Telemedicine: The Time is Now
Last month we discussed how telemedicine can impact teen pregnancy rates in the Latino population, this month we explore how telemedicine can disrupt our entire medical model. We may think of telemedicine as cutting-edge technology and in many ways, it is. However, remote medicine was conceptualized as early as the 1920's and had various practical incarnations as early as the 1950's and 60's. Telemedicine was originally conceived to bring healthcare into rural settings but healthcare professionals quickly realized the potential to use telemedicine in urban settings with provider shortages as well as in emergencies to transmit data from disaster sites[1].
It is easy to see how telemedicine provides benefits to rural and urban settings where access to providers can be limited, but even in typical medical settings this practice has the potential to greatly improve efficiency by providing cost and time savings for providers as well as patients. Telemedicine visits tend to be shorter than office visits, so provider time is used more effectively. The overhead required to support telemedicine visits is also less when considering office space, receptionists, and payroll hours dedicated to data collection. Telemedicine can enable providers to discover problems earlier and head off issues before they become dangerous, painful, and costly. Patients can more easily enter triage with a concern which promotes early detection of emerging conditions. With faster remote access to providers unnecessary ER visits can be avoided; one study found that 27% percent of ER visits, costing $1000 and up, could be replaced by a $50 telemedicine visit. In addition, specialist consults can occur more quickly at lower costs[2].
Patient time is often wasted through redundant processes and lengthy wait times for office visits and referrals. This creates problems not only for the patient but a significant amount of productivity loss for their employers as well. Companies are beginning to demand telemedicine as part of their health benefits to keep employees healthy, productive, and happy[2].
There are many potential benefits of telemedicine, however, there are concerns to address. One of the first is risk management for patient data. All parties must have appropriate software and hardware security in place. Another practical concern is reimbursement policies vary wildly from state to state and by insurance carrier. There are concerns regarding care as well. Qualifications of providers are sometimes called into question. Quality of care has been debated, for example, tele-docs are less likely to order strep tests and more likely to prescribe antibiotics for people complaining of sore throat. This practice increases risk of over-prescription which contributes to development of antibiotic-resistant germs. There is also concern about the continuity of care for patients. Who manages a patient’s overall treatment plan and how are physicians communicating with each other? Studies about quality of telemedicine care vs traditional care differ in conclusions, some say care is equal some say it is not. It seems telemedicine is proven most effective when it is used as part of a comprehensive treatment program with a team to monitor each patient. Positive outcomes decrease when it is used as stand-alone care [2].
Despite the quality debate and logistical hurdles, telemedicine is the direction healthcare is heading and with good reason. Practically speaking millennials do most things on the smartphone. Every other industry is learning how to communicate with this demographic on their device of choice. Healthcare will eventually follow suit simply because the market demands it [2]. Most importantly the U.S. spends over $2.9 trillion on healthcare every year. This is more than any other developed nation. An estimated $200 billion of those costs are avoidable. Telemedicine has the power to cut healthcare spending by reducing problems like patient noncompliance and unnecessary ER visits, as well as making typical doctor visits more efficient. Current data points to the exponential growth of telemedicine. The global telemedicine market was worth $17.8 billion in 2014, and is projected to grow well beyond that by 2020[1].
[1] Hixon, T. (2016, June 10th). https://www.forbes.com/sites/toddhixon/2016/06/10/will-telemedicine-change-healthcare-or-prove-to-be-another-venture-fad/#42c682044248. Retrieved from forbes: http://www.forbes.com
[2] eVisit. (2017). https://evisit.com/what-is-telemedicine/. Retrieved from eVisit: http://www.evisit.com