What Is Telemedicine?

As technology has developed, so has people's ability to overcome the traditional communication barriers of time and distance. The practice of telemedicine is a step forward in the health care industry to use telecommunications to bridge the gap of time, distance and affordability to reach patients in need of medical attention.

Definition of Telemedicine

Telemedicine uses technology to facilitate communication, whether real-time or delayed, between a doctor and patient who are not in the same physical location for the purpose of evaluation, diagnosis and treatment. Advances in telecommunications allow the exchange of medical information from one site to another to serve patients in a clinical setting.

Although the terms are occasionally used interchangeably, telemedicine is distinct from telehealth, which refers more generally to health and medical services including medical education and research. Telemedicine is commonly categorized into the three areas of interactive care, store-and-forward care and remote monitoring.

Interactive Care. Interactive care occurs when telecommunications are used to facilitate real-time interaction between a doctor and patient. Live video, patient data transfer and audio are a few of the elements used to open simultaneous communication between a doctor and patient. The doctor can perform a history review, physical examination and other evaluations and assessments in a manner similar to that of a face-to-face clinical visit.

Store-and-forward Care. With store-and-forward, or asynchronous, telemedicine, one doctor will store pictures, video, radiology images and other information and then electronically supply all of this patient data to another doctor, usually a specialist. The specialist can then remotely diagnose and recommend treatment for a patient.

Remote Monitoring. A third type of telemedicine is remote monitoring or home health telemedicine. In this scenario, patients who are under general observation can be supervised from their own homes, or patients who suffer from a chronic condition can have a doctor manage their care from a distance. Equipment for this care might provide video conferencing, vital signs capture and patient statistics that can be transmitted to the hospital, as well as a system to set off alarms if something goes wrong with the patient.

Telemedicine Advantages

Telemedicine offers numerous benefits for both doctors and patients. Following are a few of the advantages of using telemedicine.

Remote Access. Communicating remotely with a doctor is a primary function of telemedicine. With this technology, doctors can reach patients in remote, rural and underserved areas where there might not be an available doctor or hospital. Through telemedicine, patients can access doctors for routine visits, emergency care or diagnostics from a specialist.

Specialist Availability. Another benefit of telemedicine is increased access to specialists. Even when patients live in urban areas with numerous doctors and hospitals, specialists for rare health conditions may not practice in the area. Telemedicine enables patients in both rural and urban areas to connect with specialists who may be hundreds of miles away.

Cost Savings. Reduction in cost is another major benefit of telemedicine, and it applies in several ways. Patients save money for routine and specialist care because they don't have to pay travel expenses for distant doctors and don't have to take excessive time off work to travel and then sit in a waiting room. Doctors are also more efficient in the number of patients they can see in a day, which can help reduce overhead and related costs. In addition, remote monitoring can help lessen the much larger cost of long hospitalizations or in-home nursing, and may reduce the cost of managing chronic conditions. Remote monitoring can also help prevent hospital readmission by properly supervising care following a patient's discharge from the hospital.

Convenient Care. For some patients, the comfort and convenience of consulting with a doctor from the safety of their own homes is a tremendous advantage. The convenience can also improve care. For example, whereas patients might forget to bring medications with them to a traditional office visit, when patients are at home they have ready access to the information necessary for the doctor to diagnose and prescribe. Also, because the patient is at home, it is often easier to take notes or even include a family member who can help retain important information from the doctor.

Telemedicine Disadvantages

Although there are many benefits to the use of telemedicine, various disadvantages and regulatory limits accompany the use of this technology.

Time and Distance Barriers. The primary disadvantage for telemedicine is that the patient and doctor are not sharing the same physical space. Adjustments in examination and treatment do have to be made because the doctor cannot actually touch the patient during an examination. To replace physical touch, the doctor may, for example, ask the patient to touch his or her own throat and describe it to the doctor; however, the doctor must rely on the patient's descriptive abilities instead of the doctor's own expert touch. In addition, when store-and-forward or remote monitoring telemedicine is used, doctors must rely on a second-hand medical history report from another doctor and audio/video information instead of an actual physical examination. The physical distance (and, in the case of store-and-forward, time) that intervenes between patient and doctor is a factor that can affect patient care.

Licensing Regulations. Another major limit to telemedicine is the issue of licensing. Depending on the state, doctors are subject to different regulations regarding patient care. For example, a doctor may be required to be licensed in the state in which the patient is physically located, as well as in the state where the doctor physically practices. In addition, doctors may be limited in whether they can see a new or existing patient, what conditions they can treat and under what circumstances they are allowed to provide care. For instance, a doctor may be able to treat an existing patient for a new condition only if the doctor recommends face-to-face follow-up care within a specified time frame.

Insurance Coverage. Payment for telemedicine services is another issue that doctors and patients must contend with. Although some states require Medicaid and private insurance plans to cover telemedicine services, not all states do, leaving many patients without coverage for telemedicine. Some states that do not typically cover telemedicine under Medicaid may allow reimbursement in cases of crisis care.

The Role of Telemedicine

Fueled by technological advances and answering the clamor for consumer-convenient care, telemedicine delivers many advantages. Although not the same as sitting in an actual doctor's office, a telemedicine visit with a doctor can prove beneficial by warding off further illness or disease, stabilizing a condition until a patient is able to reach a hospital or monitoring a patient at home. Telemedicine is not a complete replacement of face-to-face health care, but it can be a tremendously helpful supplement and even a temporary substitute for traditional medical care.

More Information

Please contact Fickewirth Benefits Advisors if you would like more information on Telemedicine as an added benefit to your existing or new employee benefits plan.

This article is not intended to be exhaustive nor should any discussion or opinions be construed as professional advice.
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