Telemedicine has a growing place in modern medicine as more patients and their physicians embrace this technology. According to the Health Resources and Services Administration (HRSA), telehealth is "the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration."
Telehealth technology can connect patients and physicians through video calls, email and online patient portals and enable real-time consultations between specialists. It can also offer opportunities for following a post-operative patient or, as one health system found, allowing family members to participate remotely in a patient's care.
How Do Patients Feel about Telemedicine?
As the availability of telehealth capabilities grows, a question arises: Are patients willing to use this technology? A recent BMC Health Services Research study found that only 2.3 percent of patients surveyed had ever used a telehealth visit with their personal physician, but the number of patients who were willing to do so exceeded 50 percent. Only about 15 percent of patients would seek out a new healthcare provider who offers telehealth visits, while nearly 56 percent would not seek a different provider specifically for this reason.
When is Telehealth Appropriate?
While the number of telehealth users today is still relatively low, providers are increasingly offering these technologies to meet the growing desire for such capabilities. The American College of Physicians (ACP) encourages the use of telemedicine, but only if it does not compromise patient care. The ACP stresses the need for providers to exercise careful judgment when deciding if virtual visits or electronic communications are appropriate for their patients. Telemedicine, they claim, may be appropriate for patients in underserved geographical locations, but it should be used "intermittently" and not as a substitute for in-person visits or in-office exams.
If providers decide to offer virtual healthcare technologies, they should check sources like Medicare's list of covered telehealth services and CPT codes, such as transitional care, new and established outpatient visits and inpatient teleconsults, to determine insurance coverage details. They should also note that some state laws prescribe whether physicians can provide telehealth visits for new patients or only existing ones.
Advantages and Challenges of Telehealth
Insurance coverage is only one factor to consider when offering virtual healthcare. NEJM Catalyst notes that the costs of teleheath care are similar to in-person care. While the patient's time and travel costs are reduced, the physician still provides services, which cost time and money. Therefore, the overall improvement in care hinges on quality and service. The patient still has to make time for the visit, but she can receive care at a location that is convenient for her — possibly from her office or home — instead of taking time off to travel to the clinic.
One benefit of telemedicine is its ability to increase the speed of healthcare. A quick virtual visit can improve diagnosis and treatment efficiency, help patients experiencing complications and reduce the number of hospital admissions. As NEJM Catalyst states, for example, utilizing telehealth for specialty visits connects the primary care physician, the specialist and the patient for enhanced coordination of care and a speedy diagnosis.
In addition to speed, new technologies like ViewPoint and Tricefy offer streamlined communication models for physicians sharing images with each other and with their patients. ViewPoint allows practices in the same network to securely share ultrasound images and exam data, simplifying the documentation process and making it easy for a team of physicians to access all of the relevant information in one place. Similarly, Tricefy allows connected ultrasound systems to share images quickly and efficiently. Physicians use this tool to collaborate on making an accurate diagnosis, as well as to securely send results to their patients. Both of these ultrasound technologies improve communication and patient experience.
Gynecologists considering integrating telemedicine as a way of offering increased access to patients should consider which patients actually need to come to the office. For example, a patient with recurrent UTIs may be a great candidate for a virtual appointment, whether that be through a video call or through private messaging through a patient portal. Patients who need follow-up care without a physical exam to monitor for medication side-effects, or have non-urgent questions after surgery may also benefit from using this technology. Additionally, gynecologists can prearrange in-office virtual consultations with specialists during a patient's appointment so that the patient does not have to wait for an appointment with the specialist.
Although telemedicine helps patients have easier access to their physicians, the burden of ensuring privacy and security falls to the provider. Email communications must be encrypted, as must any patient portals through which a patient can access her records. Likewise, providers who utilize video conferencing must ensure that all conferencing meets federal standards for privacy and security. Despite these challenges, telehealth capabilities provide quick, efficient care when used properly.
