The outbreak of the novel coronavirus in early 2020 presented a stable of unique challenges to the global healthcare system, among them a sudden spike in demand for healthcare providers to work online via telecoms networks. Even prior to the outbreak healthcare over the Internet had to solve several issues. Today, healthcare communications are safer and more expedient than ever, but these challenges had to be addressed before that point could be reached.
The first concern is the increased risks to patient confidentiality when you aren’t strictly working within an office setting. Network security is a separate issue; the mere usage of Telehealth resources presents a privacy concern for more mundane reasons. For example, how does a counselor safely work with a minor who may be home alone with an abusive parent? The need for privacy in this situation is paramount, but without the ability to use the office as a safe space for the minor to share their concerns, the quality of care and the safety of the patient are both in jeopardy. In general, remote care presented HIPAA concerns that had to be tackled to ensure the safety and privacy of patients. In this specific case, a secure text chat might be used instead to avoid snooping and retaliation from the parent. For every remote healthcare scenario, steps have to be taken to ensure that patient privacy is protected, but across the board, facilitators have stepped up with creative solutions.
Network security, while not the exclusive reason for privacy concerns, is certainly still an issue when pursuing health objectives over the Internet. Zoom, for instance, ran into many high-profile security issues as its usage volume increased dramatically following the enactment of stay-at-home and shelter-in-place orders across the United States. Zoom is of course not a typical facilitator of remote healthcare for that exact reason, but its example is illustrative in that its vulnerabilities remained low profile until its usage volume increased. The same can be presumed to be true for healthcare telecoms services–as the volume of users increases, so does the reward for bad actors attempting to break into such systems. This, in turn, motivated the adoption of new security protocols to ensure the personal information of patients could be protected, and usage of healthcare communications channels is generally protected by additional layers of security above and beyond the standard for personal or enterprise communications.
In many cases, one of the largest obstacles to patient recovery is the patient themselves. Many care interventions require the patient to make lifestyle changes, even if they’re as simple as taking medications daily. Even the most well-meaning patients can have problems changing their daily routines; old habits die hard, after all. In cases where the patient may be incentivized to conceal behavior from the provider, such as chemical recovery, healthcare providers are at a disadvantage when their only contact with the patient is remote. Compliance with care directives is a constant headache in any healthcare profession, and when care must be done remotely, the provider’s ability to assess compliance is affected. Happily, this is one area where modern technology can also be enormously helpful. Patients can use phone apps and remote check-ins to set reminders to take prescriptions or follow daily instructions as well as report back to their provider with their progress.
None of this should be taken as a warning against the use of telecoms resources to connect providers with patients. The benefits of having such options available clearly outweigh these risks. That said, it is worth understanding the challenges posed by remote care to ensure patient privacy and safety moving forward into the post-COVID-19 era.