Inspirational Advocacy | Telemedicine and e-Health

There are so many things in our world that are inspirational, a stunning sunrise or sunset, a victory in a sporting event, a perfect score on an examination, or a child’s smile; the list is endless. In telemedicine and telehealth, we are inspired by those early pioneers in our field—many of you and the recipients of care through telemedicine and telehealth. In our training, be it graduate school, professional school (allied health, medicine, nursing, and law), or a trade, we are inspired in some way by our mentors, those with a little more treadwear on them. Throughout our training, our parents, our friends, our leaders, our teachers, and our colleagues are our advocates. They inspire us with their knowledge and experiences, which embolden us to adapt, try new approaches, and change the trajectory.

This is the season of graduation; all kind of students have achieved some degree of education and are now ready to enter the workforce. Even with graduation, training will continue. Those of us, long past our graduation dates, continue as lifelong learners. Yet we remain inspired by those who are coming behind us. They are hungry for continued learning and to making their way in the world.

This past month, many of us gathered in Boston for the annual American Telemedicine Association (ATA) conference and symposium. Although I personally did not stay for the entire time, the one event that struck me as inspirational was the ATA Leadership Dinner. At this dinner, the room was full of expertise and knowledge of our craft. It was a gathering several years in the making due to the pandemic. I was inspired by the conversations and the sense that we have accomplished so much in this field.

Practitioners of telemedicine and telehealth are not relegated to the sidelines any longer. We are front and center.¹ Applying the lessons learned and integrating new techniques and technologies, we have inspired a whole new approach to care and access to it. We have used, and will continue to use, telemedicine and telehealth as a tool to advocate for our patients, our communities, and our health care delivery system. In Greenhalgh and Abimbola, they use the “Non-adoption, Abandonment, Scaleup, Spread, and Sustainability (NASSS)” framework.²

This framework has seven domains: “(1) the illness or condition, (2) the technology, (3) the value proposition, (4) the individuals intended to adopt the technology, (5) the organisation(s) and (6) the wider system—along with a seventh domain that considers how all these evolve over time.” This framework can help individuals and organizations can reduce complexities or address them more cogently. Ruiz Morilla et al. study the insights of physicians on implementing technology, including telemedicine in health care. Of the 930 physicians who were invited to respond to a cross-sectional survey, 760 (86%) responded in the affirmative as to the utility of telemedicine.³

The point here is that although we can be inspired, we must be vigilant on what can be done and what makes sense. For instance, we can and in some cases have introduced avatars and robotics to assist us in our diagnosis and treatment of patients. Although inspiring, is it in fact a good thing—a fait accompli? Hamet and Tremblay commented on the society and complexities of these approaches and the need for further reflection.⁴ Although much of this was science fiction a generation or two ago, it is commonplace today. Patients may, in fact, expect the rapid integration of technology. We are in a fundamental paradigm shift, where the old guard is transitioning out and the new is transitioning in.

We are better prepared and more informed than our parents and grandparents. We are inspired by the capabilities of technology and are much better advocates for health because of the technology.

What Is in This Issue

This issue continues to showcase a variety of submissions on COVID-19 (seven total), including one from Germany. This issue also includes submissions from France, Russia, Thailand, and Turkey, with the rest coming from around the United States. Each brings lessons learned on a variety of clinical conditions and technical approaches. Please enjoy these additions to the literature. They should be inspiring to you as you continue your work in advocating for yourself, your patients, and your clients.

Stay safe during this long recovery from the pandemic!