The Future of Telemedicine

By Michele Hollow
Thursday, May 14, 2020

Convenience, fewer missed appointments and lower insurance costs benefit patients and doctors. Having access to patients’ medical records, private on-camera communication, and reducing unnecessary in-office and ER visits are a few reasons telemedicine continues to grow in popularity.

Terri D., age 35, woke up on a Saturday morning with extreme sinus pain. The over-the-counter medication she had been taking for a week was no longer controlling her symptoms. Her doctor’s office was closed, so she drove to a nearby urgent care facility and found out it was dropped from her healthcare insurance network. The closest in-network facility covered by her insurance was 50 miles away.

With a bit more online research, Terri found a telemedicine website and decided to give it a try. She filled out her insurance information and patient history. In less than 20 minutes, a doctor came on, asked some basic questions and had her open her mouth close to the camera. He sent a prescription to her pharmacy. Her cost was $45, compared to the $150 urgent care fee. Terri is part of a growing number of patients using telemedicine. Research published in JAMA found that telemedicine visits increased from 206 in to 202,374 within a 12-year period (2005 to 2017).

The study also found the average age of patients using telemedicine was 38.3 years, and that 63% of patients were women. Of those using telemedicine, 83.3% live in urban areas. Also, the majority of those virtual visits were with primary care (39%) and mental health (53%) providers.

Embracing Telemedicine

According to the American Hospital Association, 76% of hospitals in the U.S. use video and other technology to connect with patients and consulting physicians. MedTech Outlook, a medical trade publication, compares the growth of telemedicine to other consumer conveniences, such as Amazon and Uber.

Bill Siwicki, Managing Editor at Healthcare IT News wrote, “The existing landscape of telehealth vendors means there certainly is no shortage of plug-and-play options.”

In his article, Siwicki points to WakeMed Health & Hospitals for not just implementing quality virtual care, but for also engaging with more residents in its community. WakeMed is currently working with RelyMD, a virtual medicine tech service that allows patients to schedule virtual appointments and reserve an urgent care seat, check wait times for emergency services and urgent care, and access virtual urgent care.

Valerie Barlow, Vice President of Clinical and Support Services at WakeMed Health & Hospitals, told Siwicki, “Providing optimal care in the digital world means analyzing the right data at the right time and using it in the right way to increase access to care and to ensure improved health outcomes.”

A Pandemic Push

Virtual visits climbed exponentially due to the novel coronavirus (COVID-19). With local, state and federal government offices advising people to stay home, fears seeped into many communities, and social isolation was the order of the day.

The CDC recommended that healthcare providers, healthcare systems and insurers let their patients know that they were available to virtually consult. The CDC reported a shift in how health care had traditionally been delivered and how it was being provided during the COVID-19 outbreak, noting that due to the need to keep people isolated, medical professionals and facilities promoted an increased use of telemedicine. As a result, many hospitals and private medical professionals:

  • Increased the use of remote care by assessing and treating patients. Medical practitioners were able to care for patients from a distance, thus reducing the volume of patients at the hospital and other healthcare facilities.
  • Communicated with their patients by telephone in areas where video feeds were not available, again with the goal of reducing noncritical in-person contact.

In addition, many hospitals and healthcare systems reduced the cost for their telemedicine virtual visits to encourage people to stay at home to avoid the spread of infection in the midst of the public health crisis. For instance, one New Jersey hospital system, RWJBarnabas Health, promoted its telemedicine app as easy to use and available at a reduced cost of $15 per virtual visit.

Moving Forward

The American College of Physicians (ACP) agrees that telemedicine will play a role in the future of medical care. The ACP released a survey in 2019 that showed “51% of internal medicine physicians and subspecialists in their network have began using one or more of these telehealth services:”

  • Virtual online visits
  • e-Consults
  • Remote patient monitoring
  • Remote care management and coaching
  • Integration of data from wearables, such as the Apple Watch, Fitbit and other devices

What’s more, the Cleveland Clinic found chronic disease management is a virtually untapped area for telemedicine compared to behavioral telehealth and other specialties. Patients with chronic illnesses often require multiple medical visits, and many of these can be done virtually.

The Hospital-at-Home model has a lot of potential for virtual consultations. Hospital-at-Home studies have shown they’re more cost-effective than in-person hospitalization and result in shorter treatment times. In addition, the rates of delirium are lower.

According to the American Academy of Allergy Asthma & Immunology, physicians can practice telemedicine in multiple states through the Interstate Medical Licensure Compact Commission. Since 2018, 3,000 physicians have been granted permission to practice in multiple states over a more than 20-state area. In order to practice in multiple states, doctors must follow state-specific medical guidelines as a national licensure does not currently exist.