Integration of Telehealth Services in the Healthcare System: With Emphasis on the Experience of Patients Living with HIV

Abstract

The US Health Resources and Services Administration defines telehealth as the use of electronic information and telecommunications technologies to support long-distance clinical healthcare, patient and professional health-related education, public health and health administration. Many studies have supported the use of telehealth to increase convenience to patients, improve patient satisfaction, diminish healthcare disparities, and reduce cost that will ultimately lead to improvement in clinical outcomes and quality of care. However, guaranteeing confidentiality, educating patients and providers, and obtaining insurance reimbursement are some of the challenges that face the implementation of telehealth program. The use of telehealth has been investigated in acute infections, such as endocarditis and chronic infections as in hepatitis C, and HIV. The purpose of this review is to focus on the use of telehealth services for people living with HIV (PLWH). For PLWH, telehealth could be particularly useful by connecting specialty providers to an underserved population and addressing many of the factors identified as barriers to HIV care. To date, the literature supports the use of telehealth for the management of chronic diseases including HIV. Most of the studies showed a high acceptability and positive experience with telehealth services among PLWH. However, fewer studies have evaluated telemedicine for chronic direct care of PLWH. Well-designed studies are needed to show that the implementation of telehealth could improve the HIV care continuum. In addition, future research should focus on identifying the group of patients that could benefit the most from such intervention.

The Impact of COVID-19 on HIV Care Provided via Telemedicine—Past, Present, and Future

“…Remote visits have several advantages beyond promoting physical distancing, including convenience; decreased travel time, expenses, or time away from work; helping individuals who fear stigma when attending clinic visits; and, importantly, helping individuals stay safe and healthy, particularly if they have risk factors for serious COVID-19 [ 8 , 30 ]. Despite this, several concerns about the use of telemedicine exist, including quality of care, privacy in the home or other living situation, reimbursement, cost, medicolegal risks, increased administrative burden, and lack of institutional support [ 31 – 33 ]. Also, both PWH and their providers worry about decreased personal connections in their relationship [ 11 ].…”

It is Time to Include Telehealth in Our Measure of Patient Retention in HIV Care

“…In past studies on telehealth, providers were concerned about not being able to do a physical exam, longer visit times, and inability to connect with the patient [7,8]. While switching to telehealth during the COVID-19 pandemic has required a steep mental shift, most of our providers have found telehealth an acceptable alternative and easy to use.…”

Exploring the Attitude of Patients with HIV About Using Telehealth for HIV Care

“…In the future implementation of telehealth, it will be very important to develop criteria to identify what type of telehealth interventions would be used (live video replacing faceto-face clinic, store and forward, teleconsultation, mobile health), the specific services that would be provided, the sites where telehealth would be implemented, and the most important, to establish patient selection and exclusion criteria to receive care through telehealth. 30 Several factors should be included in the patient selection process, including patient's attitude toward telehealth, patient's access and ability to handle the technology, patient's disease status, and prior relationship with the provider. 31 Our study is limited to a single center, so our results may not generalize to the general population.…”