The medicine cabinet of the future might have a doctor tucked somewhere between the Tylenol and the cough syrup.
Telemedicine has expanded rapidly in the last few years to allow millions of patients to “visit” doctors on-demand through their computers, tablets, or smartphones.
More than 10 million consumers used telemedicine last year, and that number is expected to double within the next two years, according to the American Telemedicine Association, a professional and trade group of doctors, hospitals, and technology companies involved in telemedicine.
Consumers are only just beginning to be aware of telemedicine, said Jonathan Linkous, the association’s chief executive officer. But much like the ATM card changed the banking world for Americans, so will telemedicine transform the way people receive healthcare in the coming years, he said.
Want to publish your own articles on DistilINFO Publications?
Send us an email, we will get in touch with you.
“Once you have it, you cannot imagine going back to when you didn’t have it,” Linkous said. “Consumers are going to start to demand telemedicine. This is what they are going to want.”
Technology meets Obamacare
The technology of telemedicine has been around for more than three decades, but its use was limited mostly to communication between doctors and health professionals. A specialist in Texas, for instance, would use it to view the X-ray results of a patient in Florida, or doctors who treated the same patient but are based in different locations would use it for conferencing.
In the last few years, the growing use of tablets and smartphones has allowed patients to communicate with their doctors via video calls. That development coincided with the rising shortage of doctors as the Affordable Care Act continues to bring more patients into the healthcare system.
Today, many employers provide telehealth through the health insurance that they provide to their employees, said Dr. Roy Schoenberg, chief executive officer of American Well, a telehealth company that works with several healthcare providers across the country, including Blue Cross Blue Shield and UnitedHealth Group.
Linkous said telemedicine is not only faster and easier than visiting a doctor in person, but it is also less expensive and gives consumers more doctors from which to choose. Telemedicine makes physicians and specialists from a larger geographic area available even to patients in rural communities, where the availability of doctors may be limited.
But telemedicine has run into several legal and regulatory hurdles. As is often the case, technology has moved faster than regulation, he said, and lawmakers and medical boards are still in the process of catching up.
Doctors in the U.S. are licensed by state medical boards and can only practice in those states where they are licensed. That means they cannot treat an out-of-state patient through telemedicine. Lisa Robin, chief advocacy officer at the Federation of State Medical Boards, said the federation has drafted guidelines on telemedicine that will be discussed next month by delegates from state medical boards.
The guidelines will address, among other things, issues related to standard of care and privacy, she said. They will also address the issue of availability of patients’ medical records for physicians before they can interact with them through telemedicine, and will also deal with requirements to obtain informed consent from patients, she said.
“We believe these guidelines will be well received,” Robin said.
Many states also have laws that restrict the types of drugs that can be prescribed online. In other states, the laws do not require insurance companies to reimburse doctors for telehealth services, and the lack of guaranteed payment discourages doctors from providing telehealth.
Some of the reluctance to embrace telemedicine is at least in part based on fears that telemedicine has the potential to be abused, and that doctors can misdiagnose and mistreat patients when they remotely see a patient through video.
Schoenberg, however, said that telemedicine is not here to replace traditional medicine.
“There are things you can’t do with telemedicine,” he said. “Obviously, you can’t be handling heart attacks through telemedicine, and you are not going to perform surgery through an iPad.”
But a lot of doctor’s visits for primary care and minor conditions can be done through telemedicine, he said. The technology is also very useful for patients with chronic conditions who may have difficulty leaving their homes and driving to a doctor’s office, he said.
A diabetic patient, for instance, does not require a new diagnosis with every doctor’s visit, but still needs close contact with a doctor for follow up. Those follow-ups can be handled through telemedicine, saving the patient frequent trips to the doctor, he said.
Users of telemedicine seem happy to have the option. American Well’s app for Android smartphones and tablets has been downloaded by more than 10,000 users, and the overwhelming majority of them gave telemedicine a positive review.
“Revolutionary in the field of healthcare,” one user wrote in the comment section of the app. “Connect to the doctor from the comfort of your home or work place. Such a good idea.”
Another user said she connected with a doctor at 2 a.m. within minutes through the app. She said the doctor examined her son’s throat and listened to his breathing and coughing before prescribing antibiotics for her to pick up at a local pharmacy.
Rewriting healthcare delivery
Linkous said that telemedicine also encounters resistance from doctors who may not welcome the competition. Doctors often control the market in the communities where they are based, he said, but telemedicine could suddenly make world-famous physicians available in those same communities.
“That is great for the consumers, but the doctors may not like it,” he said.
Schoenberg said he is seeing an increasing number of employers and healthcare companies embracing telemedicine. Despite the various legal hurdles that the technology faces and the overall resistance to change, the growing perception is that telemedicine is a major turning point in healthcare.
“What telemedicine does is it stretches healthcare all the way to where the patients are,” he said. “It makes live healthcare available to consumers on demand, wherever they are. Telemedicine is going to rewrite how Americans get their healthcare.”
Date: March 28, 2014