Coronaviruses, a genus of the coronaviridae family, which may cause illness in animals or humans (1, 2). In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases. The most recently discovered coronavirus causes coronavirus disease-19 (COVID-19) (1). The disease originated in Wuhan, China, and has spread widely to other countries (3). Early symptoms of COVID-19 include fever, dry cough, difficulty breathing and tiredness (4, 5). Older people and those with underlying medical problems such as hypertension, heart problems and diabetes are more likely to develop the disease in its most severe form (1). This global event has been announced a pandemic by the World Health Organization (WHO) (6). A major factor in slowing down the transmission of the virus is the "social gap" that is made possible by the reduction of person-to-person contact (7, 8).
For reduce transmission, travel restrictions have been established around the world and most cities have been quarantined (9). But, people who are not infected with the COVID-19, especially those who are at greater risk of developing the disease (e.g. Elderly people and those with underlying disease), should receive daily care without the risk of exposure to other patients in the hospital (7). Also, under strict infection control, unnecessary personnel such as clinical psychiatrists strongly refuse to enter ward of COVID-19 patients (10, 11). Natural disasters and epidemics pose many challenges in providing health care (12). As a result, unique and innovative solutions are needed to address both the critical needs of patients with COVID-19 and other people who need medical care, that technological advances provide new options (13). Although the ultimate solution for COVID-19 will be multifaceted, it is one of the effective ways to use existing technologies to facilitate optimal service delivery while minimizing the risk of direct exposure person-to-person (7, 14). Telemedicine use in epidemic conditions (COVID-19 outbreak) has the potential to improve epidemiological research, disease control and clinical case management (7, 14, 15).
The use of telehealth technology is a 21st century approach that is both patient-centered and protects patients, physicians and others (16, 17). Telehealth is delivery of health care services by health care professionals, where distance is a critical factor, using information and communication technologies (ICT) for the exchange of valid information (18). Telehealth services are delivered using real-time or store-and-forward techniques (19). With the rapid evolution and downsizing of portable electronics, most families have at least one digital device, such as smartphones (20) and webcams, that provide patient and provider communication (21). Video conferencing and similar television systems are also used to provide health care programs for people who are hospitalized or in quarantine to reduce the risk of exposure to others and employees (7). Physicians who are in quarantine can cover these services to take care of their patients remotely (8, 22). Covering multiple sites with a tele-physician can address some of the challenges of the workforce (8, 23).
There are several benefits to using telehealth, especially in non-emergency / routine care and in cases where services do not require direct patient-provider interaction, such as providing psychological services (24). Remote care reduces the use of resources in health centers, improves access to care, while minimizing the risk of direct transmission of the infectious agent from person to person (25). In addition to being useful in keeping people safe, including the general public, patients and health workers, another important advantage is providing access to care givers widely. (12). Therefore, this technology is an attractive, effective and affordable option (14, 26, 27). Patients are eager to use telehealth, but barriers still exist (28, 29), the barriers to implementing these programs also largely depend on payments, accreditation and insurance (8). Furthermore, some physicians are concerned about technical and clinical quality, privacy, safety and accountability (23, 30).
Telehealth can become a basic need for the general population, health care providers and patients with COVID-19, especially when people are in quarantine, enabling patients in real time through contact with health care provider for advice on their health problems. Thus, the aim of this review was to identify and systematically review the role of telehealth services during COVID-19 outbreak.