Telehealth and the Future of Clinical Visitation

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Telehealth and the Future of Clinical Visitation

The basic concept of telemedicine and virtual visits is not new- it has roots dating back to the 1950’s. Video chatting with your physician has been seen in science-fiction for decades, but is only recently possible or reasonably achieved. Just think about the process:  making an appointment, driving to the clinic, waiting, being seen, driving to the pharmacy, and finally heading home; all for something that could essentially be done over the phone.  A simple video chat with your doctor would take minutes and result in a greater quality of care- its benefits are especially clear with regards to pain management and other chronic illnesses.

Health technology has progressed at a rate faster than is governable. It was only until earlier this year that the Center for Medicare and Medicaid Services (CMS) released a new provider reimbursement code for non-face-to-face patients (and here’s the main caveat) who have chronic illnesses. As stated before, these are the people who will benefit the most anyways- but it still doesn’t make much room for the rest of us. It is a huge step forward toward canceling out nonessential, regular visits to the doctor that may only be a check in with your physician.

In regards to reimbursement, it is still a little murky as to what happens to those with non-chronic designations. They will still probably have to go through the rigmarole of making an appointment and actually having to show up. However, this is a huge first step towards  streamlining the way physicians see patients and innovating the medical industry as a whole.

With the rising prevalence of chronic illness among a growing population of aging seniors, there has been significant pressure for a shift on the supply side of health care.  The core technologies of telemedicine regarding data collection are wearable or ingestible sensors, vital sign and health-monitoring and technology that enables communication: video conferencing, mobile apps, SMS text messages, and voice calls. These services are integral to modern society and will continue to find their way into the spaces not currently used by them- in this case: care delivery.

There are some obvious concerns with virtual visits- the exposition of sensitive information (for instance, a cancerous or terminal illness diagnosis, would best be handled in person.). Some complex diagnoses might still require an in-person consultation, etc. but, these are mostly fringe scenarios among the bevy of patients seen by physicians on a daily basis. Health care visits that are algorithmic in nature or have a low emotional impact (heart rate monitoring, blood pressure checks, dermatological reviews) can easily become virtual visits, which could be beneficial to both parties.

A new survey by the Robert Graham Center and the American Academy of Family Physicians found that nine out of ten doctors would utilize telemedicine practices, if properly reimbursed.

“It’s clear from our findings reimbursement remains one of the largest barriers to the use of telehealth in primary care,” Andrew Bazemore, MD, the director of the Robert Graham Center, said in a statement. “However, this seems to be evolving, at least in the private sector, with several national large private carriers reimbursing doctors in 2016, if not earlier,” he said.

1,557 randomly selected physicians were surveyed, answering 30 questions that assessed characteristics of the physician and practices, personal attitudes and opinions about telehealth and its barriers and usage. While both users and nonusers disagreed on many of their attitudes about telehealth, both groups agreed telehealth could potentially increase access to healthcare, decrease travel and improve continuity. Additionally, nearly all respondents recognized in-office visits are the best form of care, but using telehealth is a better alternative than patients not seeing a doctor at all.

There are several models of telehealth application currently being provided. For example, Upstate Concierge Medicine features two business plans: direct customer (physician) to patient interaction, and third-party turnkey services for larger medical practices that do not have the resources to immediately develop a telehealth plan.

It will likely still be a while before telehealth becomes common practice industry-wide, but the evidence is there to show that it is the future of clinical visitation- it is just a matter of time.

Author: Cory Clark

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