Tele-Medicine in Hepatology and ‎Gastroenterology Care: A Necessity or Novelty

Telemedicine or Telehealth, defined as the delivery of health care services at a distance using electronic means for both diagnosis and treatment where both the patient and health care provider are not in direct contact as classically practiced, it holds tremendous promise to increase access to broadly specialty care [1]. The use of telemedicine has evolved over time. Initially, it was a platform for exchange of knowledge and correction of misconceptions [2]. Later, evolved for teleconsultations and whole patient assessment and giving prescriptions [3]. The infrastructures needed for establishment of telemedicine are cheap and applicable and it have been tried in many diseases with many publications documenting the efficacy in delivery of health care services [4]. The benefits of telemedicine are not limited to access too many healthcare services, avoid driving time to health care facilities, avoid waiting time, and avoid gathering of people to decrease infection risk. Telemedicine allows enhanced patient-to-physician communication, allowing select high risk patients prone to develop more severe disease (risk stratification) for emergency room physical evaluation, and this eventually will reduce the burden on health care systems [4,5], it is a low cost processand it is widely accepted by patients [1,6].

Telehealth has become a central piece in patient healthcare delivery during COVID-19 pandemic era. Telehealth allows health care services to reach patients in their homes, keeping other patients safe through social distancing and maintaining self-quarantine [7]. Several modes of implementation are useful to overcome difficulties for patient care during the pandemic. Its benefits are specific to different fields of medical practice. Such benefits, along with the guidance and reported experiences should invite health systems to work for an effective and comprehensive implementation of telemedicine in various fields [8].

Performing the equivalent of a complete clinical examination by telemedicine would be unusual. However, components of a more traditional clinical examination are part of the telemedicine workup for specific conditions. Telemedicine clinical examinations are facilitated, and enhanced, through the integration of a class of medical devices referred to as telemedicine peripherals (e.g. electronic stethoscopes, tele-ophthalmoscopes, video-otoscopes, and so forth). Direct-to-consumer telehealth is a rapidly expanding segment of the health care service industry [9].

In the field of hepatology and gastroenterology, telemedicine have been practiced with early applications were in hepatitis C management. First, it was used to share knowledge and experiences from specialists to primary-care providers [2]. Later, the spectrum of applications expanded. Currently, telemedicine is incorporated to deliver health information, diagnose different diseases, assess the severity of others [6],  prioritize patients for emergency visits, and organ transplantation including liver transplantation and also to treat and revise medications of different diseases [4,5,10] and the future is open for further expansion that lies in parallel to advancement in the technology.