Summarizing the Plus and Minuses of Telemedicine

From The Doctor’s Company (an insurance company): Your Patient Is Logging on Now: The Risks and Benefits of Telehealth in the Future of Healthcare Thanks to John Pohl for sharing this link.

An excerpt:

Foreseeable Major Benefits

  • Increases access to care for most patients, including many patients in rural locations, patients who struggle to cover the peripheral costs of an in-person visit (transportation, childcare, time away from work, etc.), and patients with chronic conditions.
  • Enhances the ability to manage chronic conditions by making more frequent contact easier. This management is already supported by at-home devices that record blood pressure, blood sugar, and other essential data points.
  • Reduces infection risks, not just for COVID-19, but for post-op patients, patients who are immunosuppressed, etc.

Other benefits: Promotes patient satisfaction, and scheduling -fewer no shows

Foreseeable Major Risks

  • The remote exam’s inherent limitations mean physicians must know when to ask patients to come in to avoid missed diagnoses…[may be able to do] risk-stratifying patients with abdominal symptoms by, among other things, watching the patient jump up and down
  • Increases cyber liability, especially when providers are seeing patients from a variety of devices in a variety of locations.
  • Privacy issues come in high-tech forms: Is the video visit interface HIPAA compliant? And in low tech forms: Conversations may be interrupted by household members at either end.
  • Decreases access to care for some patients: … many communities do not have sufficient internet bandwidth; some patients are prevented by a language barrier or lack of technological savvy from accessing a telemedicine portal.
  • Reimbursement is uncertain: Pre-pandemic, “Low reimbursement for telehealth was viewed as a critical disincentive,” say the authors of an opinion piece in JAMA, because “Without payment, it would be difficult for clinicians to afford to provide the service, despite data from previous studies suggesting clinicians were broadly supportive about its use.”

Other drawbacks: Physician-patient relationship –glitches or delays in sound or video can impede the normal flow of conversation—a diagnostic risk, as well as a relational one.

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