Perhaps there is no specialist near you who can treat your condition. Maybe you are frail and weak, and therefore can’t manage a trip to the doctor’s office. Or, perhaps you don’t have transportation, can’t find affordable transportation, can’t get out of work, or have caregiving responsibilities. There are countless reasons that make traveling to the doctor difficult, or even impossible. Does this mean you can’t see a doctor or receive care? No! Telemedicine to the rescue. With telemedicine, your appointment is “virtual” and takes place over a phone or computer. What are the benefits of telemedicine? The drawbacks?
What exactly is telemedicine?
Telehealth is the broad term for all healthcare services that use telecommunications, including telephone alerts regarding disease outbreaks. Telemedicine, a subset of telehealth, is the use of telecommunications to provide clinical services to patients. (Although it’s worth noting that these terms are often used interchangeably.)
Doctors and other healthcare professionals conduct virtual appointments with patients via video (e.g. Skype or FaceTime). Additionally, patients can send photos to their doctors using integrated software, allowing doctors to more clearly see areas of concern, such as moles, burns or bruises. Another aspect of telemedicine includes the use of at home monitoring systems that make it easy for doctors to track a patient’s important health parameters, such as heart rate and blood pressure.
The use of telemedicine is rapidly growing as more doctors and patients participate. Over the past 15 years, many studies report patient satisfaction and support for telemedical services.
Top 5 benefits of telemedicine.
Improved access to doctors, including specialists.
Plain and simple – telemedicine improves access to doctors. Since there are widespread shortages of doctors and other healthcare providers, in both rural and urban areas, telemedicine provides access to services and doctors that would otherwise require patients to travel long distances. Similarly, if you have a rare disease that requires a hard-to-find specialist, telemedicine can connect you to a specialist in another part of the country. Furthermore, telemedicine is a great tool if you cannot get to the doctor due to illness, transportation issues or other impediments.
It’s so convenient!
Why would you want to travel to your doctor’s office and wait in the waiting room for 20-30 minutes when you could wait for your telemedicine appointment while at home or at work? Interestingly, one study found the average in-office medical visit takes 121 minutes – 20 minutes seeing the doctor and 101 minutes traveling to/from the doctor and sitting in the waiting room. Clearly, virtual visits save you time and eliminate travel-related stresses and expenses. And all that driving and waiting usually means more missed work.
It can minimize unneeded visits to the doctor or ER.
It’s a waste of time and money to go to a doctor or the ER if your health doesn’t require an in-person visit. With telemedicine, you can speak with a doctor from the comfort of your home or job. Together you can decide if you should follow up with a visit the doctor or ER.
Reduced healthcare costs.
Telemedicine can reduce or contain healthcare spending by increasing efficiency via better management of chronic diseases, reduced travel times, and fewer or shorter hospital stays. Since so many of us have high deductible insurance plans, as well as responsibility for a portion of each bill, lowering healthcare costs helps us all.
Improved quality of healthcare.
Telemedicine can improve the quality of care by making it easier to for providers to stay engaged with patients. Additionally, when doctors remotely track a patient’s health via monitoring systems, they can identify problems as soon as they develop.
Studies show that the quality of telemedicine services delivered are as good those provided through in-person appointments. Interestingly, according to the American Telemedicine Association, “in some specialties, particularly in mental health and ICU care, telemedicine delivers a superior product, with greater outcomes and patient satisfaction.”
You can’t get physical!
It goes without saying that physical exams are impossible via phone of computer. And of course, there are circumstances when an in-person visit is essential for diagnosis and treatment. However, for patient follow-ups and minor conditions, a virtual visit may be enough. (Certainly, if the patient is too ill to leave their house or cannot travel far distances for an in-person appointment, a virtual appointment is far better than no appointment at all!)
Pediatric patients might get unneeded antibiotics.
Researchers examined treatment recommendations from over 500,000 cases of children with acute respiratory infections (ARI). Their analysis found that children with ARI who were treated through telemedicine were significantly more likely to receive antibiotics. The percent of children with ARI who received antibiotics was as follows:
- 52% of those who used telemedicine services
- 42% of patients who went to urgent care
- 31% of those who saw their primary care providers
Additionally, a higher proportion of the antibiotics prescriptions written through telemedicine appointments disregarded medical guidelines regarding when to prescribe antibiotics. This was primarily due to doctors prescribing bacteria-fighting antibiotics to treat viral illnesses (e.g. colds and flus) which cannot be cured with antibiotics. Why is this important? Prescribing unneeded antibiotics increases the chances of side effects and contributes to the increase of antibiotic-resistant germs. And that is nothing to sneeze at! Experts speculate that antibiotic-resistant germs may kill more people than cancer in the coming decades. (For more information on the dangers of too many antibiotics, read this blog post.)
Interestingly, there is no evidence that adult patients receive a higher number of unneeded antibiotics from telemedicine appointments, as compared to urgent care or primary care doctor visits.
Does this mean that all patients who use telemedicine might get unneeded medications and potentially sub-par care? I don’t know, but it’s worth keeping this study in mind if/when you use telemedicine services.
You might not know the doctor on the other side of the phone.
It’s important to note that the doctor you speak with during a virtual appointment may not be a doctor you know. Some doctors use outside telemedicine companies to provide virtual care for their patients. Additionally, many employers now provide telemedicine services from 3rd party vendors as part of their benefit offerings. In these circumstances, you’ll connect with doctors who are unfamiliar with you and your medical history, which can impact care.
Data security concerns.
Cybersecurity is a huge concern in medicine these days, and telemedicine is no exception. Unfortunately, cybercriminals can hack into telemedicine systems to steal personal and private healthcare information. Not only is this worrisome, it’s a violation of HIPAA laws. Sadly, there are currently no existing solutions to stop these criminals, but many experts across the world are hard at work trying to thwart these attacks.
Just like any other medical appointment, telemedicine visits come with a fee. If you use a telemedicine company provided through your employer, there may be little or no cost for you. To avoid unexpected bills, ask your employer about cost and possible copays before you make an appointment.
If you schedule a virtual appointment through your doctor, your insurance might cover it. But don’t assume theses visits are covered – and don’t assume your co-pay will be the same as for in-person visits. Most states have telehealth laws requiring coverage, but state policies change frequently. To learn about coverage in your state, visit the Center for Connected Health Policy website. It’s also a good idea to call your insurance company and ask them about coverage, including co-pays, for telemedicine services.
Additionally, it’s important to realize that some doctors charge a convenience fee, which can range from $35 – $125, on top of the normal visit fee. These fees are not covered by insurance, so ask about fees before your virtual appointment!
What do patients think of telemedicine?
It seems like a majority of patients are willing to give it a try.
A 2015 patient survey by Software Advice found that:
- Among patients who have not used a telemedicine service, 75% express interest in using one in place of an in-person medical visit.
- Only 16% of patients would prefer care in an ER for a minor ailment, even if they also had access to telemedical services.
- 2% of telemedicine users say security is their main concern with the telemedical system used.
- 21% of patients who had virtual appointments say the quality of care was similar to or higher than an in-person visit.
And similar results were found in a 2017 survey by American Well – 2/3 of people expressed a willingness to see a doctor via video.
How popular is it?
Telehealth is gaining traction quickly. According to the non-profit FAIR Health, the number of patients using telehealth services in the US grew 53% between 2016 to 2017. To put this increase in perspective, by comparison, this increase was far greater than the increase in use of urgent care centers (+14%) and retail clinics (+7%). Interestingly, and likely related, the use of Emergency Rooms decreased 2% during that period.
Get the most of every virtual appointment.
Even though your appointment is via the phone, don’t just sit back in your favorite TV chair and relax. You need to prepare for these appointments the same way you would prepare for any in-person medical appointment. And, you need to make sure your doctor is listening to you, your questions are answered, and you understand next steps.
For more information on getting the most out of every appointment, read these blog posts:
- 10 Tips for a Better Medical Appointment
- Why Take Detailed Notes at Doctor Appointments?
- 10 Steps to Reduce Your Risk of Diagnostic Error
- Should you Speak Up if You Think Your Doctor is Wrong? YES!
- Learn a Lesson From Serena Williams: Trust Your Instincts When it Comes to Your Health
NOTE: I updated this post on 4-2-19.