When you were a kid, wasn’t being sick the best? You got to stay home from school, were waited on hand and foot by your mom, and had a whole day to watch television without being harassed to "do something constructive." Yes, those were the carefree, soup-fed days, but being sick as an adult sucks. You have to go to the doctor (or be yelled at by your spouse and coworkers until you do), go to the pharmacy and pay for medicine to make yourself better, and miss work and a workload that will continue to pile until your (sniffly) return.
But what if I told you that being sick as an adult doesn’t have to suck as much? For less money and less stress, telemedicine - the use of medical information exchanged from one site to another via electronic communications (think two-way video, email, and smartphones) - provides health care from a distance and improves patients’ clinical needs.
According to The American Telemedicine Association, it started a little over 40 years ago, primarily treating patients in remote areas, but has spread quickly and is now being implemented into places like hospitals, home health agencies, and private physician offices as well as homes and workplaces. It includes patient consultations via video conferencing, e-health (like patient portals), and remote monitoring of vital signs, making telemedicine a hop, skip, and a jump away from being resuscitated solely by robots.
Companies like Amwell, Doctor on Demand and MedZed think telemedicine is all the rage, hosting large video consultations and helping their specialists be available to those who normally wouldn’t have opportunities to meet with them. Remote-controlled robots (yup, robots again) and smart phones and e-communication help treat off-site patients and allow doctors to have sessions with patients - diagnosing diseases and prescribing life-saving medications - that would normally clog time, wallets, and waiting rooms.
"We can remotely fly aircraft and send missiles through doors halfway around the world and watch from a remote command center or office but we cannot improve remote care of patients?" said Mark Darrah, CEO and founder of Athena GTX, a company that designs tech and software platforms as full telemedicine packages for physicians. "To me, this is not acceptable."
Agreed. Let’s look at telemedicine further:
It’s covered (a little)
You know what can be annoying? Insurance. (Gasp!) Yes, I write for an insurance web site, but yes, sometimes I find it annoying. But I still find it beneficial and necessary. I (and you and we) insure for the unforeseen, and it is always better to be safe than sorry. I have health insurance, cell phone insurance, life insurance, renter’s insurance, and if I had a car, I'd have auto insurance. When I buy a house, I will have homeowner’s insurance and if I were a better dog mom, I would have pet insurance.
With telemedicine, the good news is that products, services, and reimbursement (excluding training or education) primarily stay the same as if you were being treated on site in a doctor’s office or medical clinic.
The bad news? Medicare, the largest health insurer for Americans across the United States, currently only covers the use of telemedicine in rural or medically underinsured areas and only when video conferencing is used, and Medicaid views telemedicine as a cost-effective alternative to the more traditional face-to-face physician/patient visit, but hasn’t exactly jumped on board. Medicaid sees telemedicine as more of a service to be regulated by the state: According to The American Hospital Association, the federal Medicaid program "encourages states to use the flexibility inherent in federal law to create innovative payment methodologies for services that incorporate telemedicine technology." Basically, Medicare and Medicaid are not walking down the aisle with telemedicine, but they are Facebook friends. They’ve done some shots at the bar and they’ve had lunch, but they’re still working out the kinks of varying state laws, regulations, and reimbursement.
Fortunately, companies like Blue Cross Blue Shield are on board and recently began offering the telemedicine option to the majority of its customers, including those who purchase coverage on the public health insurance exchanges. Hopefully, other insurance companies will soon follow suit and jump on the telemedicine bandwagon because when you’re sick, having poor health insurance - like ones with extremely high deductibles, limited benefit plans, or mini-med plans offered to minimum-wage employees - is almost as bad as having no health insurance, forcing you to make the tough decision of whether or not the trip to the doctor is really worth it.
It improves access
I don’t have a car. I have my license, but I don’t have a car so I have to rely on my legs and my boyfriend and Uber to get me where I need to go. It already frustrates me that I can’t get ICE CREAM when I want it, so when I am sick, imagine my annoyance. Fortunately, telemedicine is improving access for patients by connecting them to physicians--dermatologists, specialists, mental health professionals--via technology, reducing out-of-pocket costs, travel time, missed work, and stress.
"Thanks to telemedicine, all you need is an Internet connection and a webcam and you can have an online consultation with a board certified physician no matter where you are traveling in the U.S," said Dr. John Shufeldt, CEO and founder of MeMD, a leading telemedicine provider.
Telemedicine also improves access to abortions, making it easier to get a medicated abortion (rather than a surgical one) earlier, resulting in improved health outcomes. If you’re pro-life, you’re not alone: Fifteen states have banned telemedicine abortion since 2010, and it’s currently only available in Iowa and Minnesota.
Most importantly, improved access helps patients receive immediate medical attention, which minimizes the duration and severity of an illness, and reduces the amount of time wasted in waiting rooms and ERs. Thanks to the high cost of medical school and the high GPA and MCAT scores required to attend, the Association of American Medical colleges predicts that by the year 2025, the United States will face a shortage of between 46,000 and 90,000 physicians. Fortunately, telemedicine helps combat that.
Now, it’s obvious why employees like Joe the contractor and Sue the receptionist and Kelsey the freelance writer like telemedicine: they get to stay in bed, chat with their doctors online, and hopefully save a few bucks on co-pays and travel expenses. A 2011 Center for Disease Control (CDC) survey showed that 80 percent of adults discharged from the ER - meaning those who could be treated and were sent home - said they sought care at the ER due to lack of access to a primary care provider. Sadly, that lack of access is expensive, with ER visits ranging from $3,000 to $5,000 and primary care visits ranging from $130 to $190. With telemedicine costing as little as $40, it’s no wonder it’s quickly gaining traction by those who have access to it.
"Telemedicine takes away the worry about cost," said Dr. Shufeldt. "There are no surprises. Most telemedicine providers charge a flat fee per visit. A visit with MeMD will cost you $49, which is much cheaper than a co-pay to an out-of-network provider."
But what about the employers? No worries - they dig it, too. Telemedicine cuts down on their employees’ missed work from being sick and their claim costs if they’re splitting health insurance with their employees or providing it because of the Obamacare mandate. In fact, according to a study done by AmeriDoc of 17,000 telemedicine participants, hospital admissions dropped by 30 percent and doctor visits dropped by 60 percent. What’s more, according to analysis by global professional services company Towers Watson, telemedicine could potentially deliver more than $6 billion per year in health care savings to American companies by reducing the cost of healthcare and increasing efficiency through better management, professional staffing, and fewer and shorter hospital stays.
"Our efforts have shown that increasing the breadth, depth, and availability of patient data to remote care providers significantly improves outcomes," said Darrah. "There is absolutely no reason in today’s technology-driven, connected-health world that better patient-centered care cannot be provided to our chronic disease patients no matter where they are."
Patient-physician relationships are important, and telemedicine is not trying to replace them. It is, however, trying to provide more convenient, cost-effective, and safer alternatives to standard methods of healthcare by treating patients where they are instead of where the doctors are. (Plus, what’s better than Facetiming your hot doctor from bed?)
Photo credit: Ben Husmann