Dallas marketing executive Susan Thompson knew exactly where her cold was headed when she began feeling under the weather one day a few years ago. Her symptoms follow a pattern, often leading to a chest infection that requires antibiotics to clear up. “After living in this body for 74 years, I know what I’m getting,” Thompson says.
Instead of waiting a few days to get an appointment with her doctor to confirm her diagnosis, Thompson called Teladoc, a telemedicine service offered by her employer. Within 10 minutes she had a doctor on the line, and by the end of the day she had a prescription for the infection.
Thompson is part of a growing trend toward telemedicine, which uses technology to connect doctors and patients via apps, phones and videoconferencing. Telemedicine revenue is expected to grow around 40 percent a year over the next five years, from its current $645 million to more than $3.5 billion in 2020, according to a report by IBISWorld.
Telemedicine has been rapidly changing the way health care is delivered in the United States, giving doctors the ability to communicate with their patients through text and video messages from thousands of miles away in the event that an in-person consultation is either unnecessary or unattainable.
“At this point it feels like health care is lagging daily life, with the advent of smartphones and the Internet,” says Shana Alex Charles, an assistant professor in the Health Services Department at California State University, Fullerton. “Why do we still need to go to a doctor’s office and sit in a waiting room for something that can be done, especially something like daily monitoring, better and faster online?”
When it comes to serving consumers, the industry is growing in two distinct areas: non-urgent diagnosis and treatment of minor ailments like strep throat or an ear infection, and ongoing monitoring of high-risk patients or those recently released from the hospital.
In the first instance, a person experiencing flu-like symptoms would log on to an app or Web portal directly administered by a health system, an insurer or their employer and video conference with a doctor who would assess the patient and write a prescription, all from potentially hundreds of miles away. Some pharmacies have installed self-service kiosks that patients can use to video conference with a doctor who could potentially call in a prescription while the consumer is still in the store.
In the second scenario, a patient might go home with Internet-connected devices that would monitor their blood pressure, temperature and other vitals and remotely send reports to a doctor or hospital who would analyze the results for any potential problems.
“There’s been a push to lower hospital readmission rates along with health care reform,” says Sarah Turk, a health care sector analyst with IBISWorld. “You can use telehealth to examine and monitor fluctuations in their system and then address it before it becomes a costly complication.”
Telemedicine gives the patient the convenience of staying home (and not spreading or catching germs in a doctor’s office) for a fraction of the price of a traditional appointment or a visit to an ER or urgent care clinic. The cost of a telemedicine call is usually around $25 to $30.
Whether insurance will cover the service, however, varies. Twenty-nine states require insurance companies to reimburse telehealth treatment, but in other states it’s up to your insurer. Another 15 states are considering similar laws. Either way, you can pay for services using a health savings account or flexible savings account.
Insurers and some medical service providers have been at the forefront of the trend toward telemedicine and now employers are starting to take notice, particularly as they realize that they need to drastically reduce costs before the Obamacare “Cadillac tax” kicks in in 2018. They’re increasingly working with insurers to implement telemedicine programs as part of their benefit package. Some insurers are throwing the service in for free to large companies as a way to keep their business.
Companies Get on Board
Employers offering telemedicine increased by a third in 2015, according to Towers Watson, and more than 80 percent of employers are considering implementing programs by 2018. Even so, use by employees is still relatively small. Just one in 10 eligible members accessed such services last year. Increased adoption could save the health care industry more than $6 billion a year, the benefits consultant found, by reducing office and ER visits by 15 percent and urgent care visits by 37 percent.
The hesitation on the part of patients may have to do with age and general comfort with technology. A recent report by TechnologyAdvice Research found that less than half of those over age 65 would trust a virtual diagnosis, compared to 83 percent of 18-to-24 year olds.
While many in the medical field support the trend toward telemedicine and its inevitable expansion, many have also expressed concerns that patients who need in-patient care might elect for telemedicine in an effort to save money, or that doctors administering care might miss a diagnosis because they’re missing some key information in the patient’s medical history or because the patient read her vitals incorrectly.
“We think that these services should allow you to extend your existing relationship with your doctor, not to replace them with a doc of the day,” says Steve Ommen, a cardiologist and associate dean for the Center for Connected Care at Mayo Clinic.
An adoption of telemedicine by existing health care providers could help alleviate some concerns. The TechnologyAdvice report found that about 63 percent of consumers would be more likely to schedule a virtual appointment if they had previously seen the doctor in person.
An Answer to the Doctor Shortage
In addition to helping consumers access medical care in a more convenient and cost-efficient manner, telemedicine technology is also helping to address a doctor shortage, particularly in rural areas. The Association of American Medical Colleges projects that the country could be short more than 50,000 doctors by 2025, including primary care physicians, surgeons and specialists. The shortage will be felt even more acutely as an aging population increases the demand for health services.
Patients in places affected by the shortage can use telehealth to see doctors if local physicians are spread too thin, and some hospitals are using Skype for specialists to see patients who need a second opinion.