By Debra Wood, RN, contributor Jun 19, 2020
The coronavirus pandemic boosted virtual medical visits. When
it winds down, will telemedicine be the new normal?
“The existential shock of the pandemic poured fuel on to
what was a little flame and removed some of the barriers and changed people’s
way of looking at how they get care,” said Douglas Smith, managing director at
Wavestone, an IT consulting firm headquartered in Philadelphia.
Patients, physicians and other clinicians have gotten more
comfortable with telemedicine, which can be a time saver for all involved.
Those patients will drive additional growth of telemedicine,
said Mia Finkelston, MD, an urgent care telemedicine physician and medical
director of Amwell, based in Boston. Amwell offers group practices a platform
to provide telemedicine visits under their own brand, as well as opportunities
for patients to connect directly with providers.
“The general public is going to want this, and they know it
is possible,” Finkelston said. “Demand is going to drive providers to have this
offering for their patients.”
David Endicott, a managing director at Wavestone, agreed,
saying, “We have reached the point of no return.” Consumers are already used to
banking, shopping and doing other things on their electronic devices. Now, they
have become familiar with receiving medical care remotely as well.
“There will be consumer pressure,” Endicott said.
Nadine Kaslow, PhD, a professor of psychiatry and behavioral
sciences at Emory University School of Medicine in Atlanta, said she thinks
“telehealth should become the new normal,” explaining it can increase access
for people who find it difficult to go to the practitioner’s office.
However, Kaslow cautioned that not everything is suitable
for telemedicine. “We need to really figure out who it works for, under what
conditions and do a much more individualized approach,” she said.
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COVID-19: The impetus for change
When public officials issued stay-at-home orders, people
started working from home and people feared exposure to the novel coronavirus.
Interest in telemedicine increased.
“COVID was a push that moved telemedicine forward, and
because COVID still will be around, clinicians and patients will become
increasingly comfortable with the new normal,” Endicott said. “I don’t know
that we will go back.”
The Centers for Medicare & Medicaid Services gave
telemedicine a huge boost, when it agreed to reimburse for electronic visits
for Medicare beneficiaries in March of this year. Many commercial insurers
Kaslow said she hopes the CMS continues that policy. So do
30 U.S. Senators, who wrote a letter to leadership, recommending permanent
changes to expand telehealth.
Joe Kvedar, MD, vice president of Connected Health Partners
HealthCare, a professor at Harvard Medical School in Boston and president of
the American Telemedicine Association, testified before the Senate Committee on
Health, Education, Labor and Pensions, urging the lawmakers to take action now
to make access to telehealth services permanent.
“It would be difficult at this point to put that genie back
in the bottle,” Endicott said.
Telemedicine vs. telehealth
When referring to televisits, a physician or other provider
conducting an online visit and providing care to a patient, that’s telemedicine
vs. telehealth, which is a broader term. Telehealth may include other remote
nonclinical services, such as administrative meetings, medical education or
For physicians planning to continue offering telemedicine
services, Endicott suggests adopting tools that reflect the practice’s brand.
A hybrid system
So, will telemedicine be the new normal? Perhaps, but it
will not replace office practices.
“I think telemedicine is a component of a strategy that we
have to have as we think about how healthcare is delivered efficiently and at a
lower cost in the future,” Smith said.
Telemedicine can handle many types of visits, but not all
medical care can be delivered remotely, including treatments such as a
corticosteroid injection into an arthritic joint.
Finkelston agreed patients will still need to see physicians
face-to-face. A first visit might be online, followed by an in-person visit to
complete a physical, with follow-up via telemedicine to manage chronic
Telemedicine visits also give providers insight into what a patient’s
life is like. They might note whether the house is well kept, if there are
visible fall risks such as throw rugs, etc. Given all the benefits of
telemedicine, Finkelston believes it will remain part of physicians’ practices.
“People are realizing medicine can be delivered in ways other
than what they are currently doing,” she said. “It has a lot to offer for any
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Growing Acceptance of Telemedicine
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