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Will telemedicine save US health care?

Will telemedicine save US health care?

A category of unsung heroes in this pandemic are those that have been behind a video screen. For some patients, telemedicine providers have offered the only safe and convenient access to acute and preventative health care needs for months now. I believe that the conversion to virtual care will be seen as one of the biggest tools utilized during the COVID19 pandemic that saved lives and saved us from each other. Without it, patients would either have had no access to care or be too afraid to find care during shelter-in-place. The reality is that when you think about the collective impact of telemedicine services at various companies and institutions, it is a huge part of flattening the curve.  

While a pandemic forced our hands in its adoption, the harsh reality is that the widespread use of telemedicine should have been deeply woven into health care for years now. In a society where we crave technology and gadgets, health care has been woefully behind on this front — despite the fact that our consumers desire it. Younger patients in particular expect more from us — in prior years they have been dissatisfied by the technologic applications at their home health care institutions

Even before the onslaught of the novel coronavirus, many leading-edge providers had launched care and guidance services via chat, message-based exchange, or video platforms in efforts to improve access to care in a convenient fashion. We have had the fancy gadgets, the need and the capabilities for some time for this to be a normal part of everyday operations. However, implementing and scaling these digital services has varied widely and it has been universally poorly woven into health care operations.

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The adoption particularly for video telemedicine visits has been slow over the years, some of which was due to variance in individual states for insurance coverage of these services. In some states, it was difficult to push for institutional funding to increase telehealth programs without appropriate reimbursement. The current state of Medicare and many commercial carriers providing coverage for telemedicine visits, in addition to the need for social distancing, has launched telemedicine forward at an uncomfortable pace.

Change is hard, but despite the discomfort, we have all embraced advanced health care technology and communications platforms this year for the sake of patient care. With parity becoming the universal norm during this pandemic, it has allowed everyone to push quickly towards the future of health care delivery and it is now apparent how beneficial these types of services are. 

Not surprisingly, the feedback by patients is overall positive — for a brief follow up visits or clinical questions, who can argue with the convenience and the time that is saved by seeing your doctor from the comfort of your office rather than needing to take time off of work, paying for parking or public transport and sitting in a waiting room for a 10-minute visit? 

And what about those patients without easy access to transportation? Or those who serve as full-time caregivers for a family? At least they can make it “in” to see their doctor virtually rather than miss appointments or avoid health-related concerns due to lack of access, time, or ability. In today’s world, it is more likely for a person to have a smartphone (or at least access to a device) — about 96 percent of Americans have some sort of cellphone, with  8 out of 10 having a smartphone.

This makes the idea and feasibility of telehealth expansion more viable than it was 10 years ago. Yes, it is imperative to keep in mind that an annual examination or more complex issues should absolutely be seen in person with a skilled professional. However, that is why advocates for telehealth see it as a supplement for access to health care, not a replacement for in-person care

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Beyond patient care, telemedicine is a feasible option for providers to remain in medicine who need to transition from in-person patient care, whether it be due to age, physical limitations or burnout. It has been suggested that it could lend itself to alleviating some of the burden of the COVID-19 pandemic on caregivers. 

We now have more digital tools than ever before to help maintain health care yet, despite its success and popularity, Telehealth visit numbers are declining. The question is: now that telemedicine has finally arrived, will we continue to use it effectively as an economically feasible tool to improve our broken health care system and close health care disparities? Or will we go back to our dysfunctional state of affairs once the pandemic clears?

Meeta Shah, M.D., is an assistant professor in the Department of Emergency Medicine at Rush University Medical Center.