I continue to be enthusiastic about the potential of telemedicine and have blogged about it frequently (see, for example: American Well Offers Remote Physical Monitoring for Telemedicine Visits; Telemedicine as a Tool for Physician Visits in Senior and Assisted Living Facilities). There is an urgent need to reduce the overall cost of healthcare delivery and it will difficult to accomplish this goal with the current care model requiring bricks-and-mortar expenditures to accommodate more patients. With telemedicine, rapidly increasing the number of physician visits is related to the capabilities of the hospital IT "engine and network" which will be less expensive and more flexible than physical expansion of the facilities.
Up to this point, telemedicine visits across the country have been generally confined to patients with less complex problems like flu or minor muscle aches. It has been considered axiomatic that the care of patients with more serious problems requires sophisticated technology that allows remote monitoring of vital signs or heart auscultation. However, a recent article reminded me instead about the feasibility of caring for patients with chronic diseases (see: Can Telemedicine Help You Cope With a Chronic Illness?). This particular article is oriented to patient readers but provides some useful information. Below is an excerpt from it:
Do you have a chronic illness, such as diabetes or high blood pressure? The back-and-forth office visits with your practitioner can get old very quickly....Is there an easier way? ....Telemedicine, which allows you to use your smartphone, tablet or desktop computer to visit your doctor for follow-ups.With video and email, you often can get care through telemedicine without disrupting your schedule, says Family Medicine practitioner, Mark Rood, MD. “If the provider knows the patient — and if the patient agrees to it — the doctor can provide disease management remotely,” he says.“If the provider knows the issues, and there’s no need for a physical exam, the patient can decide whether to use telemedicine or return to the office every three weeks. While physical exams are important at first, 90 percent of what a physician uses to provide care comes from your health history. After that conversation, your doctor often can provide care through telemedicine exactly as he or she would in at an office visit," Dr. Rood says.
Cleveland Clinic has for years offered Express Care Online which is staffed by family medicine physicians like Dr. Rood for no more than $49 a visit. Visits are scheduled and organized using a downloadable mobile app. To quote the web site: Get a diagnosis or prescription online from a healthcare provider in one 10–minute session. This site provides a list of conditions to be treated but does not seem to have caught up with the suggestion of Dr. Rood above that telemedicine is well suited for managing chronic diseases.
Most patients with chronic diseases will be older and often less mobile. Telemedicine serves them well in terms of being able to see them in their own home environments. Offering televisits to patients with chronic diseases will also be one way to bend-the-curve of the cost of healthcare. Here's a reference to the future cost of such care; it does constitute a challenge that needs to be addressed (see: THE PROJECTED TOTAL COST OF CHRONIC DISEASE FROM 2016-2030 IN AMERICA IS $42 TRILLION):
More than 190 million Americans, or about 59 percent of the population, are affected by one or more chronic diseases. Having one chronic condition can increase the risk of developing another. Without change, the number of people with three or more chronic diseases is expected to increase to 83 million by 2030, and overall costs will accumulate to more than $42 trillion.