sessions.

Telehealth physical therapy offers several compelling benefits, particularly in

providing personalized care and enhancing patient outcomes. Based on

information from ChoosePT, one of the key advantages is the ability to connect

with a physical therapist who has experience working with patients facing

similar challenges, even if those specialists are not nearby. For older adults or

individuals at risk of falling in their homes, virtual visits with a physical

therapist can help assess and improve home safety. The therapist can offer

specific strategies for preventing falls and guide how to handle a situation if a

fall were to occur.

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Another significant benefit is the ability to have more focused, one-on-one

sessions. Unlike in a clinic, where a therapist may be managing multiple

patients at once, telehealth physical therapy offers an undistracted and

personal connection. This also allows caregivers or family members to be

present during the session, ensuring they are informed about the patient's

progress and what exercises or techniques need to be emphasized. Finally,

telehealth physical therapy boasts high success rates. Patients often show

more consistency in their exercises because they are doing them in the comfort

of their own homes, where they are already familiar with the environment. This

familiarity can accelerate progress, leading to quicker improvements and better

overall outcomes.

While the benefits of telehealth are significant and positively impact many

people, some challenges prevent it from being accessible to everyone. One key

issue is that non-English speakers may struggle to connect effectively with

healthcare providers, which can lead to communication barriers and hinder the

quality of care. Additionally, telehealth relies heavily on technology, and

technical issues such as poor internet connection, incompatible devices, or

software glitches can create a range of problems that disrupt the delivery of

care.

Technology issues are a significant challenge in telehealth, affecting both

patients and healthcare providers. For patients, one of the most common

barriers is access to the necessary technology. Many individuals lack reliable

internet, access to devices such as phones and computers, or the technical

skills necessary to navigate telehealth platforms. This divide can lead to

unequal access to healthcare, particularly for low-income or rural populations.

Even when the necessary technology is available, other issues can arise during

the consultation. Poor video or audio quality, connection drops, and lag can all

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disrupt communications between the patient and the provider, making it

challenging to accurately assess the patient's wants and needs with their

medical care.

For healthcare providers, managing various telehealth platforms can also be

challenging. The platforms used must meet strict security standards, which can

sometimes limit access to records and complicate the efforts to maintain

patient confidentiality. Additionally, technical glitches can cause frustration for

both providers and patients, potentially leading to appointment delays,

rescheduling, or the need for in-person visits.

Telehealth visits with non-English speakers often come with significant

3
challenges. According to numerous authors with Cancer Medicine on an article,

Associations between language, telehealth, and clinical… “ language barriers

have emerged as a potential obstacle to effective telemedicine engagement.”(

Azizi 2024). Language differences can make it difficult for patients to

understand medical terminology, accurately advocate for their symptoms, and

follow treatment plans. These barriers can lead to misunderstandings and the

misinterpretation of important healthcare information, ultimately threatening

the quality of care. “Limiting English proficiency is a growing challenge within

the clinical settings in the United States, affecting an estimated 2.5 million

patients, leading to poor patient outcomes, increased rates of hospital stays

4
and hospital mortalities”(Azizi 2024).

Furthermore, telehealth providers do not always offer translation or

interpretation services. When translation services are available, they may be

limited or not fully meet the standards, making communication even more

difficult. Without a translator or support from someone familiar with the

language, the quality of care can suffer due to a lack of meaningful interaction

and effective communication. Another challenge that may come up with non-

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English speakers is technology issues when dealing with medical terminology

and an unfamiliar platform. This can further complicate the ability to navigate

telehealth services and participate fully in their healthcare. Research by many

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authors with Cancer Medicine, “non-English speakers have a lower telehealth

utilization with English speakers using telehealth at 62% and non-English

speakers at 56%” (Azizi 2024).

Telehealth in a school environment can be challenging for many reasons. One of

the major concerns is privacy. In a school, it is difficult to maintain complete

privacy during therapy sessions, especially when a student is called out of

class and may be in a room with windows or a public area. Effective

communication is also a concern, as it requires coordination between the

student, school staff, healthcare provider, and parents. This is very challenging

for the younger students who may require additional assistance with tasks and

understanding instructions, making it harder to ensure they get the most out of

their sessions when parents are not present. Technology factors can also return

in the school setting, without reliable internet access, or when the kid does not

have access to a device to participate in telehealth. Telehealth in school also

calls for the heavy reliance of the school staff to coordinate with healthcare

providers.

Additionally, speech, physical, occupational, and mental therapy often require

hands-on actions by the medical professional. Remote sessions can limit the

effectiveness of these therapies, making it harder to monitor progress and

provide the necessary support to the student.

On the contrary, the benefits of telehealth can far outweigh the negatives.

Offering telehealth provides individuals in remote or underserved communities

with access to healthcare services that might otherwise be unavailable. It also

offers significant convenience, allowing patients to receive care from the

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comfort of their own homes, which saves time and eliminates the need for

travel. This is particularly helpful for individuals with mobility challenges. One

of the most notable advantages of teleservices is the increased efficiency it

offers. Virtual consultations streamline the healthcare process by reducing

wait times and enabling faster follow-ups and ongoing care.

Using video calls in telemedicine enables healthcare professionals to gain

valuable insights into a patient's living conditions, such as identifying potential

hazards related to their health issues or areas where changes could be made to

help the patient succeed. This use of teleservices has been reflected most in

occupational therapy, where therapists assess ways to minimize risks in the

home and evaluate how patients navigate their daily routines within their

households.

Telemedicine would be extremely effective in the event of another crisis, such

as a pandemic similar to COVID-19. Telehealth enables consultations and

services to continue without the need for in-person visits, even when

precautionary measures like quarantine and social distancing are in place. This

allows patients to maintain access to necessary healthcare without postponing

their needs during a time of crisis.

A significant benefit of telehealth during a pandemic is the reduction in the

spread of infection, especially in crowded settings like hospitals and clinics.

Virtual consultations allow patients to receive care from the safety of their

homes, minimizing the risk of exposure to the virus from unnecessary visits to

facilities. Additionally, individuals at higher risk of contracting the infection can

still receive care for health concerns without increasing their chances of

infection.

In an interview with Cecilia Kozeny (2025 March 19), an occupational therapist

with Hillcrest and a former OT at Elkhorn Public School, shared her experiences

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using telehealth during the COVID-19 pandemic. She explained, “ It's very hard

to utilize telehealth with occupational therapy because you have to manipulate

people's hands so they can grab certain items correctly. It's extremely difficult

to execute electronically when the hands-on interactions are not possible.” One

challenge she encountered when working with children was their short

attention span. To keep them engaged during therapy, Cecilia would wear

different hats or fun t-shirts. Telehealth sessions also required parents or

caregivers to be present, which added another layer of complexity. However,

she acknowledged the flexibility telehealth provided, as it allowed families to

attend appointments without leaving their homes. Despite these advantages,

Cecilia concluded, “Overall, I do not like the results of occupational therapy

through telehealth.”

Telehealth has emerged to be a transforming tool across various career fields

including physical therapy, occupational therapy, mental health counseling,

speech-language pathology, radiology, dermatology, and many others.

Telehealth offers improved accessibility, convenience, and personalized care.

This strategy bridges gaps between patients and providers, particularly in areas

with limited access to healthcare professionals. Telemedicine enhances

communication and allows for more flexibility with patient-centered care. As

technology continues to evolve, telehealth will advance further, addressing

current challenges such as technological issues and physical limitations.

Solutions to these drawbacks are expected to improve, ensuring that telehealth

remains a key component of the future of healthcare.

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References

Angell, A., et al. (2024) “This Is Going To Be Different, But It’s Not Impossible”:

Adapting To Telehealth Occupational Therapy For Autistic Children.

International Journal of Telerehabilitation, DOI:10.5195/ijt.2024.6608. Accessed

17 February 2025.

Azizi, A.et al. (2024 Sept.) Associations between language, telehealth, and

clinical outcomes in patients with cancer during the COVID‐19 pandemic. John

Wiley & Sons, Inc, DOI:10.1002/cam4.70099. Accessed 16 February 2025.

6
Bulkes, N. Et al. (2021, November 3) Comparing efficacy of telehealth to in-

person mental health care in intensive-treatment-seeking adults. National

Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC8595951/

7
Crawford, C. (2024, February 8). 6 Reasons Why to Consider Telehealth Physcial

Therapy. Choose PT.

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https://www.choosept.com/health-tips/6-reasons-telehealth-physical-

therapy#:~:text=Telehealth%20can%20help%

Dillon, M., et al.. (2024 Oct.) Exploration of the barriers and facilitators

influencing the use of telehealth for orthotic/prosthetic services in the United

8
States of America: An orthotist/prosthetist perspective. Public Library Of

Science, DOI:10.1371/journal.pone.0309194. Accessed 16 February 2025.

Gajarawala, S. Pelkowski, J. (2020, October 21). Telehealth Benefits and Barriers.

National Library of Medicine.

https://pmc.ncbi.nlm.nih.gov/articles/PMC7577680/

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Gali, C. (2022, February 8). History of Telemedicine. Curogram.

https://blog.curogram.com/history-of-telemedicine

Rortvedt, D. (2018) Perspectives on the Use of a Telehealth Service-Delivery

Model as a Component of School-Based Occupational Therapy Practice:

Designing a "User Experience". Boston University ProQuest Dissertations &

Theses, DOI:10933612. Accessed 16 February 2025.

Swamy, V., et al. (2024 May) Home-Based Telemedicine in Rheumatology—A

Scoping Review. John Wiley & Sons, Inc, DOI:10.1002/acr2.11660. Accessed 16

February 2025.

Watson, S. (2020, October 12). Telehealth: The advantages and disadvantages.

Harvard Health Publishing.https://www.health.harvard.edu/staying-

healthy/telehealth-the-advantages-and-disadvantages

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1. , or Comma misuse within clauses Correctness

2. real time → real-time Misspelled words Correctness

3. on → in Wrong or missing prepositions Correctness

4. , and Comma misuse within clauses Correctness

5. with → on Wrong or missing prepositions Correctness

6. the efficacy Determiner use (a/an/the/this, etc.) Correctness

7. Physcial → Physical Misspelled words Correctness

8. orthotist Unknown words Correctness

9. Curogram → Program Misspelled words Correctness

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