Telemedicine visits in the United States have decreased significantly since April 2020, but the end of the pandemic should not spell the end of telemedicine. It can play an important role in health care delivery. The key to tapping its potential is to bring many elements to the patient’s clinic. Many new technologies and services are making that possible.
Are the best days of telemedicine behind us? We don’t think they are, although the concern is understandable given that the end of the public health emergency eliminated many telemedicine regulations related to the pandemic. But we believe that the next level of virtual care can only be reached when we bring more elements to the patient clinic.
At the beginning of the Covid-19 pandemic, between unprecedented rates of telemedicine usesome wonder if it is the start of a new normal – one that has telemedicine as a core part of how patients receive care. So far, the result has been less of a change than a paradigm shift. The number of telemedicine visits per month in the United States has decreased significantly since its peak in April 2020 and now represents almost 5% of all outpatient visits. Patients and doctors have largely returned to in-person visits, in many cases because they question the quality of care in a telemedicine visit and especially the inability to perform physical examinations and key tests (eg, electrocardiograms).
Medicine is bringing the important aspects of the doctor’s office to the patient. An emerging industry aims to fill this gap. Patients can now use connected devices to check their blood pressure, blood sugar, and other physiological measurements at home and share them remotely with their doctor. There are also movements to capture this data through consumer devices such as Apple Watches. Lab testing providers such as LabCorp and Quest offer an extensive network of “patient service centers” for sample collection outside physician offices, as well as a growing array of at-home mail-in test kits. Portable diagnostic service providers can go directly to a patient’s home to take X-rays and ultrasounds or blood draws for lab tests.
These changes are only the tip of the iceberg. This future does not have to stop at simply recreating a routine visit to the doctor but can go beyond it by using new devices such as a digital stethoscope or ultrasound. Seeing a child’s ear in the doctor’s office is difficult. Usually the doctor can only get a passing look at the eardrum. TytoCare’s Home Smart Clinic and other similar theoretical tools can result in better examination than in the office by helping the parent get a comprehensive video of their child’s eardrum that can be sent to the doctor and viewed again if necessary.
New technologies can even collect data that is never used in the doctor’s office. Although it sounds futuristic, more and more sick patients are having devices implanted in their body to manage their conditions. Millions of heart failure patients in the United States have a implanted pacemaker, defibrillator, or other devices. These devices continuously record a variety of data whose scale eclipses anything collected in the clinic. Researchers are trying to identify new ways to use this wealth of data to improve chronic disease management.
These emerging technologies also have the potential to change the way patients interact with their providers. While patients previously might have visited their doctor every few months, these new offerings allow for more frequent, and sometimes 24/7, monitoring. The result is a better sense of a patient’s health status and progress. In the traditional model of care, the onus is on the patient to initiate care. In this new model, doctors can immediately observe when things are not going well and contact their patient first, engaging patients when the need is greater. In addition, by separating data collection from the visit itself, the patient-doctor interactions that occur will be most productive, focusing on treatment and guidance, which simultaneous interactions are uniquely suited to provide.
While there is great potential for the future of telemedicine, there is critical barriers which must be overcome. Many of these technologies are prohibitively expensive for the average patient and provider, especially if intended for occasional use. Ease of use can also be a major issue because the average health care consumer is older and, in general, less technologically savvy. Health equity is also an important consideration.
The future of telemedicine must be democratized and made accessible to rural populations, racial/ethnic minorities, and other historically underserved communities. Unlocking this future for the patients who need it most requires new processes and institutions that enable affordable access to these devices but also provide the necessary level of “human touch” to overcome technological barriers.
Hybrid models that includes virtual and in-person contact can help alleviate many of these barriers. For example, brick-and-mortar telemedicine hosting sites can be set up at local clinics, drug or grocery stores, or work sites; these hosting sites can provide space for telemedicine visits, the latest telemedicine technologies, and “tele-presenter” staff who are technologically savvy and can offer personalized patient support.
While we emphasize the importance of “bringing the clinic to the patient,” we recognize that many other factors will affect the future trajectory of telemedicine. With the expected dip in Covid-related temporary telemedicine policies, there are open questions what is the future of telemedicine reimbursement and regulation. Additionally, when it comes to new telemedicine technologies, the role that health plans and self-insured employers will play in supporting and covering these products is unclear. However, this uncertainty has not hindered the fortunes of companies seeking to innovate in this space.
Telemedicine has not yet reached its full potential because many doctors and patients believe that the visits lack the necessary examination and testing capabilities to provide the highest quality of care. However, new technologies and methods of care are pushing the boundaries, not only of virtual visits but also of health care in general. For health care providers, insurers, and employers, it is important to be aware of these trends and determine how you can facilitate this new future of telemedicine for your patients, beneficiaries, and employees.
Technology, however, is rarely a solution by itself. A meaningful level of “human touch” is always necessary. Companies and providers need to figure out ways to provide this together with technology in an effective way. This can be achieved by identifying partners that provide true end-to-end solutions that include technology and personal support or by establishing internal systems such as telemedicine hosting. employer based site.
