The beginning of a new era

Samir Qamar, M.D., CEO, MedLion

Telemedicine is growing with no signs of slowing down. The advent of smartphones, private video capability, and the growth of the Internet have all contributed to a rise in telemedicine. The global telemedicine technologies market, including hardware, software, and services, was valued at $17.8 billion in 2014, and is predicted to grow at a compound annual growth rate of 18.4 percent from 2014 to 2020.¹ Why is telemedicine growing? Though reasons are multifactorial, three factors play a large part: cost, convenience, and access.

1. Cost

Telemedicine consultations cost less than clinic visits. Whereas a visit to an urgent care clinic can cost upward of $200 for an upper respiratory infection, a telemedicine consultation can cost many times less. It has been estimated that employers in the United States could save up to $6 billion per year by providing telemedicine technologies to their employees.² Money drives markets, and the telemedicine industry is not exempt.

2. Convenience

The market gave us the drive-through, pizza delivery, and Uber. Consumers love convenience, and hate long waits. Telemedicine offers a convenient way to reach providers without having to go to the dreaded doctor’s office. Experts estimate that almost 75 percent of all doctor, urgent care, and ER visits are either unnecessary or can be handled safely and effectively over a phone or video.³

3. Access

In the current broken healthcare system, fee-for-service incentivizes providers incorrectly. Patients are seen every 10 minutes, and schedules have to be fully booked (even double-booked) to ensure practice viability. With little access to same-day visits (one of the reasons for the rise in retail clinics), patients are unable to get timely care. Telemedicine, with its on-demand capabilities, disrupts the cumbersome status quo.

Tip of the iceberg

Despite hundreds of millions of dollars invested in telemedicine companies like Teladoc, Doctor on Demand, MDLive, and SnapMD, telemedicine is merely the tip of the iceberg. The iceberg represents an entirely different industry – a true moonshot that lurks beneath, waiting to be mined. The ability to receive the full spectrum of medical services instantaneously, regardless of location, is the real opportunity. Today’s telemedicine is just the beginning.

Currently, telemedicine primarily consists of phone or video, giving providers the ability to see and hear patients from anywhere. The future involves a great deal more – an entire virtual medical ecosystem designed to deliver healthcare in completely new ways. We are headed toward a new medical practice era that won’t just allow us to communicate with providers from anywhere, but also get physical exams, lab studies, imaging, and medication delivery. A new type of virtual medical practice is emerging, and will eventually be integrated with current models of healthcare.

Overcoming telemedicine limitations

Telemedicine today has several limitations, including a general lack of examination capability, conflicting state laws, and challenging reimbursements. These obstacles, however, are already being negotiated.

Source: American Telemedicine Association

Medical examinations

No doctor’s visit is ever complete without an examination and basic vitals. Until recently, telemedicine examinations were limited to expensive kiosks (like the failed HealthSpot) and large telemedicine carts. MedWand, a Nevada tech startup, recently introduced the world’s first portable medical device that allows patients to be remotely examined and vitalized, turning any computer into a virtual clinic. Another startup, AliveCor, can turn a smartphone into an EKG and upload results directly to clinicians. Adding such diagnostic devices to existing telemedicine platforms multiplies the power and reach of telemedicine far beyond today’s capabilities

State laws

When it comes to the practice of medicine, technology always outpaces tradition. Tradition, however, is deeply rooted in society. Unlike most countries where clinicians are licensed nationally, medical licensure and laws in the United States. are compartmentalized state by state. Telemedicine presents an interesting dilemma with its ability to erase geographic boundaries when providing medical services. Much of the issue is due to an inability to examine patients, fear that out-of-state providers will converge on in-state patient panels, and possible reluctance to embrace a new digital era in medical practice. As telemedicine technology, familiarity, and market adoption improve, it is predicted that state laws will eventually catch up to telehealth practices.

Telemedicine reimbursements

In most cases, reimbursements for telemedicine visits are less than those of office visits. This is beginning to change. In New Mexico, for example, both visit types are reimbursed similarly for the same medical condition. As healthcare moves toward value-based systems (direct primary care, accountable care organizations) over existing fee-for-service systems, the enhanced access afforded by telemedicine gains attraction. Introducing medical examinations into telemedicine will correspondingly increase reimbursements. Tomorrow, a remote telemedicine provider will be able to “see” a patient, listen to lungs, and obtain vitals via a device like the MedWand. If a provider were to perform the same examination during an office visit, it would be logical that reimbursements would be similar.

The MedWand portable telemedicine device allows doctors to examine a patient remotely

What the future holds

Any consumer service that evaporates physical barriers tends to not only become popular, but adopted into mainstream culture. Television allows us to see cities beyond our homes. Telephones allow us to speak with others around the world. With telescopes we can look at galaxies beyond our own. With telemedicine, we can now eliminate vast distances when providing medical services. Telemedicine will eventually become a part of regular medical practice. The future of telemedicine isn’t just coming; it’s already here.

References