Telemedicine has been at the mainstay of patient care by offsetting the decline in
outpatient visits during the Coronavirus disease 2019 (COVID-19) while providing critical
patient continuity and limiting exposure to health systems and healthcare workers
(1). However, there are concerns that the decline in outpatient visits has not been
entirely offset by telemedicine, which may have consequences beyond the COVID-19 pandemic
(2). The current Research Topic, “Telemedicine during and beyond COVID-19,” presents
a collection of articles on telemedicine during and beyond COVID-19. The COVID-19
pandemic is causing an unprecedented public health crisis impacting healthcare systems,
healthcare workers, and communities. The COVID-19 Pandemic Health System REsilience
PROGRAM (REPROGRAM) consortium is an independent not-for-profit think-tank of international
healthcare physicians, researchers, and policymakers formed to champion the safety
of healthcare workers, policy development, and advocacy for global pandemic preparedness
and action with a focus on advocacy and building capacity in under-resourced settings
[Bhaskar et al. (a), (3)].
In addition to presenting an overview on disparities in telemedicine globally [Bhaskar
et al. (a)], and across various medical specialties [Bhaskar et al. (b)], including
teleneurology in Sub-Saharan Africa (Adebayo et al.), it also explores the current
and potential applications of technologies such as artificial intelligence and robotics
in designing futuristic telemedicine (Bhaskar, Bradley, Sakhamuri et al.). A study
by Sinha et al. report on the implementation and evaluation of a video visit program
at an academic practice in New York (USA) demonstrating promise for telemedicine in
the primary care settings during COVID-19.
During the initial phase of the pandemic, acute shortages in global medical supplies
were reported. An article in the current topic presents a model to profile critical
medical stockpiles and improve the medical supply chain through the use of technologies
such as advanced analytics and blockchain (Bhaskar, Tan et al.). Indeed, the provision
of adequate medical supplies such as personal protective equipments (PPEs) and mechanical
ventilators are warranted to mitigate the risks to healthcare workers and health systems
and build capacity for future infectious disease outbreaks. Moreover, COVID-19 disrupted
traditional medical education and training (Sharma and Bhaskar). This has led to the
integration of telemedicine into medical education and training. The telemedicine
enabled medical education system may continue beyond COVID-19 especially in providing
mental health support to medical students in general, and especially those from vulnerable
backgrounds.
On another tangent, Lehner et al. from Germany, share their experiences on an online
blog in assisting psychiatric patients, who have been rendered increasingly vulnerable
due to social isolation and loneliness due to lockdown measures, during COVID-19.
The ongoing and future mental health toll due to COVID-19 calls for increased attention,
where telepsychiatry has a potential role to play as it has been received favorably
by patients during various phases of COVID-19 lockdown (4). Merianos et al. present
perspectives on the use of telemedicine toward tobacco cessation and prevention in
rural areas during COVID-19. Seifert et al. provide key recommendations on mitigating
the digital divide in delivering telemedicine to elderly patients in long-term care
facilities, which have been severely impacted during the COVID-19. Interestingly,
given the focus on telerehabilitation, apropos to which Stasolla et al. present an
assistive-technologies based approach in supporting patients with neurological conditions
and communication difficulties. COVID-19 has adversely impacted the provision and
access of healthcare services to chronic disease patients (5), including those with
acute and chronic neurological conditions (3, 6).
In conclusion, despite the broadening scope of telemedicine and rapid roll-out during
the COVID-19, systemic issues such as organizational readiness, including digital
maturity, licensing, regulatory hurdles, reimbursements, ability to be used by all
groups, including the oldest and those with disabilities, infrastructural issues and
geographical and digital disparities in telemedicine adoption warrant urgent attention
[Bhaskar et al. (a); Bhaskar et al. (b)]. Future efforts should pivot around increasing
telemedicine access and provision to those from marginalized communities and under-resourced
settings (7). Telemedicine could play an important role in expanding the outreach
to remote areas and those from vulnerable backgrounds (8, 9), as well as to developed
and under-developed nations carrying a disproportionate burden of vulnerable communities
[Bhaskar et al. (a)]. This should be complemented with efforts to standardize telemedicine
care and/or workflows using common tools for the clinical examination which could
improve telemedicine practice and quality of care (10). The increasing use and expansion
of telemedicine are likely to persist beyond the COVID-19; therefore, building equitable
telehealth systems should be central to our preparedness and public health response
for the future, especially in the advent of a future pandemic.
Author's Note
The COVID-19 pandemic is causing an unprecedented public health crisis impacting healthcare
systems, healthcare workers, and communities. The COVID-19 Pandemic Health System
REsilience PROGRAM (REPROGRAM) consortium is formed to champion the safety of healthcare
workers, policy development, and advocacy for global pandemic preparedness and action.
Author Contributions
All authors discussed the results and recommendations and contributed to the final
manuscript.
Conflict of Interest
The authors declare that the research was conducted in the absence of any commercial
or financial relationships that could be construed as a potential conflict of interest.