Telemedicine, the use of audio and visual technology in providing health care, has been gaining popularity in recent years. That popularity has accelerated over the course of the pandemic as access to care has been limited to slow the spread of COVID-19. There are numerous benefits of telemedicine including improved access to care, timeliness of that access, less travel time and less time away from work. It has proven effective in the treatment and management of numerous conditions and is well-received by both practitioners and patients. 

Health care providers, practices, hospitals and other health care organizations have adopted telemedicine widely, and there are numerous telemedicine companies facilitating these services. As telemedicine continues to demonstrate its capabilities, it will likely increase access to care and expand further in terms of conditions that can be adequately treated remotely. 

As promising as telemedicine appears to be, it is still somewhat inchoate. In-person provider visits are still required for many conditions, and physical examination via video is rather limited. Several studies have demonstrated that telemedicine is more effective for established patients or previously diagnosed conditions as opposed to new patients or new conditions. The rate of complications and missed diagnoses hasn’t been established, and some authors recommend a low threshold to follow up a telemedicine with an in-person visit.

Some populations are more resistant to telemedicine, and the personal relationship established over a video visit is a poor facsimile of a face-to-face one. As artificial intelligence and other technologies are developed, some of these limitations will be overcome, but the need for in-person visits is going to remain for quite some time.

The pandemic shutdown and the need for remote schooling highlighted in many communities the existence of a significant digital divide. While telemedicine helps to increase access to care, the digital divide highlights that this access will not be uniformly applied to everyone.

Imagine the experience of a patient with private insurance, access to Wi-Fi and the means to invest in a high-quality digital stethoscope versus that of the patient on Medicaid with no internet access, much less the ability to invest in technology to make telemedicine more effective. These issues then become amplified for the latter patient living in a remote community where primary care and specialist access for in-person visits are limited. 

Telemedicine is an exciting and expanding method of delivering high-quality health care but currently suffers from the limitations noted above. Traditional medicine has the benefits of fostering a face-to-face human connection, the accuracy of a hands-on physical exam and the ability to perform the hands- on treatment that is involved in treating physical conditions of the human body.

Given that telemedicine currently has limitations, accessibility isn’t universal, and many areas of the country experience long waits for primary and specialist care, there is an opportunity for a unique hybrid model of telemedicine and traditional care. This hybrid model would inhabit the technology space incorporating telemedicine for easy access to care with an app that coordinates and enhances access for in-person visits. 

These offerings would help to bridge the gap between the benefits and limitations of telemedicine and traditional visits. Ideally, this approach would be partnered with sophisticated on-the-ground capabilities (mobile providers able to provide primary care and hands-on treatment and testing) to bring health care access to those who are economically or technologically remote. 

More than just telemedicine or a new app, this would be a reimagined hybrid of health care delivery: telemedicine for increased access partnered with a mobile delivery system for those who need more than telemedicine, with both of these bolstered by a network of providers linked by an app that creates access to primary and specialist care for everyone. 

Health care markets vary widely in the United States. There are varying mixtures of primary care and specialist providers, along with varying mixes of private and public insurances and a wide range of access to care. This reimagined health care delivery system could be easily tailored to reflect the needs of each local community. 

Imagine putting the power of access and choice in the hands of every patient. By recognizing the specific advantages of traditional health care, technology and mobility, we can break down the existing barriers to care. A nimble health care team enabled with the power of mobility and technology can help to bridge the gaps in health care access that have been laid bare in this year’s pandemic. 

Joshua T. Carothers is a physician and Chief Medical Officer of VIP StarNetwork, which is revolutionizing how the film industry offers health care benefits and increases health care access.

Published on Dec 24, 2020