Picture the scene: You are living in one of the remote corners of the world, and your chronic pain flares up suddenly. The pain is the most intense you have ever experienced, and you are starting to feel panic and anxiety. The nearest doctor is 50 miles away, and you don’t think you will be able to drive that far.
Or this scene: It is the middle of the night. Your child wakes up feverish and comes to your room. His cough seems severe, but you’re not sure if you should be concerned enough to head to an emergency room. Urgent care closed hours ago, but you think you may need to see a doctor.
Or this one: You are a rural doctor tasked with caring for communities within a 100-mile radius of your small practice in town. One of your patients who is recently returned from a tour of duty in Afghanistan is beginning to show signs of post-traumatic stress disorder (PTSD), but you feel your qualifications are not enough to truly help him. You have no mental health professionals on staff.
All three of these cases are very real, and all three of them can be addressed using one of the latest in healthcare technologies: telemedicine. Telemedicine is the practice of using live streams and video cameras connected to the internet to allow doctors to consult with patients. Also referred to as telehealth, this practice can also include consultations via email and transmissions of pictures to aid in diagnosis.
There are several areas in which telemedicine can be especially helpful, or will be in the near future.
Mental health services
Over half of the counties in the U.S. lack a qualified mental health service provider. As veterans return from deployments in the Middle East and our veteran population continues to age, these services are needed now more than ever. Mental health professionals can also offer counseling via Skype to moms with post-partum depression, teens with bullying issues, or anyone else in need of counseling. These doctors, working either in conjunction with a primary care physician or on their own, can also call in prescriptions to a local pharmacy if needed.
This aspect of telemedicine offers tremendous value for people all over the world. Doctors can consult with specialists anywhere in the world before, during, and after a surgical procedure, even in the operating room. When it is not feasible to fly to a specialist, or if a specialist is not able to fly to a patient, telemedicine offers an excellent option for doctors who need assistance.
Minor health issues
The rise of clinics in drug stores began the process of making doctor visits for illness nearly obsolete, and telemedicine may continue that. For minor illnesses such as cough, cold, and even flu, patients can chat online with a doctor and, in some cases, have a prescription delivered to their door. This may even replace visits to the emergency room in cases of twisted ankles and minor cuts or burns.
Patients under the regular care of a physician for chronic health conditions such as chronic pain or diabetes can use telemedicine as a monitoring system to communicate with their doctor. Through email and video, patients can report new symptoms or check in regularly. For newly-diagnosed conditions, this may be a great way to keep a close eye on a patient until they have stabilized.
While many health insurance companies have been reluctant to embrace telemedicine by covering all of its potential users, Medicare is looking to expand coverage for its insured. Medicare turned 50 in July and is looking to expand coverage beyond the current coverage of residents in rural areas. Following the lead of the Veterans Health Administration and many prison systems that utilize telemedicine for routine care of inmates, Medicaid is examining the potential financial incentives that might make telemedicine a viable part of healthcare for Medicaid recipients.
Likewise, many large hospital systems are recognizing the value of telemedicine not only to handle increased demand for healthcare services but also to cut down on readmission for the same conditions. Geisinger Health System in Pennsylvania saw its readmission rate cut by 44% after implementing a more robust telemedicine program. They were also able to handle an influx of patients with a shortage of qualified doctors, a feat that saved the system (and its patients) time and money. Other hospital systems are part of this trend, using the technology to monitor heart patients, quickly diagnose stroke victims, and otherwise offer more comprehensive and efficient services to patients.
Telemedicine is popping up in some unexpected places, too. In June, Doctor on Demand began operating telemedicine kiosks in four Wegmans grocery stores located in the northeast and mid-Atlantic states. For the grocery store, this is a logical expansion of the services their pharmacy already offers.
Katie Niles, pharmacy and wellness clinical services manager at Wegmans, headquartered in Rochester, New York, explained the benefits of a telemedicine kiosk this way:
“With Doctor On Demand, we can offer a full range of services to our pharmacy customers. It’s not always easy to get medical care, especially at night and on the weekends. This enables customers who might have a non-emergency medical need to access care either at the in-store virtual clinic or at home.”
So who is paying for these services? In some cases, telemedicine might be nothing more than a quick email to the doctors describing symptoms, a service which is generally included in primary care services. For other more complicated or ongoing treatments, it is best to check first with your insurance provider to see which services are covered, even before you need them. If you are the parent up at night with a sick child, the last thing on your mind should be whether or not you will receive a bill for their care.
Telemedicine is working hard to increase access to quality care across the U.S. Would you utilize telemedicine for your next trip to the doctor?
Image by Intel Free Press via Flickr