Chronic pain management is an essential service that should in no way be deferred. This is because chronic pain patients (CPPs) risk leading a significantly low quality of life if their condition isn’t regularly assessed.
On the other hand, it may not be possible for them to visit the clinic in times of nationwide or regional lockdowns and travel restrictions, as was witnessed during the peak of the COVID-19 pandemic.
That’s where telemedicine for chronic pain management comes in. It involves consulting the care provider over a video or audio service. In other words, doctors see patients virtually instead of physically. That fact alone makes it a bit different compared to the normal clinical visits. Here are 10 things to know about chronic pain management via telemedicine:
1. Privacy Is Key
In a world full of hackers, it’s critical for care providers to enforce systems that prevent the leakage of any patient information to unauthorized persons. Medical data breaches have, of late, been rampant.
Once criminals get hold of personally identifiable information, they might impersonate the victim and undergo treatment in their name. Such identity theft can lead to a loss of huge amounts of money on the victim’s part.
The criminals can also threaten to publicize the patient’s sensitive condition if they don’t pay some ransom. And if not money, the leaked information might be used to tarnish the victim’s name.
It’s for these reasons that physicians must know how to enhance privacy while holding a video conference with a patient. The government formulated the Health Insurance Portability and Accountability Act (HIPAA) in 1996 to ensure the protection of sensitive health information.
And right now, HIPAA compliance is a must for every caregiver who handles protected health information. Thus, healthcare providers must undergo HIPAA training as it’s a requirement by the law before they’re certified as telehealth providers. This way, they can hold virtual sessions with a chronic pain patient without compromising their privacy and medical information. They can achieve this through any of the following tactics:
- End-to-end encryption: Encryption, in general, is the process of converting text messages into a format that no one can read nor understand. End-to-end encryption is a style of encryption that ensures encrypted messages can only be decrypted on the receiving device. No other party apart from the sender and receiver of the message can know what information was exchanged.
- Strong passwords: Both doctors and patients should set strong passwords for access into their respective telehealth apps. This way, unauthorized persons cannot log in to the app and follow the doctor-patient conversations. Additionally, every meeting should be password-protected so that only those people with the password can join the discussion.
- Physical isolation: Aside from cloud-based hackers, there’s also the risk of malicious persons eavesdropping on the conversations between the physician and the chronic pain patient. Thus, the patient must be alone in a room with total privacy while the session is ongoing. Patients must let friends or family members know that they’re in a private session and should not be disturbed or contacted. The doctor should also be the only person in the room they’re calling from.
- Limiting the exchange of information: While holding a virtual video call, both the patient and the doctor should exercise restraint regarding the information they share. If it’s not a must that the two exchange a certain piece of sensitive information, it may be best that they refrain from discussing it.
2. It’s Viable
Some medical experts might think that telemedicine isn’t effective for chronic pain management. They might believe that it’s difficult to perform physical examinations on a patient remotely. But that’s not entirely true.
Physical examination has five critical components:
- Inspection: This is where the doctor looks for physical symptoms on the body by visual observation. They usually observe the color, shape, and symmetry of the body parts.
- Palpation: This refers to feeling various body parts with the fingers or hands to examine the size, consistency, texture, location, and tenderness of different body organs.
- Auscultation: This involves listening to body sounds through the use of a stethoscope.
- Percussion: This involves tapping body parts with fingers to assess the consistency of body organs and the absence or presence of fluid in these areas.
- Neurological and musculoskeletal assessment: This is an evaluation of the extremities and the torso for observable abnormalities. The patient can perform various motions to enable the doctor to conclude their observations.
Of these five steps, inspection is by far the easiest to carry out remotely. The good news is that it might yield the best results. Neurological and musculoskeletal assessments may also be possible with telemedicine. On the contrary, palpation, percussion, and auscultation might prove challenging to perform remotely.
While telemedicine does not aim to replace in-person physical examinations, it can suffice to some degree. When conditions allow, the patient can always go to the clinic for a thorough examination. Thus, telemedicine is a viable option for chronic pain management.
3. Device Choice Affects Effectiveness
Many telehealth apps work on different devices, so the doctor or patient may choose to use a desktop computer, laptop, tablet, or smartphone. There’s a difference in the effectiveness of these devices.
For one, a desktop computer and laptop show a large and stable image of the patient, which is essential for the doctor to carry out the physical examination. But due to the lack of portability, computers may not allow the patient to show the doctor some critical anatomical areas, such as the underfoot.
Additionally, not all computers come with audio and video capabilities. Therefore, the patient may have to purchase a webcam and headphones with microphones to make the virtual consultation possible.
Tablets and smartphones, on the other hand, show a smaller image of the patient or doctor, given that their screen sizes are usually small. As such, it may be difficult for the doctor to assess various body parts comfortably. Also, videos on these devices may be unstable, further complicating the examination.
But, the advantage of these devices is their portability. Since they can be tilted to whatever desired angle, the patient can show the parts of their body as requested by the doctor. Furthermore, virtually, all smartphones and tablets come with audio and video capabilities, so there’s no need for additional accessories.
4. It’s Challenging In Several Ways
Using telemedicine for chronic pain management comes with several challenges. Here are some of the most common ones:
- Embarrassment: Some physical examination procedures may require the patient to undress. Doing this in front of the camera might be challenging for some patients, fearing that perhaps the video may be recorded and someone else sees them in their nude state afterward. To avoid such fears, the doctor must assure the patient that no recording is being done and that no one else will ever see them undressed.
The patient should also make sure to close the door and windows for added privacy. Additionally, they should be advised beforehand to wear comfortable clothes and shoes that can easily be removed whenever the need arises. Comfortable clothing also allows them to move easily as the virtual exam goes on.
- Incomplete examination: As mentioned earlier, some forms of physical examination may not be possible with telemedicine, such as palpation. If the patient’s condition requires the doctor to examine by feeling with hands, then this wouldn’t be possible through a virtual clinical session.
For instance, palpation is important in the assessment of cervical pain syndromes. If this is what the patient suffers from, the doctor may have to rely only on inspection and neurological and musculoskeletal examination.
- Connectivity Issues: There’s no denying that some remote areas have poor internet connection. If there’s no option to use fiber internet in such areas, then the conversation between the doctor and the patient will be continuously interrupted. With both the video and audio buffering for several seconds, the two may find it difficult to understand each other, rendering the video call ineffective.
5. The Future Is Bright
While telemedicine for chronic pain management was available before the COVID-19 pandemic, it wasn’t embraced significantly. But the compulsory lockdowns that ensued forced doctors and patients to use it. For one, most hospitals have had their hands full with COVID-19 patients.
Secondly, CPPs generally have a weakened immune system. Therefore, visiting healthcare institutions full of COVID patients could endanger their lives. It was best for them to stay home so as not to contract the deadly viral disease.
These factors accelerated the use of telemedicine for chronic pain management. Indeed, research indicates that most patients like it, claiming it’s both convenient and satisfactory. Such are the advantages that set up telemedicine as a must-have option for chronic pain management. Hospitals and private doctors globally are thus looking into how to enhance its effectiveness, and soon, it might be an integral part of caregiving.
The recent pandemic forced caregivers and patients to hold clinical sessions remotely. Chronic pain patients also found themselves in this situation. Luckily, technological advancements made it possible for them to consult their doctors and get the help they needed without physically visiting the clinics. As long as both parties have high-end devices, a stable internet connection, and a means to maintain privacy, telemedicine can prove effective for chronic pain management.
Rudy Bill is a health care business manager. He overlooks daily operations and training new hires. Rudy shares his expertise through guest posting. During his free time, he plays chess, exercise, and pursue his woodworking hobby.