Virtual Doctor: About Telemedicine
What is Telemedicine?
As schedules get busier and technology advances, doctors are finding new ways to assess and treat patients. One of these is through telemedicine. 1 According to the World Health Organization, telemedicine is “healing from a distance”.2 Medical experts created the term in the 1970s, but it’s really starting to get more popular in recent years.
Telemedicine means using technology, like a computer or telephone, to talk to a medical provider. The medical provider can offer advice, educate a person on a particular health issue, or even write a prescription. These services are expanding healthcare and making it more convenient for people so they don’t have to miss time from work or travel very far to see a doctor.
How Does Telemedicine Work?
Telemedicine isn’t an entirely new concept. Doctors have used it for years to provide care for patients who may have trouble accessing medical experts. Examples include those who live in rural areas, for military personnel, and for those who are in prison.3
Drugstore CVS has provided telemedicine services since 2015, according to The New England Journal of Medicine. In a study of their health services, CVS found that 95 percent of patients were “highly satisfied with the quality of care they received, the ease with which telehealth technology was integrated into the visit, and the timeliness and convenience of their care.”
Services
Some of the services a doctor offering telemedicine may provide include:
Consultation
Diagnosis
Health Assessment
Health Information
Supervision
Goals
According to the World Health Organization, there are four main goals for telemedicine. They are:
First
To provide clinical support to people who need it.
Second
To help overcome barriers when a person lives far away from medical specialists.
Third
To receive different types of care and see specialists.
Fourth
To improve health outcomes.
At the end of the day, telemedicine is intended to help people live healthier lives. By seeing a doctor before a problem gets worse, telemedicine can help cut costs.
Types of Telemedicine Services
Often, a telemedicine session involves connecting via computer or phone to participate in a healthcare consultation with a doctor. The doctor will ask you questions about the concern you came to them about. After this, they may recommend certain treatments or prescriptions that the doctor can phone in to your nearby pharmacy.4 Some telemedicine calls may be long, others may be short; it all depends on the issue you’re seeing a doctor about.
Telemedicine Examples
Telemedicine services are expanding every day. Some examples include:
- You have an X-ray, and a radiologist looks at it from their office. They tell your results over the phone or on a videoconference.
- You are worried about an area on your skin, so you schedule a teleconference with a doctor. They prescribe you a medicated ointment you pick up at your pharmacy.
- You’ve been feeling down for a while, but don’t have a psychiatrist that lives nearby. You schedule a telemedicine session to talk out some of your worries.
Radiology and Telemedicine
According to the World Health Organization, one of the biggest telemedicine services currently is radiology. An estimated 33 percent of the world’s radiology services are provided via telemedicine. This means that you may get an X-ray at an urgent care facility and they can send it to a radiologist halfway across the world who can look at it and tell you what’s wrong.
The World’s Radiology Services Are Provided Via Telemedicine
33%
Store-and-Forward
Another telemedicine service is called “store-and-forward.” This is when you make a video of your health questions or health needs and a medical provider reviews it and sends a video, e-mail, or prescription back to you.
Statistics about Telemedicine Services
Telemedicine services are offered in most industrialized nations in the world. This means countries like the United States, Great Britain, Northern Ireland, Australia, Norway, and Sweden.
Doctors
According to the American Academy of Family Physicians, an estimated 15 percent of family health doctors used telehealth services to offer care in the last year.5 In a survey of family physicians, an estimated 78 percent said they either “agreed” or “strongly agreed” that telehealth services improve access to healthcare for people who need it.
Of these doctors, an estimated 68 percent said they “agreed” or “strongly agreed” that telehealth improves continuity of care. This means that a person is able to follow up more easily with a doctor thanks to telemedicine.
Insurance
A lot of insurance companies and employers predict they’ll keep expanding their telemedicine services. According to a survey of 148 large national employers in the United States by the National Business Group on Health, an estimated 96 percent of companies plan on making telehealth services available in the next few years.
Employers
Of these employers, 56 percent planned to offer telehealth services for behavioral health. This was almost double the amount of employers who had planned to offer these services in the year before. Behavioral health services can include counseling and therapy sessions for concerns such as anxiety and depression.
Telemedicine vs. Telehealth
Telehealth
Although the names sound alike, telemedicine isn’t telehealth. When doctors talk about telehealth, they’re usually talking about special devices that monitor someone’s health from far away. An example might be wearing a heart monitor. The monitor may transmit different heart rhythms and patterns to a computer.
Another example of telehealth is a pacemaker. A pacemaker is a special device inserted into a pocket near the heart that has special wires that go into the areas of the heart to keep up the heart’s rhythm. Thanks to modern technology, a pacemaker can transmit information about the heart’s rhythm to a computer from far away.
Telemedicine
Telemedicine means a person is getting clinical services like a doctor’s visit from far away. Telehealth is when a person may get health services from far away, but they don’t have to involve a person like a doctor.
Oxford Dictionary defines telemedicine as “the remote diagnosis and treatment of patients by means of telecommunications technology.” Using this definition, telemedicine basically means a person receives medical care or advice, but they aren’t face-to-face with their doctor.
Benefits of Telemedicine
According to the Centers for Medicaid Services, telemedicine is a cost-effective alternative option compared to face-to-face medical care. This is true for patients and medical providers. Patients who use telemedicine services don’t have to travel long distances to reach a medical specialist. Often they can see one by going to an established area of their drugstore, urgent care clinic, or even from their own home. For medical providers, they can expand how many people they see by offering telemedicine services.
But it’s not just about cost. Some of the other chief benefits of telemedicine include:
Convenience of Care: With very little equipment, you can see a medical provider.
Better Access to Medical Providers: You can see a specialist that you may ordinarily have to travel many hours to see just by using telemedicine services.
Better Productivity: You don’t have to take time off to participate in telemedicine services. Often, these can be scheduled outside of normal business hours.
Because there are a lot of positive benefits to telemedicine, a lot of health experts predict these services will increase in the coming years.
Does Insurance Cover Telemedicine Services?
It’s definitely best to check with your insurance company before using a telemedicine service just to make sure they will cover it. For example, Medicare will usually pay for telemedicine services if your location is in a non-Metropolitan Statistical Area (outside of a big city where you could more easily get a face-to-face provider) or in a Health Professional Shortage Area (a place where there aren’t that many doctors and you’d have to wait a long time just to see one).
Medicaid
If you have Medicaid, about 48 states will reimburse you for telehealth services you get from live video (like a web conference call). Of these states, an estimated 19 will cover remote patient monitoring telehealth services. A lot of times, Medicaid can have strict rules on what they will cover. For example, some states require you to go to a medical facility to participate in a telehealth chat instead of being at home. Other states require whoever the provider is for telehealth services be at an office where they care for patients and not at their own home.
Private Insurance
If you have private insurance, they all cover telehealth differently. The government doesn’t require private insurers to cover telehealth, but it doesn’t tell them they can’t. On a state level, some states have passed laws that require private insurance companies to pay telehealth services the same as they would a face-to-face clinic. Sometimes, private insurance companies may require you to see a doctor face-to-face at least one time before you use telemedicine services. The requirements really vary, which is why it’s best to call your insurance company and ask them about the telemedicine services they cover.
Employer Provided Insurance
An estimated 63 percent of large employers in the United States that offer private health benefits offered healthcare services via telemedicine in 2017. This was an increase from 2017, when 39 percent of employers offered these services.
Telemedicine Incentives
Some people are even given incentives to use telemedicine services versus in-person care. An estimated 33 percent of employers who use telemedicine services offered incentives to use telemedicine services. This could include rewards like gift cards or cash.
According to Chatrane Birbal, a senior advisor for government relations at the Society for Human Resource Management, “the rationale is that a telemedicine visit is far less time-consuming than taking time off from work for routine doctor appointments involving non-threatening health issues. This is especially true for employees who are caregivers and need to coordinate care for themselves as well as children and elderly relatives.
Concerns About Telemedicine
Insurance companies do put some limits on telemedicine because they’re worried people will try to scam insurance companies. Insurance companies don’t want a lot of fake companies setting up services they aren’t offering. Because health insurance companies can’t always monitor telemedicine services, they try to make sure the companies they pay back are actually doing what they say they are.
Other concerns include issues related to privacy. Health information can be sensitive. Companies offering telemedicine have to make sure they can’t get “hacked” and your health info shared. If you’re concerned about this, you can ask a telemedicine company about what they are doing to maintain privacy and confidentiality for patients.
Where Can You Find a Telemedicine Provider?
There’s a website called Telehealth Resource Center (TRC) where you can see a list of providers, websites, and services that Medicare usually covers. You can see it by going to telehealthresourcecenter.org.
The Society for Human Resource Management also has a list of telemedicine companies and the services they offer. You can find this list at vendordirectory.shrm.org.
You can also contact your insurance company to ask them if they have a telemedicine providers list. You can then contact the telemedicine specialists the insurance company covers to set up an appointment.
Looking Ahead with Telemedicine
Listening to your lung sounds, using an ultrasound to hear a baby’s heartbeat, or performing a physical exam – there are some in-person services that telemedicine just won’t be able to replace. However, there are many services, especially for behavioral health, that telemedicine is expanding.
In the next few years, telemedicine will likely improve access to health care for people who can’t drive long distances to see a doctor. It may also bring overall healthcare costs down because people can get help before they get too sick and need to stay in the hospital.
There is a lot of potential for telemedicine to help people. Many health experts think it’s the next step forward in modern healthcare.
Resources
- https://www.medicaid.gov/medicaid/benefits/telemed/index.html
- https://www.who.int/goe/publications/goe_telemedicine_2010.pdf
- https://www.aafp.org/dam/AAFP/documents/advocacy/health_it/telehealth/BKG-Telemedicine.pdf
- https://catalyst.nejm.org/what-is-telehealth/
- https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/telehealth-growth-barriers.aspx