The History And Growth of Telemedicine

Although remote healthcare services may appear like a recent trend, the practice of telemedicine dates back well over a century. The history of telemedicine and telehealth closely follows the history and evolution of communication and information technologies.

As health is a primary concern, it shouldn’t come as a surprise that medical professionals quickly recognized the potential of newly emerging technologies and sought to leverage them to facilitate the delivery of healthcare services.

Let’s take a closer look at the history of telemedicine or telehealth and answer a few questions.

  • When did telemedicine begin?
  • How has the delivery of remote healthcare changed throughout the years?
  • What is the current state of telemedicine and telehealth?

Since telemedicine is synonymous with remote care delivery, it is a more familiar term among healthcare providers. However, telehealth is gaining more popularity today as it appropriately describes the latest digital health trends to deliver health services to patients.

Telemedicine/Telehealth

Because telemedicine continues to evolve, the distinction between telemedicine and telehealth is becoming less and less defined. In fact, the American Telemedicine Association (ATA) treats “telemedicine” and “telehealth” as interchangeable terms. After all, both telemedicine and telehealth provide patients and providers with the ability to participate in patient monitoring and consultation, to access medical information and expertise, and even to transmit medical images and reports.

However some users like to differentiate the two.

What Is Telehealth?

In a nutshell telehealth refers to the entire spectrum of remote health care services that are delivered via telecommunications and virtual technologies. Telemedicine is actually a way to provide clinical services through the medium of telehealth. Still, many professionals use these two terms interchangeably. And as we tackle the history of telemedicine, we may use the terms interchangeably as well. Let’s jump into it.

When Did Telemedicine Begin?

Telemedicine, a term coined in the 1970s by an American neurologist, Thomas Bird, literally translates as “healing at a distance” from Latin “medicus” and Greek “tele”.

At the very beginning, telemedicine could be seen in its infant stages in Greece and Rome around 500 BC. During this time, communication between towns was conducted by human messengers, who would transfer any medical advice or medicines necessary. Even mediums like smoke signals were used to communicate medical information. These were used especially over long distances to indicate health events like births, deaths, and disease outbreaks. With all due respect to this ingenuity, we won’t be looking that far back into the past.

For the purpose of this article, let’s consider telemedicine as the use of telecommunication technology to provide and exchange medical information and services.

The Civil War and Telegraph Transmissions

Communications across long physical distances was revolutionized with the invention of the telegraph in the 1840s.

The first major instance of telecommunications for medical purposes came about a decade later when 15,000 miles of telegraph cable was laid during the Civil War.

The telegraph made remote wartime communications possible. It was used to order medical supplies and transmit casualty reports. The technology was so integrated that telegraph wagons commonly idled behind the frontline, sending and receiving information from the battlefield as needed.

The Telephone Revolution

In 1876, Alexander Graham Bell was awarded a patent for his telephone and the rest, as they say, is history. This was a monumental step in remote communication, one which medical professionals quickly adopted.

In 1879, an article in “The Lancet,” a peer-reviewed medical journal, featured a physician who asked a new mother to hold her child up to the phone so that he could hear the child’s cough. Upon hearing the baby cough the doctor concluded that it was not the croup, a viral upper airway infection, as the mother feared. The doctor was spared a trip out at midnight, and the family was able to follow the doctor’s instructions from the telephone conversation.

The article, by an anonymous writer, was one of the first references to communication technologies furthering health care remotely. Many doctors began to embrace the phone, noting its convenience and potential to reduce disease transmission by limiting in-person contact.

1905: Heart Sound Transmission

Dutch physician William Einthoven is regarded as the father of modern electrocardiography for his development of an early electrocardiogram. The device captured the heartbeat by printing the shadow of a string galvanometer, which moved when a current from the heart passed through it. The string’s movement corresponded with the strength of the current and, accordingly, the heartbeat. Einthoren explained in a 1906 paper how he used telephone wire to record heart signals from patients nowhere near his facility. In 1924, Eithhoven received the Nobel Prize for his work.

The 1920s: Two-Way Radio Communication

The Haukeland Hospital in Norway started using two-way radio communication in 1920 to connect physicians with ships and enable treatment of seafarers. Several countries followed suit and embraced two-way radio communication in the following decade.

Hugo Gernsback

Of course, there were rather more unorthodox attempts at technological innovations as well. In 1925, for example, Hugo Gernsback, an inventor who designed the first home radio set, hypothesized the “teledactyl.” This was a peculiar tool that would have remotely examined patients using radio technology while relaying a video feed to an onlooking doctor. The gadget never came to actual fruition, which perhaps is just as well. It did, however, help plant the seed for remote consultations with patients via video link, albeit, it took many more years for this to become an everyday reality.

1940s: First Electronic Medical Record Transfer Occurs in Philadelphia

A 1950 paper published by the Radiological Society of North America detailed the transmission of X-rays over telephone or radio wire between West Chester County Hospital and Philadelphia 24 miles away. The system had been in use since 1848, and the paper is considered one of the earliest mentions of telemedicine in medical literature.

1959: The First Use of Two-Way Video Communications for Telemedicine Occurs

As the 1950s were drawing to an end, two-way video communication became a reality for telemedicine and was cemented in history.

The University of Nebraska spearheaded the first use of two-way video communication for telemedicine in the United States. In 1959, clinicians used interactive video communication to transmit neurological examinations across campus to medical students. It is universally considered the first use of real time video communication in telemedicine.

Various universities across the country followed suit, leveraging telemedicine in academic settings, mainly focusing on transmitting medical data like X-rays, ECGs, stethoscope sounds, etc.

NASA and Telemedicine

A breakthrough in telemedicine happened in the 1960s. NASA, the Lockheed Corporation, and the Indian Health Services launched a wide-scale telemedicine project. The main idea behind the “Space Technology Applied to Rural Papago Health Care (STARPAHC)” project was to provide easier access to healthcare to American Indian reservations, leveraging the same telecommunication technologies initially intended for NASA astronauts.

Satellite communications greatly expanded telemedicine opportunities and facilitated healthcare delivery in rural areas. In 1972, NASA’s Applications Technology Satellite (ATS-a) enabled telecommunications access for various smaller communities in Alaska, including larger hospitals. The success of STARPHAC and the advanced satellite communication capabilities led to the significant expansion of telemedicine in the following years.

1990s: Studies Confirm High Rates of Diagnostic Agreement Between In-person and Virtual Visits

Many studies have found that both in-person and virtual visits result in the same diagnosis. One 1998 study on teledermatology had both in-person and virtual examiners assess one patient and found that they arrived at the same diagnosis 80% of the time. Another study from the same year focused on emergency departments and concluded that there was no difference between patients in regular and telemedicine treatment when it came to factors like patient needs for additional care and positive interactions with doctors and nurses.

The Internet Transforms Telemedicine

As we are all aware, the internet changed everything. The speed with which humans could communicate and transfer information was revolutionary. In the case of telemedicine, the internet was essentially the technological breakthrough it had been waiting for. Scientists and medical experts had more opportunity and more dynamic tools to conduct remote treatment.

The internet unlocked a new frontier for telehealth, due to factors such as:

  • Digital tech made the efficient transmission of data over long distances possible. As a result, telemedicine’s speed and scope was forever enhanced.
  • The digitization of information made sending, receiving, managing, and storing data much safer and easier.
  • The internet’s widespread adoption in all personal and professional settings led to substantial cost savings for the digital technology needed to deliver telemedicine.

Telemedicine has been consistently improved and refined over the last few decades, but powerful digital technology is still the foundation of telehealth operations today.

The Covid-19 Pandemic Increased the Call for Telemedicine

Before the Covid-19 pandemic spurred its popularity, healthcare providers in the United States had been using telemedicine to treat patients remotely, but only on a minimal level.

There was slow growth of telemedicine due to the lack of uniform coverage policies across states. With the national health crisis brought by the pandemic hitting hard, the federal government took the necessary steps to make providing and receiving care via telemedicine easier.

Today, most healthcare providers in the U.S. are either entirely or partially involved with telemedicine. The Covid-19 pandemic prompted these practitioners to promote healthcare services to their patients while addressing safety issues.

There were three primary benefits of telehealth during the Covid-19 pandemic:

  • Limited in-person contact
  • Ensure continuity of care
  • Served as triage to help determine patients who needed care the most

Technological Advancements Built Present Day Telemedicine

Telemedicine has come a long way since the early 20th century when doctors would listen to stethoscope sounds over the phone. With the current state of technology, a licensed medical professional can perform medical examinations through telemedicine video visits and diagnose and treat patients remotely.

The distance between doctors and patients is no longer a barrier. Patients can schedule online appointments with a single click of a mouse or a tap on their phone screen with a Telemedicine software solution. They don’t have to drive to the nearest healthcare provider’s office; telemedicine makes it possible to receive medical care from home or any other private location.

The impact and benefits of telemedicine are undeniable. With an apparent lack of doctors and specialists in the United States, telemedicine and telehealth will continue to prosper in the coming years. Remote healthcare services improve access to medical care for patients in rural areas, facilitate remote patient monitoring, and help doctors and patients save time and money.

Telehealth is a lasting care model as its industry continues to grow. With constant advancements in technology, remote care will soon open more possibilities for patients to access care and healthcare professionals to deliver their medical services.