Telemedicine: Overcoming barriers

People looking for alternative ways to get treatment for health issues are discovering telemedicine.  Working-from-home and social distancing practices in recent months has increased awareness of telemedicine. Even before the onset of COVID-19, over 60% of health insurance plans, health institutions and hospital systems were offering telehealth as a viable, cost-effective and convenient option to treat patients for non-urgent medical issues.

A recent survey by the National Business Group on Health (NBGH) estimates that virtually all large employers (96 percent) are making telehealth services available in states where it is allowed. In addition, more than half of employers (56 percent) offer telehealth for behavioral health services, which is more than double the number in 2017.1

Access is to a virtual medical provider is convenient.  Providers are available 24/7, including after hours, nights, weekends and even holidays.  You can typically access one within 30 minutes for a wide-range of non-urgent conditions, and they are able to prescribe medications.  The cost of a telemedicine visit is can be less expensive than an actual in-office visit.

A recent study in JAMA found that the average time for an in-office medical visit is 121 minutes, including time for travel, waiting, paying and completing paperwork. Within these two hours, only 20 minutes is actually spent face-to-face with the doctor. The entire encounter costs patients $43 in lost productivity.1

The global telehealth market expects to grow to $19.5 billion by 2025.2

Regardless of these statistics, telemedicine continues to have low utilization rates mainly because of number of barriers.

Quality of Physician

The practitioner using telemedicine technologies must be licensed to practice medicine in the jurisdiction where the patient receives treatment as dictated by current law.  Generally, telemedicine providers require practitioners be board-certified which raises the level of quality.Apprehensive may still exist if you’re used to seeing your own doctor.  Telemedicine providers, who maintain private practices, are professionally trained just like your own doctor to evaluate and treat patients.  Telemedicine providers are experienced in handling telemedicine; they can quickly develop rapport and engage in the medical evaluation.   At the end of the day, it’s up to you whether to implement their treatment recommendation.

Unclear on Conditions Treated

Telemedicine can support the evaluation and treatment of a wide range of non-urgent medical issues including:

Allergies Earache Pink eye
Bronchitis Fever Respiratory
Cold, Flu, Cough Headache Sinus infections
Constipation & Diarrhea Insect Bites Skin and rash problems

If the medical condition is not something they can treat, they will provide recommendation for follow up with your own provider or referral to an emergency room if urgent/life threatening.

A number of telehealth providers offer specialty services to treat chronic conditions, as well as behavioral health.

Used to seeing doctor in the office

The in-office experience often includes a series of steps such as check-in with the front office, interview by the nurse including check of your vitals, and then an interaction/meeting with the actual doctor.
The telemedicine process has similar steps, but instead you’re going through the process virtually.

Essentially, the doctor will first have a conversation with you about your situation to understand and evaluate.  If needed, they will ask for visual confirmation of the body part with the medical issue.  This can be done either by uploading a photo or sharing via two-way video chat through your mobile device or PC.

A telemedicine visit can be seen as a low-cost way to triage your situation starting small before embarking upon more time intensive, costly medical appointments that require in-person visits.

 
IT/Technology limitations

Mobile devices are ubiquitous.  While you can access telemedicine through your computer, you have the option to download the telemedicine App to your mobile device utilizing all of the same features and tools as the web browser access.  Therefore, access to telemedicine is limited by your own access to the internet or mobile service.

Laws are also in place to protect privacy. The HIPAA Privacy Rule is designed to be a minimum level of protection. Some states have even stricter laws in place to protect your personal health information. Telemedicine providers can share your information with your primary care physician in accordance with applicable state and federal laws.

Other Concerns

Underutilization of telehealth is widely attributed to a gap in benefit literacy or a lack of awareness.  People also express an apprehension to use a credit card when paying for telehealth services.

Keep in mind that the cost of a telemedicine visit through your regular doctor may cost the same as if you were to visit your doctor in their office.   Telemedicine providers like Teladoc, MDLIVE and AmWell who offer access 24/7 are different, and may charge significantly less than what your regular doctor would charge.

Ask your health insurance company or your employer whether telemedicine is available.

Medical offices, like where your regular doctor practices medicine, may provide access to virtual medical visits, which may include access to your own primary care doctor or others within the same practice.  MyChart, an online health connection for patients, provides for face-to-face video sessions with doctors.  Check with your medical provider to see if they offer MyChart.   Keep in mind the cost of a telemedicine visit through your regular doctor may cost the same as if you were to visit them in person for an office visit.  Ask up front what the cost of the visit may be to avoid surprises later.

Telemedicine is here to stay.  Access to healthcare is important. Learning how to use telemedicine can be a viable, cost-effective alternative to support our healthcare needs. To learn more about the telehealth industry, visit the American Telehealth Association website.

References

  1. https://www.mdlive.com/wp-content/uploads/2018/03/MDLIVE_Telehealth-Utilization_Whitepaper.pdf
  2. Transparency Market Research. Telehealth market: global industry analysis, size, share, growth trends, and forecast 2017–2025 Mar 2018p1–2240 Rep Id: TMRGL41591 accessed 11/1/18.

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