COVID-19 Pandemic: The Critical Role of Telehealth Applications

Dilek YAPARa,b, Hacer DEMİRKÖSEc

aMuratpaşa District Health Directorate, Antalya, Türkiye
bAkdeniz University Institute of Health Science, Department of Medical Informatics, Antalya, Türkiye
cRepublic of Türkiye Ministry of Health, General Directorate of Public Health, Department of Infectious Diseases and Early Warning, Ankara, Türkiye

ABSTRACT
Telehealth refers to the delivery of health services, such as diagnosis, treatment, and follow-up care, using technologies like wireless and mobile connections when the patient and healthcare professional are not co-located. Essentially, it bridges the gap in patient-doctor communication by allowing the transfer of medical or social data across distant locations. This study aimed to examine the pivotal role of telehealth in the healthcare sector, using the example of the COVID-19 pandemic. The COVID19 pandemic accelerated the adoption of telehealth. Healthcare professionals, including doctors, psychologists, dietitians, midwives, and nurses, leveraged it to offer remote medical care, preventive health services, and more. The scope of telehealth services spans reviewing medication histories, medical education, health preservation practices, treatment management, remote medication reviews, psychotherapy, and even patient consultations via video calls. Telehealth faces challenges beyond visible technological limitations such as failed or interrupted connections, poor video and audio quality, or lack of technological equipment. Addressing these challenges is crucial for the widespread adoption and success of telehealth in the future.
Keywords: COVID-19; health services; telemedicine

Referanslar

  1. World Health Organization [Internet]. COVID-19 Epidemiological Update - 29 September 2023. [cited: October 19, 2023]. Available from: [Link]
  2. World Health Organization [Internet]. WHO Coronavirus (COVID-19) Dashboard. [cited: October 19, 2023]. Available from: [Link]
  3. Yapar D, Avcı YD, Sonuvar ET, Karakaya İ, İlhan MN. Gelecek Salgınlara Ders Olması Gereken COVID-19 Deneyimi: Bir Üniversite Hastanesinde Görevli Sağlık Çalışanlarının Enfekte Olma Kaygısı Üzerine Nitel Bir Çalışma. Turkish Journal of Clinics and Laboratory. 2023;14(2):370-9. [Crossref]
  4. Monaghesh E, Hajizadeh A. The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence. BMC Public Health. 2020;20(1):1193. [Crossref]  [PubMed]  [PMC]
  5. Chauhan V, Galwankar S, Arquilla B, Garg M, Somma SD, El-Menyar A, et al. Novel Coronavirus (COVID-19): Leveraging Telemedicine to Optimize Care While Minimizing Exposures and Viral Transmission. Journal of Emergencies, Trauma, and Shock. 2020;13(1):20-4. [Crossref]  [PubMed]  [PMC]
  6. Smith AC, Thomas E, Snoswell CL, Haydon H, Mehrotra A, Clemensen J, et al. Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19). Journal of Telemedicine and Telecare. 2020;26(5):309-13. [Crossref]  [PubMed]  [PMC]
  7. Kruse C, Heinemann K. Facilitators and Barriers to the Adoption of Telemedicine During the First Year of COVID-19: Systematic Review. J Med Internet Res. 2022;24(1):e31752. [Crossref]  [PubMed]  [PMC]
  8. Ohannessian R. Telemedicine: Potential applications in epidemic situations. European Research in Telemedicine/La Recherche Européenne en Télémédecine. 2015;4(3):95-8. [Crossref]
  9. Zhou X, Snoswell CL, Harding LE, Bambling M, Edirippulige S, Bai X, et al. The Role of Telehealth in Reducing the Mental Health Burden from COVID-19. Telemedicine and e-Health. 2020;26(4):377-9. [Crossref]  [PubMed]
  10. Hollander JE, Carr BG. Virtually Perfect? Telemedicine for Covid-19. New England Journal of Medicine. 2020;382(18):1679-81. [Crossref]  [PubMed]
  11. Shaw SE, Seuren LM, Wherton J, Cameron D, A'Court C, Vijayaraghavan S, et al. Video Consultations Between Patients and Clinicians in Diabetes, Cancer, and Heart Failure Services: Linguistic Ethnographic Study of Video-Mediated Interaction. J Med Internet Res. 2020;22(5):e18378. [Crossref]  [PubMed]  [PMC]
  12. Institute of Medicine (US) Committee on Evaluating Clinical Applications of Telemedicine. Telemedicine: A Guide to Assessing Telecommunications for Health Care. Field MJ, editor. Washington, DC: The National Academies Press; 1996. p. 288.
  13. Baker DC, Bufka LF. Preparing for the telehealth world: Navigating legal, regulatory, reimbursement, and ethical issues in an electronic age. Professional Psychology: Research and Practice. 2011;42:405-11. [Crossref]
  14. Organization WH. Telemedicine: opportunities and developments in member states. Report on the second global survey on eHealth: World Health Organization; 2010.
  15. Lupton D. Critical perspectives on digital health technologies. Sociology compass. 2014;8(12):1344-59. [Crossref]
  16. Wurm EM, Hofmann‐Wellenhof R, Wurm R, Soyer HP. Telemedicine and teledermatology: past, present and future. JDDG: Journal Der Deutschen Dermatologischen Gesellschaft. 2008;6(2):106-12. [Crossref]  [PubMed]
  17. Korkmaz S, Hoşman İ. Sağlık Sektöründe Tele-Tıp Uygulamaları: Tele-Tıp Uygulama Boyutlarını İçeren Bir Araştırma. Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi. 2018;4(3):251-63. [Crossref]
  18. Doğramacı YG. Teletıp, sağlık turizmi ve uzaktan sağlık hizmetleri: Mesafeli sözleşmeler. İstanbul Hukuk Mecmuası. 2020;78(2):657-710. [Crossref]
  19. Sungur C. Teletip Uygulamalarinda Hasta Memnuniyeti: Bir Sistematik Derleme Çalişmasi. Hacettepe Sağlık İdaresi Dergisi. 2020;23(3):505-22.
  20. Williams AM, Bhatti UF, Alam HB, Nikolian VC. The role of telemedicine in postoperative care. Mhealth. 2018;4. [Crossref]  [PubMed]  [PMC]
  21. Resmi Gazete Sayı: 31746 Tarih: 10.02.2022. Uzaktan Sağlık Hizmeti Sunumu Hakkında Yönetmelik. [Erişim Tarihi: 2.05.2022]. [Link]
  22. Yorulmaz O, Derin S, Göcek Yorulmaz E, Gültekin G, Baş S. Türk Psikologlar Derneği. Çevrimiçi Psikolojik Müdahale ve Uygulamalar için Telepsikoloji Kılavuzu. 2020. Erişim adresi: [Link]
  23. Daniel H, Sulmasy LS. Policy recommendations to guide the use of telemedicine in primary care settings: an American College of Physicians position paper. Ann Intern Med. 2015;163(10):787-9. [Crossref]  [PubMed]
  24. Aslan D. Koruyucu hekimlik ve telesağlık/teletıp uygulamaları. TELETIP. 2021:17.
  25. Alam L, Alam M, Malik AM, Faraid V. Is Telemedicine our cup of tea? A nationwide cross-sectional survey regarding doctors' experience and perceptions. Pak J Med Sci. 2021;37(5):1319-25. [Crossref]  [PubMed]  [PMC]
  26. Chaet D, Clearfield R, Sabin JE, Skimming K. Ethical practice in Telehealth and Telemedicine. J Gen Intern Med. 2017;32(10):1136-40. [Crossref]  [PubMed]  [PMC]
  27. Ong MK PM, Mullur RS. Telemedicine for adults. Uptodate. [cited: Sep 01, 2022]. [Link]
  28. Versluis MA. Telemedicine: a dream come true? Postgrad Med J. 2010;86(1022):687. [Crossref]  [PubMed]
  29. Haper C, Raines R. Telemedicine Considerations During The COVID-19 Pandemic. Law360. 2020. [cited: 04.09.2022]. [Link]
  30. Cooper J, Matsuzaki T. Telemedicine in the time of coronavirus. The Hill. 2020. [cited: 06.09.2022]. [Link]
  31. Ertek S. Endokrinolojide tele-sağlık ve tele-tıp uygulamaları. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2011(3):126-30.
  32. Kane CK, Gillis K. The Use Of Telemedicine By Physicians: Still The Exception Rather Than The Rule. Health Aff (Millwood). 2018;37(12):1923-30. [Crossref]  [PubMed]
  33. Organization WH. Global diffusion of eHealth: making universal health coverage achievable: report of the third global survey on eHealth: World Health Organization; 2017.
  34. Barnett ML, Ray KN, Souza J, Mehrotra A. Trends in Telemedicine Use in a Large Commercially Insured Population, 2005-2017. Jama. 2018;320(20):2147-9. [Crossref]  [PubMed]  [PMC]
  35. Smith AC, Gray LC. Telemedicine across the ages. Med J Aust. 2009;190(1):15-9. [Crossref]  [PubMed]
  36. T.C. Sağlık Bakanlığı, 'Teletıp Sistemi' [Internet]. [Erişim tarihi: 09.09.2022]. [Link]
  37. FitzGerald M, Williams R. Commonwealth Fund. 2020 Nov 20. [cited: May 15, 2022]. Available from: [Link]
  38. Doty MM, Tikkanen R, Shah A, Schneider EC. Primary Care Physicians' Role In Coordinating Medical And Health-Related Social Needs In Eleven Countries. Health Aff (Millwood). 2020;39(1):115-23. [Crossref]  [PubMed]
  39. Bokolo AJ. Exploring the adoption of telemedicine and virtual software for care of outpatients during and after COVID-19 pandemic. Ir J Med Sci. 2021;190(1):1-10. [Crossref]  [PubMed]  [PMC]
  40. Hashiguchi TCO. OECD Health Working Papers: Bringing Health Care To The Patient: An Overview of The Use of Telemedicine in OECD Countries. 2020. [cited: May 15, 2022]. Available from: [Link]
  41. Fieux M, Duret S, Bawazeer N, Denoix L, Zaouche S, Tringali S. Telemedicine for ENT: Effect on quality of care during Covid-19 pandemic. Eur Ann Otorhinolaryngol Head Neck Dis. 2020;137(4):257-61. [Crossref]  [PubMed]  [PMC]
  42. Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: A systematic review. J Telemed Telecare. 2018;24(1):4-12. [Crossref]  [PubMed]  [PMC]
  43. Hong Z, Li N, Li D, Li J, Li B, Xiong W, et al. Telemedicine During the COVID-19 Pandemic: Experiences From Western China. J Med Internet Res. 2020;22(5):e19577.. [Crossref]  [PubMed]  [PMC]
  44. Mojdehbakhsh RP, Rose S, Peterson M, Rice L, Spencer R. A quality improvement pathway to rapidly increase telemedicine services in a gynecologic oncology clinic during the COVID-19 pandemic with patient satisfaction scores and environmental impact. Gynecol Oncol Rep. 2021;36:100708. [Crossref]  [PubMed]  [PMC]
  45. Chang PJ, Jay GM, Kalpakjian C, Andrews C, Smith S. Patient and Provider-Reported Satisfaction of Cancer Rehabilitation Telemedicine Visits During the COVID-19 Pandemic. PM R. 2021;13(12):1362-8. [Crossref]  [PubMed]  [PMC]
  46. Regelmann MO, Conroy R, Gourgari E, Gupta A, Guttmann-Bauman I, Heksch R, et al. Pediatric Endocrinology in the Time of COVID-19: Considerations for the Rapid Implementation of Telemedicine and Management of Pediatric Endocrine Conditions. Horm Res Paediatr. 2020;93(6):343-50. [Crossref]  [PubMed]  [PMC]
  47. OECD. Digital health. In: Health at a Glance. [cited: October 19, 2023]. Paris: OECD Publishing; 2021.
  48. Hashiguchi TCO. Bringing health care to the patient: An overview of the use of telemedicine in OECD countries. OECD Health Working Papers. 116. Paris, France: OECD Publishing; 2020.
  49. Smith WR, Atala AJ, Terlecki RP, Kelly EE, Matthews CA. Implementation Guide for Rapid Integration of an Outpatient Telemedicine Program During the COVID-19 Pandemic. Journal of the American College of Surgeons. 2020;231(2):216-22.e2. [Crossref]  [PubMed]  [PMC]
  50. Au SCL. Revisiting the role of telemedicine under the 2019 novel coronavirus outbreak. Eur J Geriatr Gerontol. 2020;2(1):26-7. [Crossref]
  51. Ucael DÖ, Özden M, Altintaş E, Aslan D. Halk sağlığı bakış açısıyla teletıp. Turkish Journal of Public Health. 2021;19(3):295-303.
  52. Özdemirkan T, Şimşek AÇ, Şenlik ZB, Kotanoğlu M. Telehealth and Telemedicine in Health Service Presentation: Telehealth and Telemedicine. Turkey Health Literacy Journal. 2022;3(3):153-60.
  53. Şimşek AÇ, Kara A, Baran-Aksakal FN, Gülüm M, Ilter B, Ender L, et al. Contact tracing management of the COVID-19 pandemic. Turk Hijyen ve Deneysel Biyoloji Dergisi. 2020;77(3):269-80. [Crossref]
  54. Bojdani E, Rajagopalan A, Chen A, Gearin P, Olcott W, Shankar V, et al. COVID-19 Pandemic: Impact on psychiatric care in the United States. Psychiatry Res. 2020;289:113069. [Crossref]  [PubMed]  [PMC]
  55. Duden GS, Gersdorf S, Stengler K. Global impact of the COVID-19 pandemic on mental health services: A systematic review. J Psychiatr Res. 2022;154:354-77. [Crossref]  [PubMed]  [PMC]
  56. Stein MB. COVID-19: Psychiatric illness. UpToDate. [cited: Sep 03, 2022]. 2022. [Link]
  57. Zhou J, Liu L, Xue P, Yang X, Tang X. Mental Health Response to the COVID-19 Outbreak in China. Am J Psychiatry. 2020;177(7):574-5. [Crossref]  [PubMed]
  58. Nabiyeva N, Yapar D, Yardımcı A, Metin Ö. COVID-19 Pandemi Sürecinde Telepsikiyatri Hizmetleri Kullanımı ve Dijital Okuryazarlık İlişkisi. 6. Uluslararası 24. Ulusal Halk Sağlığı Kongresi. 1-4 Aralık 2022; Antalaya, Türkiye. s. 249-62.