Telemedicine is defined as the remote diagnosis and development of a treatment plan for a patent by using some type of telecommunication technology. It may involve a telephone call, a video call, or some other form of remote patient monitoring.
The modern form of telemedicine began in the 1950s when some hospital systems began to share information over the telephone. It connected doctors and specialists who worked with the same patients. With the rise of the internet, however, the practice of telemedicine has evolved into an experience that is very similar to what a visit to a local doctor’s office entails.
Telemedicine should not be confused with telehealth, as it refers specifically to remote clinical services being provided. Here are the pros and cons of telemedicine to consider.
List of the Pros of Telemedicine
1. It is more convenient for patients.
How often have you been forced to sit in a waiting room for a doctor’s visit? Then how long did you stay in the exam room, waiting for the doctor to arrive? Modern medicine, especially in the United States, is incredibly inconvenient. With telemedicine, on-demand care can be provided without as much time being wasted. For individuals who live in very rural areas, are home-bound, or cannot get away from their responsibilities, it is an opportunity to have basic medical needs met without as much sacrifice.
2. It saves doctors a lot money.
Telemedicine is often a lot cheaper than a traditional visit to the doctor for an examination. The America Hospital Association reports that the average telemedicine program in the United States saves 11% and triples the return on investment for those who are involved. That is because there are fewer no-shows which happen through telemedicine. It also turns the on-call time for a doctor into potential billable hours. Offices providing telemedicine can also reduce their overhead costs.
3. It saves patients a lot of money.
In the United States, the average cost of a visit through telemedicine services in 2017 was priced at $79. The average cost of an in-office visit for a patient during the same time period was $146.
4. It increases specialist access for rural patients.
In the rural United States, there are only 43 specialist providers available for every 100,000 people. That means people who need to see a specialist are forced to drive long distances, endure long wait times, and may have access issues when needing to access advanced medical care for chronic conditions of specific diseases. The use of telemedicine increases the access rural patients have to the specialists they may need. It is also an opportunity for specialists to expand their patient service area, especially if they are new to a certain region.
5. It improves patient engagement rates.
There are many reasons why people may avoid medical care. They might be embarrassed by their condition. They might hate the long wait times that happen at their local office. For one-third of respondents to a National Institutes of Health survey, it was an unfavorable evaluation process. Telemedicine can improve patient engagement rates because it eliminates many of the barriers that cause people to stop seeking care, such as high costs or time constraints.
6. It improves the ability to treat health conditions.
The National Institutes of Health discovered that 17% of patients who were diagnosed with rectal tumors reported waiting 12 months or more before seeking a medical consultation. They waited even though they were experiencing bothersome symptoms. Some waited more than 5 years to seek treatment. By increasing the availability of doctors through telemedicine, the rates of late disease detection can be reduced, which creates higher survival rates and reduces preventable causes of suffering.
7. It could reduce the impact of future doctor shortages.
In 2015, the Washington Post reported that the United States could face a doctor shortage of up to 90,000 positions by the year 2025. Even on the most conservative estimates, the U.S. faces a shortage of at least 61,700 doctors. By offering telemedicine services, doctors are able to serve more patients effectively because it allows them to focus on providing physical examinations to those who require it. Telemedicine also allows doctors to focus on what they do best because it resolves core distribution problems.
8. It can provide better overall patient care quality.
One of the biggest advantages telemedicine is able to provide is real-time urgent care patient consultation. Care timeliness is improved with this approach, which means there is less overall stress placed on the patient. If an acute issue occurs, instead of trying to make it to an urgent care center before it closes (or a costly emergency room), a telemedicine appointment in real-time can be made.
9. It reduces hospital admission rates.
Facilities which offer telemedicine to their patients experience lower rates of hospital admissions. According to a study published in the American Journal of Managed Care in February 2015, telemedicine patients are 38% less likely to be admitted to the hospital when compared to figures from the general population. Patients who use telemedicine regularly also score lower for stress, anxiety, and depression.
List of the Cons of Telemedicine
1. It can result in cost increases for patients.
A research study published by Health Affairs suggests that just 12% of telemedicine visits actually replace an in-office visit to a local community provider. Almost 90% of the telemedicine services provided in the U.S. represented new service requests by patients that were in addition to the regular in-office care they received. That means for most people, the availability of telemedicine increases their medical care costs over the course of a year instead of decreasing them. That is why they are so profitable for medical practitioners who utilize this service.
2. It offers technology restrictions.
There are many issues with telemedicine that are associated with the technology. Telemedicine allows for a visual examination of a patient and an interview of specific symptoms. It does not, however, provide for a physical examination of the patient. When combined with poor internet connections, there can be a higher risk of patient mismanagement through the process of telemedicine when compared to the services provided during a standard in-office visit.
3. It may not be covered by health insurance.
Healthcare laws and insurance policies are lagging behind technological advancements in the field of telemedicine. The industry is growing rapidly, and new best practices are being developed, but at the same time, there may not be an accurate reimbursement policy available in some regions. That means some patients may actually pay more for telemedicine than they would for an in-office visit. A $40 co-pay is cheaper than a $79 charge for a 15-minute telemedicine session.
4. It could reduce the care continuity that patients receive.
One of the ways that high-quality healthcare is provided to patients is by allowing one doctor or one office to provide medical services to an individual. Through telemedicine, more doctors – and more opinions – enter the equation. Those additional doctors may not share their observations or treatment plans with a patient’s primary care provider. That lack of sharing results in an incomplete medical record for the patient, which could affect the potential outcomes which are possible with a treatment plan. This issue may reduce over time as more providers adopt telemedicine services, but for now, it is up to the patient to ensure that their medical file remains updated.
5. It eliminates jobs.
According to a March 2012 report published by Kaiser Health News, telemedicine services provided in Anchorage, Alaska, allow one nurse to supervise 33 patients. From an office desk, telemedicine technologies allow nurses to care for more patients with the same levels of effectiveness. As this technology continues to improve and be used, it is going to eliminate jobs. In the field of home health, a nurse might see about 7 patients per day. Through telemedicine, that can be multiplied by a factor of 5, which means 4 nursing jobs would be possibility eliminated.
6. It requires doctors to have technical training.
To achieve the best possible outcomes, telemedicine requires all personnel, including doctors, to have the technical training necessary to make the system work. That means IT staff may be required, equipment purchases may be necessary, and everyone on the staff may need to be trained on the new system. Not everyone is technically savvy, which means some workers may feel pressured to leave their job because they are not as effective at providing telemedicine services as their colleagues.
These telemedicine pros and cons create unique benefits for patients and medical offices, as well as some specific disadvantages for practitioners. It may create billable hours from on-call time, though it also creates fewer employment opportunities with each provider. Having better medical access is the goal of this system and it accomplishes that goal for most patients, which is why the positives with telemedicine often outweigh the negatives.