Updated on December 13, 2022.
Telemedicine, which connects patients and healthcare providers (HCPs) in different locations, is a timely, cost-effective option for healthcare, especially for those with specific health or geographic challenges.
Though its use had been increasing for years, many HCPs rapidly adopted telemedicine when COVID-19 hit the United States in 2020, allowing them to treat people with certain health conditions via video, phone, and messaging. At its height during the pandemic, more than half of all patient care was provided virtually, according to the data and analytics firm The Chartis Group, LLC.
Telemedicine use has since dropped significantly, but it has been cemented as a crucial element of care for millions of Americans.
The benefits of telemedicine for routine care
Telemedicine is often more convenient than an office visit. Web-based, on-demand services provide access to HCPs, including specialists who can discuss, diagnose, treat, and sometimes prescribe medications for conditions without the hassles of travel, parking, waiting, or missed work.
Telemedicine is less expensive, too. Many calls are about half the cost of an office visit—even if you call after hours or on the weekend. Health insurance covers some telemedicine services and many insurers have worked to increase the use of virtual care by offering telemedicine visits for no copay. Check with your insurance provider to see what they cover.
Providers offering telemedicine are required to provide the same standard of care for telemedicine as for in-person care, and to adhere to industry standards and guidelines. Furthermore, all telehealth providers must comply with HIPAA regulations (the Health Insurance Portability and Accountability Act of 1996) to protect health data privacy and security.
If you have a life-threatening emergency, however, such as chest pain or shortness of breath, skip telemedicine and seek immediate care at the emergency room.
Beyond routine care
There are several areas in which telemedicine stands out, in some cases, making the difference between life and death.
Talk therapy. Given the verbal nature of psychiatric and psychological consultations, telemedicine and talk therapy are a good match.
“You only need a laptop on each end. You don’t need any other equipment, just a secure connection,” says Travis Hanson, JD, MS, executive director at The F. Marie Hall Institute for Rural and Community Health at Texas Tech University Health Sciences Center in Lubbock.
The use of telemedicine for treating mental health issues became especially important during the COVID-19 pandemic, as conditions such as depression and anxiety grew increasingly prevalent across the country. In fact, during the spring and summer of 2020, telehealth appointments skyrocketed from 1 to 40 percent of total outpatient visits for mental health and substance use issues, according to the Kaiser Family Foundation. One year later, as telehealth visits dropped overall, it still represented 36 percent of visits for mental health issues.
More than 150 million Americans live in areas where there is a shortage of mental health professionals, meaning broad swaths of the country are without psychiatric support, notes Corey Scurlock, MD, medical director of the eHealth program at Westchester Medical Center in New York. Telepsychiatry can reach these patients.
“As there’s less stigma about mental health and people are more open about their problems, telepsychiatry is really filling a growing need,” Dr. Scurlock says.
In the Hudson Valley region of New York, Scurlock’s hospital has provided pediatric tele-psychiatry to several school districts. The teen suicide rate in the area is high, Scurlock says, and there’s often a six-month waiting list to see a psychiatrist in person. Teens already FaceTime, so they’re comfortable with the technology. The program has been so successful that some of parents have participated, as well.
Triaging accidents. West Texas, where Hanson lives, is extremely rural, with oil fields and long stretches of empty highway. When an accident occurs, help is often a long way off. Because of this, Texas Tech has implemented a next generation 911 pilot project, equipping ambulances with mounted cameras and portable backpacks.
“The emergency medical services team uses telemedicine while the ambulance driver is onsite so the emergency room physician can see what’s happening, rather than relying on radio traffic alone,” Hanson says. The project was created to determine if patient care and communication could be improved, and whether patients could be directed more quickly to the right facilities, saving time and money.
Stroke. “Strokes are increasingly common as the population ages,” explains Scurlock. They require immediate medical attention at a hospital.
“Luckily, we have life-saving medications and life-saving procedures. However, they need to be done in certain time windows and those time windows are pretty short.” If you’re in a large city, chances are there’s a neurologist who treats strokes on staff at your nearby hospital, Scurlock says. People who live in rural areas, however, are often not as fortunate.
“With provider-to-provider telemedicine, we can provide a neurologist to a patient as soon as they hit the emergency room,” Scurlock says. Once a patient is at the hospital, the measured average time for a telestroke consult is about 12 minutes, he says. The local emergency room provider, who’s trained in performing neurological exams, can quickly do a CT scan and send the imaging to the remote neurologist who determines the best treatment for the patient.
The key to success with telestroke care is adhering to predetermined protocols for stroke care. Much of what goes into telemedicine is making sure processes and provider education is in place, so when telestroke care happens, it happens consistently and efficiently, says Scurlock.
Wave of the future
Telemedicine can be put to good use in a wide range of healthcare situations, from cancer treatment to respiratory care to management of chronic illnesses such as diabetes or heart disease. More recently, it’s become helpful for managing long COVID, as well.
In 2018, Congress passed the FAST Act (Furthering Access to Stroke Telemedicine), expanding Medicare coverage for telestroke services. The federal government and many states also made policy changes to encourage and enable telehealth during the pandemic. While some of those have been rolled back, many are expected to stick. Under certain conditions, these include Medicare covering virtual behavioral health visits, allowing people to use telemedicine from home, and expanding the kinds of providers who can bill for telehealth services.
Telemedicine is not a replacement for all bedside care, but it is increasingly being used to complement in-person care, improve access in underserved areas, and expedite many healthcare services.
“Telehealth puts patients first,” says Scurlock. “Patients like to have convenience. What could be better than this? It’s a way for patients to really get the care they desire with minimal inconvenience.”
