Telehealth are health-related services and information through electronic communication technologies to help patients with or people influenced by COVID-19. It allows long-distance patient and clinician care, education, and monitoring. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. 

Telehealth (telemedicine) and COVID-19

- Ebola Contact Tracing App
- Swiss Centre for Telemedicine
- SARS Teleconsultation 

Telehealth Programs

Despite developments in technology, access is still a major issue.

Globally, only 24% of the most vulnerable have access to internet connection, versus 74% of the least vulnerable according to 2019 polling by Gallup’s Basic Needs Vulnerability Index.   Although this divide is notable globally,  this inequity is even more pronounced in developing economies in which the least vulnerable are more than three times as likely to have internet access than the most vulnerable.  This presents a major challenge to telemedicine as an accessible institution. 

This is in part due to prohibitively high costs for individuals and in part due to limitations of infrastructure which pose the largest barriers in rural regions and developing countries.

Limitiations to Telemedicine Access

Telehealth is health-related services and information through electronic communication technologies. It allows long-distance patient and clinician care, education, and monitoring. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring.

University of Michigan - Ann Arbor

Focuses of Health information technology

(the first wave is defined as being from mid-March 2020 to mid-May 2020)

The four regions for this study included Ontario, Quebec, Western Canada, and Atlantic Canada 

Demchenko and their team found these findings in their survey study:

- Generally, hospitals prioritized inpatient acute treatments over outpatient acute or maintenance treatments

- Usage of telemedicine was 50% in the Atlantic region, 45% in the Western Region, 33% in Ontario, and 19% in Quebec

- Most of the time, clinical ethicists had not been involved in decision-making regarding ECT policies during the pandemic

- Stigma and lack of understanding of ECT procedures were more of an issue in the Ontario and Quebec regions

*see child nodes for definitions of some of the terms in this node*

How did COVID-19 impact Electroconvulsive therapy in Canada in the first wave? 

Wikipedia

Telehealth (Telemedicine)

A client is admitted to a hospital, staying overnight. The hospital staff would monitor them. 

 Impatient Treatment

When there is a treatment for a client that does not require that client to stay in a hospital.

Outpatient Treatment (Definition)

A clinical ethicist is someone who works to maintain and improve policies within the healthcare industry.

What is a Clinical Ethicist?

Overall, I think there needs to be more awareness around mental health care in hospitals and healthcare settings. Staff in healthcare settings should understand why mental health treatments are essential and the consequences of not receiving treatment, especially when ECT can treat symptoms of a severe mental disability.

Outpatient and patient treatments should be prioritized too - if these clients do not have supervision it could lead to symptom exacerbation. Telemedicine could also be used more, but the issue of clients who may not have equitable access to technology often comes up. Clinical ethicists, if they had been more involved, could have advocated for more client resources.

Conclusions from COVID-19's impact on ECT in Canada

- They have direct contact with the medical team and aren't part of a separate ethics team. This allows them to better think about the population they serve and to bring up issues that may affect patients down the line
- They are educators and can help medical professionals solve problems, at first with the ethicists' help and then independently. They can educate multiple disciplines of the medical field and also make educational materials for people who want to serve in these roles.
- They can be care providers in the sense that they can provide a therapeutic/peaceful presence for patients who need to make hard decisions.

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