Fever, sore throat, cough, chills…The last thing anyone with these symptoms wants to do is get out of bed and sit in the waiting room at the doctor’s office. That is if there’s even an appointment available.
With telemedicine, healthcare providers can accommodate routine visits virtually. This provides patients with a more convenient way to access care, while reserving in-person appointments for more complex health issues. Other common applications of telemedicine include remote follow-up, treating patients with chronic conditions such as diabetes, as well as expanded care for patients in remote or rural locations. Couple virtual visits with the latest wearable health devices such as heart monitors, blood and glucose sensors, and activity trackers, and providers can remotely monitor at-risk patients who require additional care — while also freeing them from frequent in-person visits.
Despite years of buzz and technological advancement, however, telemedicine, or telehealth, has failed to achieve widespread adoption. In fact, most medical consumers aren’t even aware telemedicine is an option —never mind having actually participated in a remote visit with their physician. In concept, telemedicine seems like an ideal solution for many of the current challenges facing healthcare. Patients receive convenient treatment and providers have more time to focus on patients who really need it. So why is adoption lagging?
The Doctor Will Call You Now
Even though more than half of U.S. hospitals offer some sort of telehealth program, only 17 percent of the population reports ever using telehealth – despite the fact that over two-thirds of patients say they’d be interested in such a service.
If these stats seem contradictory, that’s because they are. Lack of awareness is perhaps the greatest hurdle telehealth faces to achieve mainstream adoption.
Interestingly, this isn’t because telehealth is a new innovation. Believe it or not, telehealth was first proposed in medical literature soon after Alexander Graham Bell patented the telephone in 1876. However, it took until the 1960s and 1970s for the concept to truly develop, when NASA, the U.S. Public Health Service, the Department of Defense and other federal agencies took interest in the concept. While the practice made sense for astronauts orbiting the earth, it didn’t take off back here on the ground. Patients still preferred to see their doctor face to face, and without the live video streaming capabilities we enjoy today, interest in telehealth waned.
Fast forward to today, however, and from a technology standpoint, we now have the tools needed to make telehealth an appealing and effective option. Applications like FaceTime and Skype allow physicians to have far more meaningful, effective conversations then they ever could over the telephone, enabling them to deliver more informed diagnoses. More recently, wearable technologies like the Apple Watch have further empowered physicians with remote monitoring of vital signs such as heart rate and blood pressure. As we look toward the future of virtual care, wearable innovations mean communication doesn’t stop at the end of a visit — remote monitoring can take place 24/7, alerting the physician of anomalous vitals and enabling rapid intervention.
Despite their desire for virtual care, however, patients are still wary. After all, sharing personal health information and receiving medical care via a smartphone isn’t quite the same as FaceTiming with your mom. Additionally, despite telehealth’s lengthy history, the healthcare industry and federal government are still unsure what a successful telehealth program will ultimately look like. Things like scheduling, clinic workflows, billing, data management and patient privacy are all challenges that still need to be addressed.
Getting A Second Opinion: What Are Physicians Saying?
Even with increasing awareness, questions still remain. Are telehealth visits even effective? Who will pay for them? As with everything surrounding telehealth, the answer is complicated and still coming into focus.
Until very recently, reimbursement and billing for virtual care has been nebulously defined, at best. With the Centers for Medicare & Medicaid Services (CMS) and private payers trying to figure out if and how they will reimburse providers, many early adopters today simply take cash for virtual visits. However, as part of the Trump Administration’s 2019 budget, that is changing. In late October, CMS officially announced a new rule, which, for the first time, allows physician reimbursement for virtual check-ins, remote image evaluation, and other remote technology-enabled services. With this regulation in place, providers may be more prone to suggest virtual visits with patients, particularly those in need of minor check-ups.
A significant step forward, this new policy is not a cure-all. Many doctors remain worried about liability and some fear that it’s easier to miss things in a remote visit. In a 2016 study, a group of researchers posing as patients with skin conditions tested 16 different telemedicine apps. The researchers found that some of the doctors misdiagnosed skin conditions such as herpes and syphilis and others failed to ask important questions and ended up prescribing unnecessary medications. Additionally, two of the apps connected the “patients” with doctors who weren’t licensed to practice in the state where the patient was located.
Skeptics point to research like this as reason enough to avoid a virtual care delivery model. That said, technology such as video streaming and wearables have changed drastically since this study was conducted. Importantly, the new CMS regulations only apply to patients who have established relationships with a doctor, not those reaching out to a doctor they’ve never met with in person before, as was the case in the 2016 study. Additionally, widespread adoption of electronic health records (EHR) means physicians now have more complete access to patient histories, while better streaming capabilities like 4 and soon 5G, along with wearable technologies, make remote diagnosis more viable and accurate than ever before.
Today, many physicians believe that telemedicine, when used correctly, is a useful and important tool for doctors to have in their arsenal. In fact, we recently polled physicians at Modernizing Medicine’s annual user conference and found that 77 percent believe telehealth will be the biggest change to healthcare technology in the next five years.
What’s The Prognosis On Telehealth?
For years, telehealth has been lauded as the next big thing in healthcare, but so far has failed to come to fruition. However, new innovations take off when both technological maturity and a pathway to regulatory acceptance are achieved — and telehealth sits poised on this tipping point as we enter 2019.
Not only that, but big industry players and entrepreneurs alike now have skin in the game. Billions of dollars and countless startups continue to flood the telehealth market, and by some estimates, it’s expected to become a $2.8 billion industry in the U.S. by 2025, up from $240 million just five years ago. Importantly, Amazon is reportedly planning to enter the telehealth space as well, and currently has a stealth team working on a platform that would help facilitate virtual visits between doctors and patients. There’s no doubt that the next few months will be telling for the telehealth market.