Telemedicine, ready for liftoff
Telemedicine has been applied to patient record management, virtual consultations, disease diagnoses, treatment, and patient self-monitoring. Early disease detection and diagnosis saves many patients’ lives as well as increases the impact of every healthcare dollar spent. This relies on ease of access to care, and telemedicine, particularly virtual consultation, is well-positioned to better connect physicians and patients.
Who will benefit?
In rural areas, there are not only shortages of physicians and certain specialties, but also more dispersed health systems. This twofold problem manifests in reduced access to and consistency of care for patients. During my undergraduate years in central Virginia, I shadowed neurologists in the teaching hospital. Some patients would drive many hours from Kentucky, Tennessee, and West Virginia to have 30 minute consultations. A high proportion of patients suffered from a chronic and degenerative disease, myasthenia gravis, and would need to come in for regular appointments. On a steady basis, patients would cancel visits or be no-shows because they were unable to take the time off from work or get transportation. In these instances, a virtual consultation or written exchange between physician and patient would be preferable to a skipped appointment.
In other instances, the patient has access to care, but the experience and skill level of the available practitioner is not the best fit (i.e., patient with cancer whose nearest doctor is a pediatrician or nurse practitioner). Telemedicine consults between a primary care provider located in a rural or small hospital setting, and a specialist located elsewhere would bolster the exchange of information and ability to treat patients.
In a survey conducted by Rock Health in 2018, the adoption of telehealth is rising. Both urban and rural residents are open to the idea, with 80% of urban residents and 67% of rural residents having used at least one form of telemedicine. This survey defined telemedicine as email, live phone, text, picture/video sent, and live video.
Who will pay?
Centers for Medicare and Medicaid (CMS) reimbursement is typically a very good leading indicator for private insurance coverage. Recently, CMS released its “Report on Medicare Telehealth” which contains beneficiary and service usage numbers that show ~20% YoY increase in both metrics between the years 2014–2016.
In my next post, I’ll discuss tailwinds, like regulatory changes and health economic outcome research, that will increase telemedicine deployment as well as some real-world examples.
