Telemedicine: From Face-to-Face to Interface

Less than a year ago, a “virtual” visit to the doctor’s office would have seemed perplexing. After all, the healthcare that is core to medicine is traditionally defined by in-person interactions and face-to-face contact. In the past, the very idea of telemedicine has been considered by many as callous, insensitive, and even unethical. Once the COVID-19 pandemic hit, however, changes had to be made almost instantaneously by healthcare providers in the U.S. and across the globe to reshape the entire virtual care landscape.

The pandemic has made hospitals and clinics nearly inaccessible for patients, as social distancing has been strictly enforced to minimize spread. In compliance with COVID-19 guidelines, telemedicine has experienced an unprecedented rise in usage by healthcare providers and patients alike. Since April, telehealth visits have increased by 8336 percent and have proven to be effective in the delivery of acute, chronic, primary, and specialty care. The re-energized advent of telemedicine has opened doors to additional opportunities that will not only reduce exposure to COVID-19 and mitigate strains on hospital systems, but also expand access to healthcare and improve overall health outcomes for years to come.

Untapped potential

For people with conditions ranging from a sore throat to chronic diabetes, the most significant benefit of telemedicine comes from being able to see a doctor with the click of a button — convenience. Telemedicine has helped streamline care, especially in a field where waiting infamously takes up a lot of time and resources. In a study published in the Economic Inquiry last year, it was discovered that a 10-minute-longer wait increases the cost to care for patients with true emergencies by an average of 6 percent, indicating a higher possibility of lower-quality care and adverse health outcomes.

“The longer patients wait, the more their conditions can deteriorate,” said the study’s author, Lindsey Woodworth, an economist with the University of South Carolina. “Sicker patients cost more to treat.”

In addition to replacing many of these unnecessary visits and deleterious wait times, telemedicine can broaden the accessibility to healthcare in underserved communities. For those who live in rural settings, are older adults, or have limited mobility, telemedicine reduces barriers to getting care for low-risk emergencies, mental health, and chronic diseases, among others. In rural communities, where distance particularly limits access, healthcare personnel can gain further education and training from virtual peer-to-peer medical consultations. In terms of cost savings, many insurers and beneficiaries of the CARES Act can also waive copayments and allow coverage for telemedicine visits on a pre-deductible basis.

The recent merger between Teladoc, a major telemedicine platform, and Livongo, a remote diabetes monitoring system, highlights the shifting perspectives towards telemedicine. The $18.5 billion deal will build on the range of health management solutions already provided by Teladoc, specifically by enhancing the monitoring of chronic diseases for its 70 million U.S. consumers. Teladoc, like many other virtual healthcare providers, is truly revolutionizing the way healthcare is approached and providing scalable solutions for challenges posed by COVID-19 and otherwise.

Limitations and solutions

While telemedicine readily widens the scope of healthcare as a whole, its heavy reliance on technology can paradoxically widen the disparities in access for vulnerable populations. A study conducted in a large New York City health system found that patients over age 65 were least likely to use telemedicine and that black and Hispanic patients were less likely to use it than their white or Asian counterparts. Especially in a time when vulnerable communities have been disproportionately impacted by the pandemic, it is more important than ever to bridge this gap. To confront this issue, various digital assistance and language interpretation programs have been successfully implemented; the Veteran’s Health Administration established a tablet loan program, while the state of Washington created Wi-Fi hotspots for those who needed broadband access.

The adjustment to telemedicine has also raised potential concerns about rising costs and bureaucratic requirements that may serve to undermine its inherent benefits. While the existence of the pandemic has temporarily loosened many regulations regarding payment methods and virtual interstate visits, they may not last. Instating a more permanent primary care model in the long term will inevitably reflect higher costs of treatment via telemedicine, prompting the question: Is telemedicine here to stay?

The future going forward

Many experts foresee telemedicine playing a significantly larger role in healthcare, one that is defined by a balance of both virtual and in-person interactions. In current legislative considerations, there have been talks of expanding the CARES Act and enacting permanent changes in Medicare and the Affordable Care Act to cover more telemedicine benefits. This would effectively keep the costs of telemedicine visits at their reduced amount and create an integrated plan for reimbursement. Only time will tell whether these measures will be successfully passed, but until then, we might just have to get used to seeing our doctors on the screen.