Telemedicine Pros and Cons

Development of telemedicine has launched health care into the modern age, enabling physicians the ability to access patients across long distances, transmit medical records between facilities, and even allow paramedics to transmit vital medical information en route to the emergency room.

Innovation in the field of telemedicine can be widely considered a societal good and the benefits cannot be understated.

However, as with all things, there are some downsides when adopting telemedicine and both the pros and cons of this modern field should be considered by physicians and patients alike.

Telemedicine is growing in popularity across medical practices and institutions and over half of all U.S. hospitals already utilize it.

This number will continue to rise as electronic medical records become required in all health centers and technology becomes not only more efficient but more affordable.

Additionally, a survey recently revealed that 90 percent of health care executives have either implemented or began development of telemedicine in their organizations.

Smaller, private practices have also adopted telemedicine in an effort to compete with commercial health care clinics and subsequently retain their patients.

Although moving to telehealth is a wise and beneficial decision, implementing new technology, best practices, data transition and staff training is a time-consuming endeavor and should be carefully considered before beginning the patient service transition.

The benefits of telehealth are numerous and can help lower health care costs, increase revenue, improve efficiency and improve patient retention.

Convenience is the most important factor when patients consider quality care.

According to a recent Cisco global survey, 74 percent of patients reported that easy access to health care services is preferable to in office face time with a physician.

Smartphone apps and video conferencing allow homebound patients, those in rural areas or those who cannot make an office visit because of time constraints the ability to still receive care.

This accessibility saves not only precious time that can be spent seeing other patients, but also reduces the cost of patient no shows.

Telehealth plays a remarkable role in reducing health care costs across most aspects of health institution and office maintenance.

Electronic data storage and remote monitoring services reduce service costs for all parties involved, including the physician, patient, and insurance company.

Low priority ER visits are reduced and transportation expenses become unnecessary for standard check-ups.

These savings can be quantified.

The American Hospital Association discovered that a telemedicine program saved 11 percent in service costs and even tripled ROI for the investors.

Physicians can also profit from telehealth programs.

The time saved by telemedicine allows physicians to turn on-call hours into billable hours and attract new patients.

Doctors can opt to work from home for part of the week, reducing office overhead.

All players in the health care system stand to gain from the implementation of the telemedicine system.

Another benefit of telemedicine is directly tied to the original roots of the practice.

When telehealth gained popularity through the 20th century, its primary utilization was health outreach to rural populations.

This benefit has not changed today. A mere 43 specialists are available to 100,000 rural patients today.

With telemedicine, rural patients can be treated by the specialists they need without the long wait times and difficult commutes they would ordinarily have to endure.

Physicians can also expand their practice to include regions that would not normally be accessible through traditional means.

The benefits to both the patient and the doctor make telehealth an obvious logistical choice.

Greater accessibility and convenience thanks to telemedicine results in patients becoming more involved and ambitious in their health care needs.

They are more likely to make and keep their appointments and voice any questions or concerns to their doctors with greater frequency.

When patients are consistent with maintaining their health and engaging in preventative care, health care costs are reduced and emergency procedures are less common.

Establishing and maintaining a healthy lifestyle becomes an easily attainable goal when patients are offered the convenience that telemedicine provides.

Most importantly, telemedicine offers a higher quality of patient care.

When patients are given agency in their own health care decisions, they can speak candidly to their doctors about their questions, concerns, and ultimate goals for health.

The timeliness that telemedicine provides allows patients rapid treatment if an urgent problem arises.

Furthermore, a recent study shows that patients utilizing telemedicine report less stress, depression and anxiety and have 38 percent fewer hospital admissions.

Although the benefits of telemedicine are numerous, some caveats do remain and must be taken into consideration before both patients and physicians decide that telehealth is the best path for them to take.

Considerate time and money must be invested to transition to a telemedicine supported office.

Existing IT staff in the practice must be trained to ensure that patient data is secure.

Furthermore, their current responsibilities would need to be drastically altered in order to aid in the transition and then maintain the new infrastructure.

Training must also be provided to the remaining staff in the office, consuming considerable time and resources during the workday.

Staffing would also need to be reevaluated and possibly reduced since telemedicine could allow a single nurse to monitor many patients from a single location, making traditional rounds and face to face interaction with a full staff redundant.

The traditional patient and physician relationship may become obsolete as telehealth becomes more common.

When a patient has the ability to utilize video conferencing in times of need, he or she would not necessarily be connected to a doctor familiar with his or her medical history.

The primary care physician would then be faced with an incomplete record of the treatments the patient receives if the physician is unable to access the medical records from prior providers.

A revolving door of care providers puts the patient at risk for inaccurate treatment and inconsistent execution of a long term health care strategy.

However, reduced care continuity is forecasted to reduce with time as more practices adopt telemedicine methods.

When that occurs, transfer of a patient’s medical records from office to office will reduce the chances of a patient being forced to visit an urgent health clinic or hospital.

Convenience and accessibility are telemedicine’s strongest asset.

However, modern day convenience does subsequently reduce the relationship between a physician and his or her patient.

If a patient has not established a long term relationship with his or her health care provider, they may be more hesitant to voice any questions or concerns related to their care.

This hesitance may lead to inaccurate diagnoses, adverse prescription interactions, and lapses in preventative care.

Furthermore, some appointments must be conducted at the practice.

In house tests and physical exams cannot be substituted with a video conference.

Digital infrastructure is not infallible even if an IT staff is consistently monitoring the equipment and network.

Networks and servers can and do go offline until an IT specialist is able to diagnose the issue and bring the infrastructure back online.

Adverse weather can cause widespread blackouts.

Run of the mill human error can knock a system down. A more insidious risk is an attack on the network.

The recent WANNACRY virus crippled European hospitals and made accessing digital medical records impossible until the security vulnerability was patched.

Although digital services provide enormous benefits, the problems that arise when they are no longer available are numerous and severe.

The move away from physical medical records makes a purely online system more precarious.

Lastly, complicated logistical issues must be considered when making the transition to telemedicine.

Insurance reimbursement policies vary greatly from state to state.

Not all states have telemedicine parity laws in place, which would ensure that private payers reimburse the same way they would in a traditional in the office setting.

Medicaid coverage also varies across states when patients decide to utilize telemedicine.

Some state Medicaid plans offer generous telemedicine coverage while others are more limited.

Patient consent laws also differ based on location and must be researched before offering care to patients across state lines.

Finally, the physician must ensure that he or she is properly licensed before accepting patients from different states.

Only Maryland, New York, Virginia and Washington DC legally allow interstate licensure around neighboring states.

A conditional telemedicine license is also only available in Alabama, Louisiana, Minnesota, Nevada, New Mexico, Ohio, Oregon, and Tennessee.

Although interstate licensure is still a hurdle, progress is being made as telemedicine becomes more commonplace.

The Federation of State Medical Boards has created the Interstate Medical Licensure Compact which would simplify the out of the state licensing process in participating states.

11 states have signed onto the compact, a mark of progress that will make telemedicine accessibility easier to implement.

Despite the logistical hurdles and continuity of care challenges, telemedicine’s benefits outweigh the difficulties.

When considering a patient’s needs, the initial capital and time investment is a one time sacrifice that reaps numerous advantages.

The convenience of care, patient retainment, patient satisfaction and increased profits make telemedicine an attractive option to bring to a practice.