Telemedicine in 2016: 3 key takeaways

It’s a summer day in St. Joseph, Missouri, and family medicine physician Michael R. Brown, DO, is providing a telemedicine consultation to a patient with chest pain. The patient thinks it’s just indigestion, but as he describes his symptoms, the conversation takes an urgent turn. Dr. Brown directs him to the emergency room for a full cardiac workup.

“That patient saw me because there was a telemedicine kiosk at his workplace—he might not have gone to see a doctor otherwise,” says Dr. Brown, the assistant chief medical informatics officer at Mosaic Life Care in northwest Missouri. “His story really illustrates what a huge difference telemedicine can make in patient care.”

Dr. Brown, who conducts “modern-day house calls” through Mosaic’s eVisit telemed program, is at the forefront of a health care trend that has drastically picked up speed over the past several years. In 2016, here are three key takeaways on telemedicine.

Insurers increasingly cover telemedicine.

As of this year, 29 states have laws requiring private insurers to cover telemedicine services—a total that’s more than doubled in the past four years, according to the American Telehealth Association.

Among state Medicaid programs, 48 cover telemedicine, though the type of care deemed eligible varies widely from state to state. Medicare coverage for telemedicine is patchier.

Some patients prefer telemedicine, and it can improve access, too.

Along with increasingly favorable regulation, patient interest in telemedicine is driving its expansion, DOs agree. “Telemedicine is a big deal, and if we don’t give our patients what they’re demanding, they’ll go elsewhere for care,” Dr. Brown says.

Though physicians may have concerns about treating patients from afar, some patients actually prefer telemed care, says Doug Rosendale, DO, the CEO of CairnFORMATICS, a health informatics consulting firm.

“At the VA, telehealth has been magnificently successful in mental health treatment,” Dr. Rosendale says. “Many patients have the attitude that they’re only talking to a box or a smartphone, which feels easier than talking to a person, and they just open up.”

Telemedicine is efficient and cost-effective.

Telemed enables physicians to keep closer tabs on patients who live in remote areas or have difficult-to-manage chronic conditions such as chronic obstructive pulmonary disease. Conducting follow-up visits remotely can help improve patients’ appointment attendance.

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Telemedicine appointments are typically cheaper for patients as well; Dr. Brown estimates a trip to the ER or an urgent care facility would cost his insured patients $75, as opposed to the $50 they pay for an eVisit.

David Edward Tannehill, DO, says telemedicine allows him to be more efficient in his role as a critical care physician. A member of the intensive care unit telemedicine program at Mercy Clinic in St. Louis, Dr. Tannehill spends about 30% of his time providing telemed support to physicians at other hospitals, some of which are rural facilities that don’t have ICU intensivists on staff. In return, when he’s treating ICU patients in St. Louis, Dr. Tannehill’s telemed physician colleagues are on call, ready to help if needed.

“If I’m in one room putting in a central line for a patient and a nurse comes to tell me about a problem in another room, my telemed colleagues can work with onsite nurses to start addressing the problem while I finish the procedure I’m working on,” Dr. Tannehill says.