While it might have seemed futuristic just a few years ago, telehealth and virtual care are now commonly accepted parts of the healthcare landscape.
In 2020, most medical centers began offering some version of remote healthcare to minimize the spread of COVID-19. Now, with the pandemic receding, many still offer those services.
Virtual healthcare is also opening up new ways to assist those impacted by disasters and conflicts.
In a first-of-its-kind development, Israeli doctors are helping Ukrainians injured or displaced by war –– from 2000 km away in Ramat Gan.
Here’s a closer look at how virtual hospitals and telemedicine make healthcare more accessible, efficient, and patient-focused.
Research from the private think tank McKinsey & Co. finds that telehealth usage has increased 38 fold compared to its pre-pandemic levels.¹
Telehealth, also known as telemedicine, combines the words telecommunication and health. Essentially, the term refers to long-distance healthcare. Telecommunication means communicating electronically — like by phone or video — to bridge a physical distance. Virtual care is a similar term but a bit broader.
It describes the many digital ways healthcare professionals and patients communicate with each other in real-time — by instant messaging, video, audio, or telemedicine apps. For many individuals who live rurally, are less mobile, or serve as caregivers, telehealth is already a crucial component of maintaining adequate access to medical care.
According to the American Hospital Association (AHA), 76% of US hospitals were already connecting patients to physicians remotely, but now, COVID-19 has accelerated remote healthcare even further.²
In a February 2021 interview with PWC Australia, Professor George Braitberg AM, Executive Director of Strategy Quality and Improvement at Australia’s Royal Melbourne Hospital, also described a considerable leap in telehealth usage: “[Pre-pandemic] only 20% of our outpatient visits were being done by telehealth, either by telephone or some form of telehealth platform. During COVID-19, that number rose to 85%,” said Braitberg.³
Economically speaking, McKinsey & Co. predicts that telehealth represents a quarter-trillion-dollar market opportunity.¹
While telehealth has become a vital tool during the pandemic, the war in Ukraine and the need for medical relief show just how indispensable it is.
Following Russia's invasion of Ukraine on February 24th, 2022, and the displacement of hundreds of thousands of Ukrainians, Sheba Medical Center in Israel has made a groundbreaking move.
The internationally recognized healthcare facility offers telehealth services and a virtual hospital — known as Sheba Beyond — to care for those injured or displaced by the war.
According to Sheba Beyond's blog, their chief technology officer, Sarit Lerner, flew to nearby Moldova (where 15,000 refugees had fled) with a group of 15 doctors and paramedics from United Hatzalah.
While known for attending emergencies within Israel, this is not United Hatzalah’s first time sending emergency teams abroad.
For example, in June 2021, they provided aid at the tragic condo complex collapse in Surfside, Florida.
Still, offering telemedicine to war refugees in this way is unprecedented.
Their volunteers provide on-the-ground care, alongside physical examinations, prenatal ultrasounds, health vitals monitoring, and blood sample analysis, all through Sheba hospital in Israel, 2,000 km away.
Through the latest technology used by the small local team, doctors based in Israel can offer advice and support as if they were physically there.
Without the right technology, the virtual hospital wouldn't be possible, and several leading technologies developed in Israel are playing a critical role.
Handheld devices, video-enabled technology, and real-time monitors are all used to send healthcare information to doctors back in Israel.
TytoCare donated 50 units of their on-demand device to Ukrainian villages via UNICEF to help physicians with remote assessments.⁴
Their device allows on-demand checkups for the lungs, heart, throat, ears, and abdomen. It can also assess blood oxygen level, body temperature, and pulse rate — all of which can be conveyed back to remote doctors.
A device called i-STAT from Bibeat Medical Technologies monitors vital signs. It's a handheld blood analyzer that allows the on-the-ground team to perform blood chemistry analysis.
The data syncs with a physician's dashboard in Israel for real-time monitoring and care.⁵
There is also specialized care for those who are pregnant. For example, a technology from Pulsenmore takes prenatal ultrasound images, which OBGYNs in Israel can then analyze.⁶ care is one-of-a-kind:
“This is the first time I know that a humanitarian mission is adding extraordinary value to the local first responders there. Sarit [Lerner] took with her the technology that brings all of Sheba’s excellent clinicians and specialists to the war zone,” Dr. Barkai recently told digital magazine ISRAEL21c.⁷
Dr. Barkai also noted the COVID-19 pandemic’s role in advancing remote healthcare delivery:
“Most of our experience began during the first wave of COVID-19 and by now we have seen what works well and what works less well...That’s when we decided the time is right to really establish a new organization to bring Sheba’s medical expertise anywhere in the world,” she explained.
What’s happening with Israel’s virtual hospital for Ukrainian refugees illustrates the critical need for technologies that allow specialists to enter war zones without physically being there.
Virtual care requires many technologies, particularly the Internet of Things, wearable tech, artificial intelligence (AI), and mobile devices.
Virtual hospitals use software and technology to monitor patients’ health 24/7. Therefore, a highly connected ecosystem is necessary. The Internet of Things (IoT) creates this ecosystem.
IoT refers to devices equipped with sensors, processing ability, software, and other technologies that connect and exchange data with other devices and systems over the internet.
In a virtual hospital, high-definition video, two-way communication devices, microphones, and other connected technologies facilitate interactions between patients, in-person health care providers, and doctors and nurses located in a remote, central hub.
IoT technology helps to do everything from consulting with patients to managing intensive care units and providing real-time care.
A plethora of wearable fitness and medical devices are available to consumers today. For example, many bracelets and wristwatch devices monitor heart rate, daily activity levels, sleep hygiene, and more.
According to market research from Insider Intelligence, the uptake of these devices is substantial—more than 80% of consumers are willing to wear fitness technology.⁸
Even more advanced devices are available for monitoring vitals like glucose levels, blood coagulation, pulse, blood oxygen, blood pressure, and even mental state.⁹
Artificial Intelligence (AI) is premised on programming computers to complete tasks more efficiently and accurately than if a human completed them.
Thanks to AI's ability to process large amounts of data quickly, doctors have an increased ability to make informed diagnoses, provide relevant treatment options, and make critical decisions.¹⁰
AI also has a significant impact on the early and accurate detection of disease.
According to the American Cancer Society, a high proportion of mammograms lead to false-positive results — in which the mammogram appears abnormal, but there is no cancer.¹¹
AI can help solve this issue by reviewing and translating mammograms 30 times faster (with 99% accuracy) reducing the need for unnecessary biopsies.¹²
The telehealth ecosystem also includes large networks of mobile devices, including tablets, laptops, and cell phones, that can transfer data, display a dashboard, connect to wearables and other devices, and allow patients and doctors to connect via video and voice.
For example, with the help of a tablet, a specialist can appear at the bedside of multiple patients in a virtual hospital without ever physically being there. Bluetooth connectivity enables them to check blood pressure, pulse, and more.¹³
While Sheba Beyond appears to be the first of its kind, virtual hospitals are nothing new, though still uncommon. Since the early 2000s, several virtual hospitals have opened across the US, Europe, the Middle East, and Asia.¹⁴
St. Louis, Mercy Virtual Care Center aims to provide faster care to patients while reducing hospital visits.¹⁵
In Mumbai, India, Medico Experts offer virtual second opinions before patients make critical decisions.¹⁶
Another virtual hospital was piloted in Australia to help treat COVID patients, and it may eventually be available nationwide.¹⁷
Virtual hospitals and telemedicine are not without their limitations.
While many patients are open to using virtual health care, some are uncomfortable with the idea. Still, the benefits likely outweigh the limitations.
A recent survey in Australia showed that almost 50% of people would never visit a virtual hospital, believing they wouldn’t receive the same level of care as in-person.¹⁸
However, 20.13% of the same survey participants indicated that they would use virtual services to reduce their health care costs.¹⁸
In-person consultations will still be necessary for some forms of care, such as surgical procedures or treatment of severe injuries.
The cochair of the Canadian Medical Association (CMA)’s a virtual care task force, Dr. Ewan Affleck, also notes that medical licensing bodies aren’t evaluating clinicians’ judgment in virtual care in Canada.
“[T]here’s not a systematic approach to the integration of virtual care into the curriculum of most medical schools in Canada,” explains Affleck.
A key element of telehealth is remote patient monitoring (RPM). RPM involves real-time monitoring of vital signs, such as:
Blood glucose level
Monitoring can happen either continuously or periodically via a remote dashboard that delivers alerts to nurses or specialists when a medical issue arises.¹⁹
Early evidence suggests that both physicians and patients feel optimistic about RPM.
A market researcher survey by Savanta MSI found that four out of five respondents support RPM, and roughly half wanted the service integrated with clinical care.²⁰
65–70% of participants also said they would be willing to participate in an RPM program with their care providers.
In 2016, 7 million patients in the US monitored their health via remote technology.²¹ By 2025, that number is expected to reach 70 million.²²
RPM comes with many benefits, namely ensuring that patients receive care when they need it. Additionally, patients gain peace of mind knowing that their vital signs are monitored.
RPM can also help to:
Reduce unnecessary doctor or ER visits
Lower travel costs for patients
Improve disease management
St. Luke's Boise Medical Center in Idaho has had notable success with RPM and uses it with their discharged COVID-19 patients.
Dr. Eric Rich, a pulmonary and critical care physician at St. Lukes, elaborates, "When patients are on RPM, they perform daily scheduled health sessions via a tablet and medical-grade peripheral devices that obtain vital signs.”²³
Once released, patients also respond to daily questions about their health and send responses back to specialists at the virtual care center.
The COVID-19 pandemic significantly accelerated the growth of telehealth and virtual care, and there is little expectation of a slowdown. One of the most extraordinary uses of virtual care thus far is the creation of Sheba Beyond, which applies the latest technology to provide remote essential care to Ukrainian war refugees. In addition to virtual care’s humanitarian potential, experts project that the telehealth sector could be worth a quarter of a trillion dollars.
While many patients and practitioners are open to using virtual services, there is still some hesitancy. However, RPM has high adoption rates and proves its ability to reduce hospital visits and allow patients to take control of their health. Adopting virtual care within hospitals — both on the practitioner and patient side — is needed to take full advantage of the potential benefits, including improved health outcomes, streamlined service, and increased user accessibility.
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Telehealth: A quarter-trillion-dollar post-COVID-19 reality? | McKinsey & Company
Fact sheet: Telehealth | American Hospital Association
i-STAT 1 | Abbott
Latest trends in medical monitoring devices and wearable health technology | Insider Intelligence
Limitations of mammograms | American Cancer Society
Virtual hospitals – The future of healthcare | Engineers Garage
Global snapshot: Virtual hospitals | Care Monitor
World's first facility dedicated to telehealth | Mercy Virtual
Australia's first virtual hospital rolls out for COVID-19 patients | The Sydney Morning Herald
Telehealth: Bringing medical care right into your home | Open Colleges
Remote patient monitoring: Why everyone wins | Dr. Kumo
Remote patient monitoring market grew by 44 percent in 2016, report says | Mobile Health News
The author, Chloe Garnham is a writer exploring a broad range of topics, including healthcare, education, and technology.
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