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 Sensors International 2 (2021) 100117

Contents lists available at ScienceDirect

Sensors International
journal homepage: www.keaipublishing.com/en/journals/sensors-international

Telemedicine for healthcare: Capabilities, features, barriers,

and applications
Abid Haleem a, Mohd Javaid a, *, Ravi Pratap Singh b, Rajiv Suman c
a
Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
b
Department of Industrial and Production Engineering, Dr B R Ambedkar National Institute of Technology, Jalandhar, Punjab, India
c
Department of Industrial & Production Engineering, G.B. Pant University of Agriculture & Technology, Pantnagar, Uttarakhand, India

A R T I C L E I N F O A B S T R A C T

Keywords: Regular hospital visits can be expensive, particularly in rural areas, due to travel costs. In the era of the Covid-19
Healthcare Pandemic, where physical interaction becomes risky, people prefer telemedicine. Fortunately, medical visits can
Remote treatment be reduced when telemedicine services are used through video conferencing or other virtual technologies. Thus,
Telemedicine
telemedicine saves both the patient's and the health care provider time and the cost of the treatment. Further-
Virtual appointment
more, due to its fast and advantageous characteristics, it can streamline the workflow of hospitals and clinics. This
disruptive technology would make it easier to monitor discharged patients and manage their recovery. As a result,
it is sufficient to state that telemedicine can create a win-win situation. This paper aims to explore the significant
capabilities, features with treatment workflow, and barriers to the adoption of telemedicine in Healthcare. The
paper identifies seventeen significant applications of telemedicine in Healthcare. Telemedicine is described as a
medical practitioner to diagnose and treat patients in a remote area. Using health apps for scheduled follow-up
visits makes doctors and patients more effective and improves the probability of follow-up, reducing missing
appointments and optimising patient outcomes. Patients should have an accurate medical history and show the
doctor any prominent rashes, bruises, or other signs that need attention through the excellent quality audio-video
system. Further, practitioners need file management and a payment gateway system. Telemedicine technologies
allow patients and doctors both to review the treatment process. However, this technology supplements physical
consultation and is in no way a substitute for a physical consultation. Today this technology is a safe choice for
patients who cannot go to the doctor or sit at home, especially during a pandemic.

1. Introduction heart disease decreased the risk of mortality and hospitalisation and
increased quality of life. There are several compelling reasons for people
Advanced technologies with quality network services enable in- to get a diagnosis or recovery plan. This can make patients feel assured
dividuals to improve healthcare delivery and make it available to more that they are receiving the best quality treatment. Telemedicine is an
and more people. Telemedicine is a more beneficial technology that can excellent choice for treating mental health issues. It eliminates some of
make it easier for people to get preventive treatment and help their long- the causes that prevent patients from receiving this critical form of
term health. It is particularly true for those who face financial or regional treatment [1–3].
causes to receiving quality treatment. Telehealth has the potential to Telemedicine enables patients to receive medical attention at the
make health care more effective, organised, and available. The research convenience of both doctor and him, and at the same time, he is safe. This
on this area is still in its early stages, but it is expanding. For example, the may imply that a person does not need to take time off from work or
telephone-based care and telemonitoring of vital signs in persons with arrange childcare. Going to the doctor's office entails sitting in close

* Corresponding author.
E-mail addresses: ahaleem@jmi.ac.in (A. Haleem), mjavaid@jmi.ac.in (M. Javaid), singhrp@nitj.ac.in (R.P. Singh), raje.suman@gmail.com (R. Suman).

Production and hosting by Elsevier

https://doi.org/10.1016/j.sintl.2021.100117
Received 17 June 2021; Received in revised form 18 July 2021; Accepted 19 July 2021
Available online 24 July 2021
2666-3511/© 2021 The Authors. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/).
A. Haleem et al. Sensors International 2 (2021) 100117

quarters with others can cause infection. This is especially risky for better-suited tools for networking, data storage, report management, and
people who have chronic medical problems or a weakened immune leveraging on each other's specific skills. This improves the quality of
system. It prevents the possibility of contracting an infection at the medical practice, allowing doctors to spend less time on rural assign-
doctor's hospital. Telemedicine service providers could have lower ments and providing more care to patients. Telemedicine also enables
overhead rates. Clinicians may find that telemedicine supplementing private healthcare specialists to practise and will enhance the patient
their income by allowing them to take care of more patients. When experience. Patients will no longer have to stand in long queues, and
caregivers see patients online, they are not exposed to the infections that physicians will be able to access patient information more conveniently
the patient may bring. The patient may be happy with their physician if and efficiently with electronic files and eliminating overall wait times.
they do not have to fly to the office or wait for treatment or get infected Furthermore, remote appointments allow doctors to devote less time to
from the hospital [4,5]. each patient, allowing them to treat a more significant number of patients
Telemedicine has improved the capacity of healthcare providers to [15,16].
take care of many people without physically being there. Furthermore,
now that it has proved its worth, it will be around for a long time. 1.2. Why healthcare system needs telemedicine?
Although introductory video conferencing brought many providers to
telehealth, the new wave of telemedicine technologies would have much Rising healthcare costs and a need for better treatment are motivating
more to offer. For example, during a patient, clinicians can use natural more hospitals to investigate the benefits of telemedicine. They want
language processing to take notes automatically. During emergency op- improved contact between physicians and far-off patients and better
erations, specialists will weigh in from afar. The knowledge gathered by usage of healthcare facilities. Here telemedicine also promotes better
healthcare instruments may be submitted to an Internet of Things (IoT) connectivity, which has resulted in fewer hospital re-admissions and
cloud platform, where the healthcare provider consolidates it. This in- patients entirely adhering to their prescription care plans. Telemedicine's
formation will then be sent to IoT systems used by healthcare providers increased contact advantage extends to doctor-to-doctor communication
for patient management. The most recent advancements in telemedicine as well. Doctors may use telemedicine to build support networks to ex-
technologies include Artificial Intelligence (AI) to help physicians func- change their skills and provide better healthcare services. Telemedicine
tion more effectively. This technology keeps patients updated with is a way of delivering medical treatment over the internet, usually
wearables and other remote patient tracking resources and even uses through video chat. This technology has several advantages for both
robots to deliver specialised treatment to areas it has never been before patients and healthcare providers. Though there are still technical hur-
[6–8]. dles and critics, telemedicine can supplement and enhance the overall
Telemedicine technology holds great promise for patients in remote patient experience [17–19].
areas. The most significant effect is provided in various countries where
healthcare facilities are both scarce and unavailable. To ensure an ac- 2. Capabilities and features of telemedicine when used in
curate medical history, all patients and doctors must have sufficient healthcare management system
hardware and software security in place. Some clinics can provide virtual
appointments with a doctor through online video conferencing. When an The concept of telemedicine and associated services have now been
in-person visit is not required or necessary, these appointments enable well established and proven for societal help. Fig. 1 reflects the various
them to continue receiving treatment from a usual doctor. Web-based features and facilities offered by the telemedicine concept, specifically
visits with a doctor or nurse practitioner are another form of interac- for the healthcare domain. It provides chronic health management,
tive appointment. As part of their health care offerings, several major prescription compliance, remote services, care-for-all under critical and
corporations have access to automated doctor's offices. On the other severe cases, etc., which ultimately enable this methodology to support
hand, a nursing call centre is staffed by nurses who use a question-and- the healthcare and medical care sphere. In addition, a series of tele-
answer format to offer advice for at-home treatment [9–11]. wearables heals up the patients and keeps them updating about their
This technology allows people to take blood pressure medicine, refill health status in a unique way [20,21].
medications, and recall their appointments. In addition, patients can Telemedicine is an innovative technology, and many call it disruptive
describe their symptoms to doctors by email, take a series of self-tests, innovation. Thus, to cater to a distant patient, telemedicine employs a
and enrol in step-by-step training services tailored to their specific con- range of electronic communications media, ranging from teleconfer-
dition. For all scenarios, electronic health technology makes chronic encing to image-sharing to remote patient surveillance. Doctors may also
illness control easier by simply placing care monitoring apps and use automation to offer quality treatment to their patients. They need to
smartphones in the hands of patients [12,13]. This article briefs about develop better IT support systems and learn a new way of file manage-
telemedicine and its need in Healthcare. Significant capabilities, features, ment. For example, a virtual appointment encourages primary care
barriers, and applications are discussed briefly. physicians to receive advice from experts when they have concerns about
the illness or treatment. Exam reports, history, medical findings, X-rays,
1.1. What is telemedicine? or other images are sent to the expert for examination to the doctor. The
specialist can answer electronically, set up a virtual meeting with the
Telemedicine is a health-related service with the help of tele- doctor. These virtual consultations can eliminate the need for unnec-
communicating and electronic information technologies. It refers to the essary in-person referrals to specialists, reduce wait times for specialist
whole collection of deliverables designed to enable patients and their feedback, and eliminate the need for unnecessary travel. Telemedicine
physicians or healthcare providers. It has a wide range of uses, including strategies are more useful where a doctor can see the patient, identify a
online patient consultations, remote control, telehealth nursing, and disease, and chart the experience [22–25].
remote physical and psychiatry rehabilitation. It allows better health care An electronic personal health record system uses health records that
choices, increases emergency service quality and performance, reduces can monitor and preserve. We can use a web-enabled device, such as a
time in making a diagnosis, and saves costs for both doctors and patients desktop or smartphone, at any time. A personal health report will quickly
by optimising clinical procedures and reducing travel expenses to hos- provide essential details to emergency responders in an emergency, such
pitals [14,15]. as diagnoses, prescriptions, substance preferences, and the doctor's
Telemedicine has increased access to high-quality healthcare facil- contact information. The applications of this technology have been
ities. Patients will now get more customised clinical services. They can developed to assist customers with properly organising their medical
also meet the best medical providers simply by using video application records in one safe location. Recovery programmes must establish targets
software, consultations can be taken from afar, and clinicians have for effectively improving patient behaviour, which is getting more

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A. Haleem et al. Sensors International 2 (2021) 100117

Fig. 1. Various capabilities & features of telemedicine for healthcare domain.

uncomplicated due to mobile health technologies. It allows patients to This tool means more funding for local health services for a remote pa-
count calories, record vital signs, record exercise, and control prescrip- tient's population. In addition, this technology can allow all patients to
tion doses and schedules. Aside from diabetes, telemedicine's idea of remain with family and friends [33–35].
patient self-management can be extended to other long-term chronic
disorders such as hypertension and a host of digestive diseases [26–28]. 3. The treatment work flow process as being used in
Telemedicine solutions will significantly assist doctors. However, telemedicine care
when combined with Artificial Intelligence (AI), it can become even more
effective. It can simplify basic tasks by reducing doctor workloads and Fig. 2 is showing a line-way representation of the workflow for
increasing job satisfaction. The application relay data in a timely and attempting telemedicine culture-based treatment in healthcare services.
high-quality manner to ensure that an appointment runs smoothly. It It provides an ultra-edge type facility and attention at every step during
would enable doctors to do a more rigorous review of a patient's health its implementation. It all starts with the patient's entry or detailed in-
and inspections for any abnormalities. Patients are encouraged to see a formation, further followed by the telehealth supportive care unit. This
doctor's open (available) time slots, as well as their upcoming appoint- step is further associated with the setting up of the doctoral assistant to
ments and the ability to reschedule them. Healthcare analytics is often the patient and then after the diagnosis and appropriate treatment
used to interact with the gathered data and view it from a user interface. offered to the person under utmost care [36,37].
In the long term, store and forward approaches imply improved time and Telemedicine and other technology improve clinical and adminis-
cost utilisation. Telemonitoring is based on various electronic technolo- trative operations by telecommunication. It is a multifaceted technique
gies that transmit patient statistics directly to a healthcare provider's that provides emergency care in both critical and non-critical situations.
analytical interface [29,30]. In general, it is used to treat patients who are suffering from chronic
This technology has proved valuable and essential in a variety of diseases. On the other hand, a hospital with an appropriate ambulance
capacities within the telehealth and medical industries. It is notably crew or other personnel can compensate for telemedicine. Furthermore,
revolutionising surgeries, medical training, and schooling. Once the additional functions such as the patient's treatment history, diagrams of
doctor has approved the desired appointment, the patient should obtain treatment dynamics, and e-prescriptions can be added to the telemedi-
confirmation. Internal records, such as reviews, changes, and critical cine solution.
hospital alerts, can be included in their profiles. Physicians can be able to Furthermore, doctors can easily continue to call patients for follow-
make meetings using schedules as well. Scheduling, and rescheduling, ups or findings following an appointment. Therefore, text messages are
are the standard features of modern telemedicine applications. When essential because they enable the doctor to speak directly and quickly
physicians are informed of an appointment, they can access the patient's without another appointment. In addition, data and medications can be
medical record and other details as needed in order to have an appro- exchanged between offices by physicians [38–40].
priate consultation and diagnosis [31,32]. In the current situation, healthcare surveillance is vital to maintain
Virtual Reality (VR) systems have transformed communication ap- the quality of Healthcare. With the implementation of digital health
plications in telemedicine devices, making them more immersive. In tracking technologies and services, there are smart connectivity systems.
virtual reality, doctors and their teams can now watch a 3D monitor This technology opens the door for direct patient control to provide much
when performing surgical procedures. By using video conferencing, greater insight into patients with simple video conferencing. The doctor's
physicians and even surgeons will work on people that are thousands of catalogue saves both patient's and healthcare provider's time. It improves
miles away. This enables even intercontinental medical teams to the precision of the doctor-patient treatment procedure. The appoint-
collaborate and hold video meetings on complex and urgent situations. ment scheduling function keeps doctors informed of the status of their
The telehealth platform might use VR to simulate the patient's data and a appointments. Until communicating with a patient, doctors may review
graphical environment with video conferencing to streamline commu- scheduling requests and patient profiles. This shows the patient queue
nication with a doctor. This method is also helpful in rural or isolated and allows to filter of patient profiling. The doctor can now easily post-
regions, and it is critical for providing patients with local Healthcare. In pone appointments at any time in case of an emergency. Data protection
rural areas, this ensures increased trust in the local healthcare system. is often ensured by cloud-based medical record-keeping of telemedicine

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A. Haleem et al. Sensors International 2 (2021) 100117

Fig. 2. Work flow treatment process through telemedicine support.

data with patient information and captured video consultation [41–43]. Telemedicine technology can be reduced the requirements through
There is an easy sharing of medical records with any clinician spe- an internet network, a video platform, technical equipment, and prob-
cialising in treating a specific patient's disease, even a patient's caregiver ably portable equipment. Healthcare facilities may have extensive ser-
who needs the information for insurance purposes. Patients can ask vices, which can perform telemedicine visits using a scaled-back variant
questions about their symptoms by communicating with their doctors via of the same equipment. The assistance required to run a telemedicine
teleconference. Photographs and video consultations are replacing In- programme is just as necessary as the hardware decisions. Any software
person evaluations. Telemedicine application software companies use requires a qualified computer and technical assistance to run correctly.
app connectivity and cloud technologies to allow real-time collaboration Depending on resources, physicians access the needs at all times. The
and remote patient diagnosis. It saves time for both patients and physi- support team will be able to ensure consistent and safe internet access. In
cians by monitoring health progress and inspecting when necessary. The addition, it assists with logistical and technological issues that could arise
telehealth app ensures seamless patient record collection and consoli- during a clinic day to avoid patient treatment interruptions [52–54].
dation in a single location. It helps pharmacies, customers, and pre- Telemedicine provides a great deal among healthcare professionals.
scribing physicians by delivering healthcare services more quickly. With Healthcare organisations incorporate telemedicine in medical offices and
an e-prescription feature, doctors can create and deliver prescriptions skilled nursing hospitals to deliver more effective services. Technologies
with lesser errors. It would help to save time while also improving con- combined with telemedicine software, such as electronic medical re-
nectivity and customer satisfaction [44–47]. cords, AI diagnosis, and medical streaming applications, can help phy-
Telemedicine solutions for Healthcare improve the quality of treat- sicians diagnose and manage patients more effectively. This enables
ment for both patients and doctors. Today, telemedicine app growth is physicians to track patients in real-time and modify care plans. Using
increasing as the demand for mobile telemedicine applications grows and telemedicine, doctors can treat more patients without adding more em-
will continue to expand. It also enables doctors to view documents on the ployees or expanding their office rooms. However, several physicians and
prescription insurance form and provide all information in electronically patients, mostly older adults, are having difficulty adjusting to tele-
connected pharmacies. The ability to pay medical bills from mobile medicine [55,56].
should be a must of every telemedicine app. The ability for patients to
rate and compare their doctors is an essential feature of any telemedicine 4. Barriers for the adoption of telemedicine practices in making
app. Patient feedback is regarded as an essential part of quality man- healthcare services effective
agement and professional development. Furthermore, it will assist many
new patients in locating the specialist doctor that is ideally suited to their Fig. 3 exemplifies the several fences that came across the successful
needs [48,49]. implementation of telemedicine care to support the healthcare units and
Telemedicine applications have the potential to speed up the treat- patients for their utmost care. There are very typical and usual barriers
ment of a variety of medical conditions. It is more successful when a needed to be taken care of while looking to apply telehealth-related
person gets medication from a professional doctor who provides detailed practices for Healthcare and its allied domains. The things must be
knowledge about their symptoms. Telemedicine is a method of main- very free from any kind of privacy loss, confidentiality revealing, fraud &
taining continuous contact with patients and healthcare providers. It has abuse, inaccurate solutions, etc. as any of these issues may become a
expanded access to healthcare facilities through the use of advanced reason for anyone's discouragement, or the case may become complex as
technologies and services. Telemedicine provides any hospital or treat- far as health sediments are concerned [57–59].
ment centre with immediate access to medical professionals, consultants, Telemedicine and other telehealth monitoring methods may assist
and additional education and statistics. It is the fastest way to exchange patients and physicians in managing severe health problems such as
all services with any hospital or clinic in the country. Telemedicine diabetes and asthma. Providers will also track patients at home after
application specifications may be as simple and few simple requirements being discharged from the hospital or recovering from an accident. Pa-
and some decisions [50,51]. tients' mismanagement is a significant source of anxiety for physicians.

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A. Haleem et al. Sensors International 2 (2021) 100117

their homes. Disease transmission is minimised when people with in-

fectious illnesses do not reveal themselves to those in cramped waiting
rooms. Individuals will also book consultations during job breaks or even
after hours [68–70].
Telemedicine creates a new technology-assisted level of treatment by
further connecting patients with their caregivers, access to physicians
and experts, and encouraging both patients and providers to escape high-
risk environments. Patients with drug abuse can be treated with different
telemedicine methods. Overall, the cost of treatment is lower, resulting in
cost savings. The cost savings would become more apparent as technol-
ogy advances. When it comes to care and diagnosis, telemedicine is
fantastic for physicians and patients. It can serve as an excellent support
system. This form of telemedicine technology is handy for healthcare
professionals for appropriate medication and care of the patient. Tele-
medicine can save money for both the individual seeking treatment and
the provider when opposed to conventional care. In order to proper
treatment, the healthcare provider would have telemedicine facilities on-
site [71,72].
Telemedicine technology allows for continuous patient care. This will
promote proper self-care and help diagnoses. AI-enabled telemedicine
services will automatically interpret patient data and assist physicians in
responding rapidly to new technologies. Providers will be able to treat
Fig. 3. Frequent barriers in supporting healthcare through telemedicine. more patients by the use of telemedicine technologies. Visits can be
reduced in length, and hospitals can be reduced in size. Access to tele-
Although advancements in medicine have made it easier to use tech- –urgent treatment has the potential to minimise emergency room visits. It
nology, device outages occur from time to time. Healthcare systems that enables experts to collaborate on cases in rural hospitals. These ex-
are considering adopting telemedicine technologies meet with industry changes live streams with remote specialists who can have on-screen
experts. They have a host of realistic options for practitioners interested consultation. Telemedicine is the remote transmission of medical infor-
in incorporating telemedicine into their clinics, making the integration mation from one location to another. This is done in order to improve a
smoother [60,61]. person's fitness. Getting an appointment with a primary care doctor or a
This telemedicine method helps physicians exchange patient details specialist can be challenging. This remote network is actively gathering
with another doctor who is located in another country. A primary care and transmitting data to other healthcare organisations for analysis. This
practitioner will now exchange patient history and medical details with a technology allows mental health practises to see more patients while
doctor without being in the same room. Systems can relay data over large maintaining a high degree of medical care. This results in greater prof-
distances between systems, allowing one practitioner to know what itability and better time control. Parents will now stop taking their sick
another has already done. As a result, there is less duplication in moni- child out of the house to visit a doctor [73–75].
toring and fewer cases of inadequate drug management. A physician can Telemonitoring is the use of technologies to transfer medical data
collect and exchange information with their patient using patient portals. from people in various geographical areas. This type of monitoring allows
Medical devices can transmit vital signs and other data to physicians, physicians and primary caregivers to track patients through electronic
allowing them to make treatment changes. Patients can now send bio- equipment. Telemonitoring systems also allow patients to be cared for at
metric data to their clinicians through wearables or remote monitoring home. This lowers hospital visits and gives them greater control over
devices such as pulsometers or blood pressure cuffs. It can access patient their illness treatment. Patients at far-out locations cannot fly to hospitals
information from a dashboard or clinical decision support system, or patients without access to affordable healthcare benefits from tele-
compile data, and display patient status in near-real-time [62–64]. medicine. Acting with other healthcare workers daily can be incredibly
Telemedicine helps patients to exchange information over long dis- time-consuming and is one of their daily tasks. Radiologists may collect
tances and become a game-changer. Healthcare records such as imaging high-quality photographs and obtain input from anywhere using tele-
photographs, blood analysis, and other data may be exchanged in real- medicine. They no longer need to be in the exact location as the provider
time for proper patient evaluation. Overcrowding in emergency de- sending over the images, allowing for a more efficient operation. Mental
partments can be eliminated using telemedicine by making patients first health practises, likely one of the most common specialities for tele-
consult with a remote physician via video chat. Healthcare networks that medicine, and offer therapy sessions from anywhere [76–78].
have implemented telemedicine technologies will testify that it takes a
significant amount of time and resources. Practice administrators, clini- 5. Telemedicine in healthcare: significant application areas
cians, doctors, and others must understand how to use the device to
achieve benefits. While telemedicine is initially costly, healthcare facil- Telemedicine technology has access to various treatment options,
ities can have a good return on investment over time due to more patients including primary care consultations, psychotherapy, physical therapy,
and fewer employees. Using this technology, physicians can evaluate a and many more. It provides treatment through the use of wireless tech-
patient's medical background, administer clinical examinations, and nologies such as laptops and smartphones. In most cases, video confer-
more [65–67]. encing is used in telemedicine. Some services, on the other hand, choose
There are now telemedicine options available that enable patients to provide treatment through email or phone messages. Often patients
from the convenience of their own homes. It is beneficial for those who use telemedicine in conjunction with their primary care physician. This
use the services of a physician but do not have the means to travel technology is helpful where a patient must maintain physical distance or
thousands of miles or wait a long time. High-risk children will be seen by is unable to visit a healthcare centre. It allows practices to sell extended
a doctor at another hospital in seconds by merely sharing the footage. or weekend hours without incurring the cost of having the office open.
This also reduces the need for babies to be moved to a different hospital, This also makes practices more attractive to the growing number of pa-
which is expensive and time-consuming. Patients who formerly had little tients who insist on telemedicine as a primary care provider choice
access to health care facilities will now see a specialist without leaving [79–81]. It is a cost-effective and easy way to assist people with severe

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A. Haleem et al. Sensors International 2 (2021) 100117

illnesses in managing their disease, being involved in their treatment, Table 1

and preventing complications from worsening. Table 1 gives the signif- Telemedicine applications areas for the Healthcare sector.
icant applications of telemedicine for Healthcare. S Applications Description References
Various innovative technologies are used in the field of engineering. No
Healthcare and their associated field [146–149]. These are helpful to 1 Telehealth Technological advancements and [82–85]
solves various problems related to design, manufacturing and to create healthcare creativity have
sustainable environment [150–152]. Telemedicine is often used to link considerably expanded their
doctors operating with a patient in one place while experts are in another applicability. With the
implementation of this technology in
to help them through telecommunication. This is highly beneficial to Healthcare, clinicians, researchers,
remote or difficult-to-reach areas where experts are not readily acces- lab staff, and doctors may also use
sible. It is used to perform remote visits at a lesser cost and time. The the concept of telehealth. It is now
advent of the internet age brought about significant improvements in the time for hospital systems, medical
groups, suppliers and to incorporate
practice of telemedicine. The emergence of this smart technology is
telemedicine into their medical
capable of high-quality video streaming paved the way for remote services. In addition, many
Healthcare to be delivered to patients in their households, offices, or organisations want to collaborate
assisted living centres as an alternative to in-person appointments for with a telemedicine provider to ease
both primary and specialist care. Many people say that telemedicine has the process and deployment.
Telemedicine is performed by using
existed in some way or another since the telephone was invented. One a telemedicine device, which
can send images instead of data over the handset. Telemedicine is also an includes a computer and handheld
accepted component of the way Healthcare is provided in various medical equipment. Physicians also
countries. It has a surprising number of applications, which allows pa- use high-resolution imaging cameras
to give accurate diagnostic
tients to plan a follow-up appointment by video, improves consistency
photographs to experts.
with aftercare visit guidelines and reduces the pressure on both patients 2 Facilitate service to Telemedicine facilitates access to [86–89]
and doctors [153–155]. disabled patients services for a patient having
Modern mobile health apps support telemedicine and bind an inter- disabilities. It also increases access
active clinical interface to software. Treatment of patients with minor for other groups, such as the elderly,
the culturally isolated, and the
diseases, exchanging data investigation information, or imaging findings
incarcerated. Telemedicine can aid
are examples of noncritical events. Patients can also buy drugs and get in the treatment of a variety of
prescriptions from a dedicated app. Close coordination with payment medical conditions. It is effective
gateways. Here analyses and information transmission take place in real- when an individual receives medical
attention from a competent provider
time. These telemedicine systems are often integrated; as a result, it al-
who gives detailed information
lows patients and physicians to easily collaborate via a single app to chat about their symptoms. According to
and exchange data. It can be easily collected direct patient data and some reports, patients who use
forwarding it to the appropriate doctor. This evidence may be a transcript telemedicine spend less time in the
of an appointment or a test report saved in an Electronic Health Record hospital, saving money.
Additionally, less travel time could
system folder. In addition, it allows doctors to interpret data once it has
imply lesser secondary expenditures
been collected [156–158]. such as petrol.
Telemedicine makes extensive use of confidential medical records. It 3 Remote treatment Remote treatment can be done [90–93]
is used for capturing, preserving, and distributing data, which helps to virtually, which have been found a
successful way to keep people out of
consider essential criteria in this area. Telemedicine is a website that
the hospital. Patients who wish to
allows one to chat with a doctor remotely [159–161]. Mobile applica- see a provider with highly
tions serve as a connection between the device and the hospital's internal specialised experience of a specific
infrastructure. Dedicated modules can submit warnings, research notes, illness will do so without driving
and data visualisations to assist clinical decisions. This programme uses a long distances and video visits. Each
specialist's knowledge and skills can
remote control to care for people with severe and chronic conditions. Any
be used to the best use. Healthcare
patient admitted to the hospital and held under care during surgery takes can be a competitive sport at times,
up a precious bed. Home health Telemedicine collects vital signs, has with primary care and specialist
video conferencing services, and can sound alarms at a nurse's station physicians collaborating to ensure
the best possible health result for the
[162–165].
patient. Telemedicine facilitates this
by allowing all clinicians to
6. Discussion on the findings communicate with the patient and
each other through a safe remote
Telemedicine allows doctors and patients to communicate directly link.
4 Treatments of school- Telemedicine can play an essential [94–97]
through audio and video conferencing. During the call, and even before going children role in the treatment of our rapidly
the doctor can see the ill person's health records. Telemedicine is a ageing population. When a child
branch of health information technology that entails using technologies becomes ill at school, they can see a
to provide clinical Healthcare over safe video and audio connections. school nurse or be picked up by their
parents and taken to an urgent care
This also allows for online treatment of sick people. Via telemedicine, a
facility and mostly inconvenient and
sick person can communicate with a doctor at any time and from any perhaps needless. The forward-
location through a secure audio and video call, and the sick person can thinking schools can partner with
even exchange records and photographs. Telemedicine technologies can doctors to perform video tours from
be cost-effective and convenient if correctly oriented and conducted. the classroom. The provider may
decide what action is required and
During the Covid-19, it has become quite popular, and creative appli- provide parents with guidance or
cations are being developed to increase health outcomes, reduce costs, reassurance. It has also been shown
and ensure that each patient receives the high-quality treatment they (continued on next page)
deserve.

6
A. Haleem et al. Sensors International 2 (2021) 100117

Table 1 (continued ) Table 1 (continued )

S Applications Description References S Applications Description References
No No

that having on-call doctors Patients benefit from fewer days

accessible overnight and on away from work, fewer travel costs
weekends will help keep patients or time, less overlap with the child or
who live in assisted living facilities elder care duties, privacy, and no
out of the hospital. proximity to potentially infectious
5 Effective for disorders Telemedicine is effective for any [98–101] patients.
not requiring lab disorder that does not necessitate 9 Minimise travelling of Telehealth would drastically [112–115]
examination laboratory examinations or a patients decrease the amount of time
physical exam. This technology also available for appointments. Patients
provides continuing treatment, such will no longer have to waste hours
as psychotherapy. During the travelling to or waiting in a hospital.
COVID-19 pandemic, a patient who Now, they will be able to make an
lives long distances away from a appointment online and then
primary care centre can also achieve navigate to their meeting with the
better treatment. The patient who is app. Furthermore, Healthcare can be
unable to transport themselves, more affordable than ever before. A
providers can broaden the list of patient can be able to meet with a
conditions they are willing to doctor from the safety of their own
handle. For example, a doctor might homes. It may also help those who
use telemedicine to administer need emergency medical attention.
antibiotics for a possible infection. Doctors who can view on-demand
6 Doctor's appointment In this age of social distancing, [102–105] necessitate the use of an internal
virtually millions of people look forward to database of built-in queries. Fast and
virtual doctor appointments. straightforward access can also be
Telemedicine has improved provided by a variety of application
medication management, patient programming interfaces and
quality of life, and reduced facilities.
healthcare costs. Telemedicine app 10 Teledentistry This technology enhances dental [116–119]
growth is now a key target for care, allowing dentists to obtain
healthcare providers who want to teeth, dentures, and other dentistry
deliver healthcare services to parts photographs or other related
patients online and remotely. This evidence to evaluate and transfer it
technology creates suitable to another practitioner for
telemedicine applications for doctors examination. The critical advantage
and patients. In addition, patients of telemedicine in dentistry is to
find it dependable and exchange records among dentists
straightforward when minimal and dental specialists to decide if a
specifics are combined with a robust particular treatment is required.
authentication mechanism. Specialists may also assist dentists in
7 Enhance overall Telehealth refers to a wide variety of [106–108] identifying problem areas and
healthcare system technology and facilities used to recommending prevention steps to
performance provide patient care and enhance the patients to stop expensive and
overall performance of the complex procedures. Like other
healthcare system. Telemedicine telemedicine applications, this
encompasses a greater range of partnership benefits people in
online healthcare facilities. In remote or underserved areas who
addition to healthcare care, it is may not usually have access to
applied to remote non-clinical medical specialists.
services such as provider 11 Better service for Telemedicine provides rapid growth, [120–123]
recruitment, administrative clinician and patient which offers many benefits to both
meetings, and continuing medical clinicians and patients. The
education. Telemedicine uses mobile paramount need for any healthcare
messaging and assistive tools to provider is to have better patient
deliver health care to people who services, which telemedicine systems
cannot see a doctor physically. This will achieve while still assisting
technology is also suitable for follow- physicians to refine and improve
up appointments, chronic illness their private practice. As a result,
treatment, expert consultation, drug developing medical video
management, and various other conferencing applications in some
health resources that can be accessed kind of medical institution is critical
remotely through secure video and in order to make better medicine.
audio connections. The gap barrier is a well-known
8 Improve patient Telemedicine has the potential to [109–111] cause in the healthcare sector using
coordination improve patient coordination and telemedicine technology. This is due
better healthcare services. Treatment to the seriousness of the global
shortages, overuse of medical care, shortage of skilled healthcare
inadequate drug use, and providers. This shortage of doctors
unnecessary or overlapping care may can be easily fulfilled by using this
also result from fragmented care. technology.
The patient can quickly pay the 12 Digital health Telemedicine systems with digital [124–126]
nominal charges of telehealth monitoring health monitoring capabilities,
services. This service can be combined with artificial intelligence
provided to patient comfortably and machine learning, will provide
which improve patient's more accurate diagnoses and
coordination with the doctor. treatment recommendations. Using
(continued on next page)

7
A. Haleem et al. Sensors International 2 (2021) 100117

Table 1 (continued ) Table 1 (continued )

S Applications Description References S Applications Description References
No No

video conferencing tools and video consultations are typically less

machine learning technologies with expensive than in-person
the help of each patient's case will consultations, saving money on
enable refining the algorithm to travel and hospital setup costs.
provide a better diagnosis for each Furthermore, making the online
one. Telemedicine is the method of booking as well as video
connecting physicians in one area conferencing included in healthcare
with patients in another using solution saves money. This is
networking devices. Appointment, particularly useful in areas where
review, and photography transcript patients may find it challenging to
applications provide an alternative get to a hospital for medical care.
to in-person sessions. It allows Another thing that telemedicine is
doctors and patients to be safe in a doing is expanding the medical
pandemic and expand the medical industry's frontiers. This field's
services digitally. studies, science, and growth are now
13 Skincare Patients can communicate with their [127–130] made more available. With the
dermatologist through telemedicine assistance of video conferencing
by using a smartphone, tablet, or streamlines, medical students'
computer. Dermatologists may schooling and preparation are now
evaluate patients suffering from more realistic.
psoriasis, bedsores, eczema, and 17 Reduce face to face Telemedicine has several functional [143–145]
other conditions using high- meeting applications. In certain situations,
resolution photographs and film. face-to-face meetings are
This is particularly useful for patients unavoidable, which can be easily
who are confined to their homes. sort-out by using this technology.
Dermatologists can safely and This offers its own set of advantages
reliably identify and treat skincare that increase the hospital's overall
disorders using telemedicine operability. On the other hand,
technologies. Furthermore, it telemedicine allows healthcare
prevents a patient from going to a providers to monitor several patients
doctor, but it also lets them keep simultaneously without leaving the
their integrity. Telemedicine will hospital. There are appointments
help the doctor to communicate and supervision through
more effectively. Any healthcare telemedicine, which helps relieve
providers have electronic patient overcrowding in emergency
management services in place. departments and care for patients in
14 Track patient for Telemedicine technology allows [131–135] more critical conditions. Hospitals
medication providers and other healthcare can exchange medical details for
personnel to track when and how offering care even more quickly with
their patients take their medication. the aid of telemedicine. Finally, it
Physicians will now track their provides treatment for patients who
patients' welfare over long distances need supervision contributes to a
using high-tech medical equipment. reduction in overall health risk.
This technology enables information
such as pulse rhythm, blood
pressure, glucose levels, and more by Telemedicine use emerging networking systems, application software
transmitting data from one system to for communication & file management, advanced devices such as com-
another. Since older adults are more
likely to fail to take their
puters and mobile devices to view and control health care facilities to
prescriptions, so telemedicine may view our medical reports, appointments, order prescription refills, pay-
help in this regard. ment or contact doctor can be used as an online patient portal. Forward-
15 Secure patient from Telemedicine helps everyone live in [136–139] thinking school partners with doctors to perform school-based remote
infectious disease a safe world. For example, patients
visits. The provider may measure the severity of the situation and provide
suffering from the flu or a cold
should consult with their doctor parents instructions or reassurance. Telemedicine technology has also
without taking germs into the been seen to successfully hold residents in assisted living facilities out of
workplace. When providing the hospital. On-call physicians may use telemedicine to perform a
guidance and tracking patient remote visit to decide if hospitalisation is needed at remotely located
success, providers are well secured
from infectious diseases. This
clinics. Several telehealth options are now becoming available to assist in
encompassing solution incorporates managing health care and receiving treatments.
robust network security capabilities Telemedicine, a prominent example of IoT in Healthcare, should
as well as managed access rights ideally be user-friendly, accessible, and adaptable. Computer hardware
management. This can help to secure
should have a simplified design factor that is appealing to both patients
patient information shared over
telemedicine devices. It is also a way and healthcare practitioners. In addition, the system should be simple to
to reduce the number of emergency incorporate into the current healthcare systems. Another factor to
department visits. remember is the instruction that consumers would need to run smoothly
16 Cost-effective When compared to conventional [140–142] for the system. Healthcare organisations should use the power of IoT to
ways of healthcare administration,
telemedicine is a more cost-effective
create robust, cost-effective, and accessible telemedicine applications.
approach. This is valid since These healthcare systems track the user's vitals and record data over time.
physicians and patients do not need Some of these instruments can also forecast impending diseases
to travel each time; they need to see depending on the user's general health. The aim of deploying an IoT-
a doctor or patient. In addition,
powered system is not limited to patient surveillance. For example,

8
A. Haleem et al. Sensors International 2 (2021) 100117

hospitals can mount IoT sensors on wheelchairs, nebulisers, de- and manage. Though a valuable and worthwhile facility, telemedicine
fibrillators, and other medical equipment to allow for real-time tracking. can be prohibitively expensive for smaller healthcare facilities. Poor
This method may also be used to monitor the position of medical communication will also make it impossible to provide reliable care.
personnel involved with the hospital.
Telemedicine is now used in medical areas such as dermatology, 8. Future of telemedicine in the healthcare sector
mental health, medicine, and cardiology to deliver improved treatment
to populations underserved by doctors and clinics. It is often thought to In the future, patients will book an appointment with the doctor of
be a way to minimise significantly the expense of treating health prob- their choice after completing a quick and straightforward registration
lems such as asthma, diabetes, and sleep apnea, which benefit from process. Instead of typing, patients will upload medical history, verifi-
continuous observation of a patient's condition. Telemedicine technology cation documents, medical reports and past prescriptions. The patient
in recovery tackles these problems in various areas, including performing interface is a proper function that allows the doctor to create an urgent
cognitive or psychiatric assessments, leading group counselling meet- care plan. It displays an outline of the patient's physical and personal
ings, supplying patients with internet services, and remotely observing records, assisting the doctor in deciding. Local healthcare resources can
patients. For example, this technology will help people recover from lung be quickly mobilised to offer both emergent and non-emergent services.
disease by undergoing video therapy sessions and supervised physical This will allow clinicians to concentrate on high-demand, complicated
recovery at a local satellite site. Cardiovascular disease is the primary cases in person rather than low-level cases that could be handled
cause of death worldwide. However, many incidents can be avoided with remotely. In the future, emergency departments to use video consulta-
the aid of drug therapies or social/lifestyle changes. tions to triage their patients, non-emergency situations are discharged
Telehealth may be making health more affordable and, as a result, earlier. As a result, there is less emergency diversion and improved pa-
growing Healthcare's importance and getting immediate treatment for tient conditions. Several healthcare organisations are adopting tele-
patients. However, people must fly thousands of miles around the globe medicine application software to prepare for the future. It connected
or continents to get affordable Healthcare. Several applications that have cardiologists with patients who came to the rural facility for care. They
been created for health-related purposes have ensured that this hurdle is will also shorten the time required for follow-up appointments and
removed. Telemedicine service makes it much easier to have a video complement the regular system. Remote patient management has arisen
medical appointment with any doctor in the shortest amount of time. as the next major cause for virtual Healthcare, and this challenge is
Patients can be able to customise their needs, venue and allow compat- generating significant opportunities for many businesses.
ibility with current patient records. They can make personalised meet-
ings and physicians who can collect vital details prior to the meeting. 9. Conclusion
Furthermore, it allows various algorithms to view pertinent information
on the home screen. For example, a search engine with complex filter Telemedicine is a valuable technology in linking clinicians with pa-
algorithms would allow patients to choose several filters that can tients to ensure they make long-term lifestyle changes. It has significant
operate. benefits for medical office staff. This many times eliminates the burden of
Telemedicine applications associate patients with doctors who con- patient check-in and concentrates on higher-value tasks. With online visit
sult them via video chat. The doctors available depends on the software capability, clinicians may care for their patients while still potentially
by using the number of physicians who have registered with it. Any assisting other affected practices. This also reduces distance limitations
telehealth applications will also help to treat illnesses like diabetes, high by exchanging information about a diagnosis, care, and disease preven-
cholesterol, or addiction. The apps will also send prescriptions to pre- tion between the doctor and the patient through electronic means. The
selected pharmacies, allowing them to pick up medications conve- most extensive telemedicine application can get health coverage closer to
niently. Telemedicine provides expert medical advice, diagnosis, recov- people who live in rural areas where quality treatment is otherwise
ery plans, and medications. The doctors can receive advanced training impossible to access. In recent years, this technology has been shown to
through internet consultations. Telehealth applications are entirely increase the quality of healthcare facilities by allowing the exchange of
modern technology used for patient care and rapidly changing Health- information across many distant areas. It expands access to underserved
care and its effectiveness. It supports technologically-inspired health care areas, making it easier for them to schedule and hold appointments.
systems. People with reduced mobility get doctors' opinions and prescriptions
which they need more quickly. Medicine and testing and procedures they
7. Limitations of telemedicine in healthcare have to manage at their place. Telemedicine minimises the doctors' &
patient travel around the globe and changes each sick person's life,
Telemedicine, when compared to conventional treatment ap- ensuring that each sick person receives the appropriate health treatment.
proaches, has lots of possible drawbacks to using telemedicine. It is no
substitute for the conventional healthcare system; it compliments the
Declaration of competing interest
healthcare system for minimal functions. There is a serious issue of
hacking patient's medical data, especially if the patient connects to
The authors declare that they have no known competing financial
telemedicine from a public network or an unencrypted channel. When a
interests or personal relationships that could have appeared to influence
person requires emergency care, this technology can cause the medica-
the work reported in this paper.
tion to be delayed, mainly because a doctor cannot deliver life-saving
care or laboratory tests remotely. State rules differ, and physicians will
be unable to practise medicine across state boundaries based on the state References
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