The idea of doctors making house calls has been a persistent idyllic dream that resonates with many people’s desire to return to simpler times when the town’s doctor knew everyone.
While such times are never going to return, at least part of the promise of telehealth, or telemedicine is that patients can receive care from the comfort of their own homes. No more driving through traffic or over long distances, parking and waiting rooms, just a click of the mouse at the appointed time and your doctor appears on screen.
While telemedicine has been around for decades, it really is beginning to come into its own in the last five years as broadband access, telemedicine platforms and healthcare policies have converged to make remotely delivered healthcare not just a real possibility but an economic necessity.
Now, the World Health Organization has expanded its definition of telehealth from the use of telecommunications outside traditional healthcare facilities to include virtual home health care, where patients such as the chronically ill or the elderly may receive guidance in certain procedures while remaining at home. Telehealth has also made it easier for health care workers in remote field settings as well as local clinics and hospitals to obtain guidance from specialists elsewhere in diagnosis, care and referral of patients.
For that vision of telehealth to be realized however, it will require much more than technology. The reality is that the value of telemedicine will ultimately be determined on the same basis as traditional in-person care, i.e. evidence-based assessment of outcomes, quality, cost, and patient satisfaction. While there have been a lot of studies over the decades showing the feasibility and potential of telemedicine, there is little data measuring those indicators of efficacy and value.
In a June 2019 meta-analysis of telemedicine used for emergency patients prior to hospitalization published in the Journal of Telemedicine and Telecare the researchers concluded that, “As a whole, this body of literature does not yet adequately speak to the most important concerns of medicine: quality, cost and satisfaction.” In other words, the jury is still out, and more research will be needed before we can begin to determine the place of telemedicine in healthcare.
At the same time, economic considerations will determine the future of telehealth. In an analysis of telemedicine in the Telemedicine Journal and eHealth, Rashid Bashshur at the University of Michigan and colleagues at other universities concluded that with the demonstrated feasibility of telemedicine across a wide spectrum of applications, it is time to construct effective business models if telemedicine is to be sustained and expanded into mainstream healthcare.
“At least for the foreseeable future, telemedicine in the United States can only sustain itself on the basis of long-term business models that rely on recurring revenue and diverse sources of financing,” the authors wrote.
To that end telemedicine is evolving as companies have arisen that develop the technology and telemedicine platforms necessary to make remote care practical. To make business sense for the immense investments these companies are making in technology, it has become necessary to expand the potential market beyond rural and remote populations to increasing access to care for urban populations as an adjunct to conventional care.
What had been essentially video conferencing tools, are now becoming telehealth hubs that add sophisticated clinical examination tools that allow patients under care of a home health provider, or in their local doctor’s office to undergo a specialists’ diagnostic workup. The result extends both the access of the patient to specialty care without geographic barriers and allows local doctors to partner with specialists to offer a broader range of services.
For all of that to become incorporated and sustainable healthcare system, however, the technology companies will also need to design their systems to mesh with current office and clinic scheduling and billing systems and to not just fit into providers’ workflows but enhance workflows, according to Bashshur and colleagues.
In short, as Bashurshur concludes, realizing the promise of telemedicine will only come if it ultimately demonstrates improved quality through the provision of evidence-based care together with economic evaluations that comprehensively take into consideration the reduction of costs for patients and providers, and the ability of telemedicine to reduce, if not eliminate, redundancy and waste of resources, improve provider productivity, and improve care at the appropriate site.
PercuVision LLC’s mission is to improve patient care and safety by applying microfiber-optic bundle technology to commonly invasive medical procedures. The DirectVision Telehealth Hub connects patients with specialists by supporting a wide range of professional examinations through an all-in-one built-in HIPAA compliant telemedicine platform solution. Contact us via phone at (614) 891-4800 or use our online contact form.
Sources: Journal of Telemedicine and Telecare “Evaluation of the triple aim of medicine in prehospital telemedicine: A systematic literature review;” Telemedicine Journal and eHealth “Sustaining and Realizing the Promise of Telemedicine;” The World Health Organization, “Health and Sustanable development: Telehealth”