Using cutting-edge telecommunications and diagnostic technologies, telemedicine brings professional medical care to patients who might otherwise be unable to avail themselves of such services. Whether they live in remote rural areas far from the nearest doctor or are stricken by illness in the middle of the night or during the weekend, telemedicine can help to address their immediate needs, stabilize them if necessary, and refer them to appropriate medical services for follow-up care.
Obviously missing from the telemedicine encounter is the human touch one might expect from a typical in-person visit to a doctor’s office. Is this missing ingredient a fatal flaw in the telemedicine equation? It’s unlikely to matter much to the worried mother seeking immediate help for an infant with a high fever or a disabled patient unable to visit the doctor in person. In many cases, the patient’s choice is to consult a doctor via telemedicine or not at all. Given those stark options, a telemedicine consultation is the welcome choice of most such patients.
Where Telemedicine Excels
It’s true that telemedicine performs better in some disciplines of medical care than others. Because talk therapy is usually at the heart of psychological counseling, mental health services are handled well via telemedicine. Dermatologic consultations also adapt well to the telemedicine model, given the high-resolution teleconferencing technology that allows the doctor to closely examine skin lesions and eruptions from a remote location.
For emergency care, particularly that offered to patients living some distance from the nearest medical center or hospital, telemedicine offers an excellent screening tool but almost never the final solution. The doctor, located remotely from the patient, can quickly assess the nature of the medical emergency and suggest a plan of action or even summon emergency medical transport if warranted.
Not Yet Reducing Overall Costs
Telemedicine has grown rapidly in recent years but thus far has failed to fulfill one of its early promises: the reduction of overall health care spending by substituting less expensive virtual visits for most costly in-person visits to the doctor or hospital. A recent study, published in the March 2017 issue of “Health Affairs,” found that only 12 percent of direct-to-consumer telehealth visits replaced traditional visits to health care providers. The remaining 88 percent represented brand new utilization of health care services that conceivably would have gone unmet were it not for the availability of telemedicine.
The study, conducted by RAND Corporation policy researchers and other health policy experts, found that telemedicine’s “increased convenience may tap into unmet demand for health care, and new utilization may increase overall health care spending.”
Telemedicine’s Benefits Reviewed
Smith & Jones, a health care marketing agency based in upstate New York, recently took a look at the pros and cons of telemedicine from the viewpoint of medical professionals. On the positive side, they found that:
- extra, telemedicine-facilitated visits with doctors could keep patients out of the hospital;
- telemedicine offers yet another way for people to connect with their doctors;
- virtual visits could serve as a prelude to in-patient care for new patients; and
- medical professionals offering telemedicine services could attract new patients with these services, particularly if their local competitors aren’t offering those same services.
How About Its Disadvantages?
Counterbalancing these positive attributes and benefits of telemedicine, Smith & Jones analysts found a similar number of disadvantages. They found that:
- many users of telemedicine services are abusing this high-tech service by using it too often, as if it were just another form of social media;
- overall health care spending is likely to increase because the easy availability of telemedicine services tempts many consumers to use it more often than they really need to;
- younger tech-savvy consumers access telemedicine services more often than those in rural areas who actually need the services most desperately; and
- the demand for additional telemedicine sessions with their patients increases the overall workload of medical professionals offering such services.
Telemedicine Can Save Lives
While acknowledging that telemedicine services can’t offer the same human or personal touch as experienced during a face-to-face patient-physician encounter, a recent article at CaliforniaHealthline.org points out that such services can be life-saving. CaliforniaHealthline is a daily online news service published by Kaiser Health News on behalf of the California Health Care Foundation.
The article recounts the 2015 experience of Kimberly Griffiths who was faced with a medical emergency when her week-old daughter suddenly became seriously ill. “She was turning blue and had very labored breathing,” said Griffiths, who rushed her baby to the local emergency room in rural Sonora, California. Medical professionals there were unable to diagnose the problem, and the closest pediatric specialist was in Sacramento, roughly 100 miles away.
Telemedicine Link to Specialist Set Up
Fortunately for Griffiths and her child, doctors at Sonora were able to quickly set up a two-way video connection with a neonatologist based at UC Davis Medical Center in the California capital. Through the advanced technologies of the telemedicine hookup, the Sacramento-based specialist was able to monitor the infant’s vital signs in real time and to view high-resolution images of the child. Suspecting that the baby was suffering from a congenital heart condition, the specialist prescribed a medication that stabilized the child’s breathing.
“Without telemedicine, our daughter would have died that night,” Griffiths told CaliforniaHealthline. The family’s health care insurer reimbursed for the remote services Griffiths’ child received that night. “Nobody should be denied the health care they need because of where they live,” Griffiths said. In an emergency case such as this, it’s likely that the absence of the human touch mattered little to Griffiths, whose primary concern was getting the necessary medical help for her child.
Not Appropriate for Delivering Bad News
While telemedicine can extend professional medical care to those who might otherwise fail to get such care, there are some areas of medicine that doctors feel require face-to-face encounters between physician and patient. A January 2016 article at mHealthIntelligence.com reported that a survey of 309 physicians by Aptus Health found that 88 percent of the doctors said they would insist on a face-to-face meeting with a patient to deliver bad news, such as a biopsy finding of malignant tissue or similar negative findings.
According to one of the survey’s respondents, “It is much harder to convey empathy to a person via electronics. The power of human touch should never be underestimated.”
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