The Potential of Telemedicine with Biofeedback in a Primary Care Setting

Abstract

  Telemedicine has been implemented to maintain social distancing to prevent COVID-19 and remote access to healthcare services may increase participation for those who need medically and psychologically treatment. Remote access can also help preserve the patient-provider relationship at times when an in-person visit is not practical. However, these remote health care services usually do not make use of real-time data from physiological monitoring. This can be remedied by integrating three biofeedback approaches with telemedicine. First, heart rate variability biofeedback using pulse oximeters can be used to monitor O₂ saturation and re-establish sympathetic-parasympathetic balanced to support the immune system and reduce the stress caused by the pandemic. It can also be used to prevent the progression of symptoms by the early detection of “asymptomatic hypoxia” in COVID-19 patients. Second, electroencephalographic biofeedback (neurofeedback) is recommended by the American Academy of Pediatrics as a level 1 evidence-based practice for ADHD and the training with remote neurofeedback can be done at home. Third, skin conductance measurements can be integrated with virtual reality (VR) therapy. The skin conductance that indicates sympathetic arousal is used to adjust the VR exposure intensity to avoid excessive arousal and is combined with psychotherapy such as cognitive-behavioral therapy. Telemedicine with biofeedback and VR may be useful in remote healthcare during and even beyond COVID-19 pandemic.