Understanding Telemedicine

It seems like everyone’s talking about telemedicine these days. And why not?  Technology is taking over many industries and services.  Why not medicine?  Telemedicine refers to the remote delivery of health care services using telecommunications technology.  It was developed to help make medical care more accessible, especially to patients living in remote rural areas, and to be more efficient and less costly.  Over time, telemedicine was used for patients who live in urban areas with health service shortages and for medical emergencies as well.  With telemedicine technology, patients can be treated without an in-person interaction with clinicians.  With telemedicine techniques, providers can evaluate, diagnose and treat patients quickly and economically.

Although it seems so modern a technology, in fact telemedicine has been around for decades. In 1948, radiology images were transferred between two towns in Pennsylvania via telephone lines.  In 1959, using interactive television, physicians transmitted neurological examinations across the University of Nebraska campus to medical students.  As technologies have become more sophisticated, the uses of telemedicine have expanded.  Today, eCare, as the Federal Communications Commission calls it, refers the electronic exchange of information in medicine and is being widely used.

There are several types or methods of telemedicine: remote patient monitoring, using mobile medical services that collect data about, for example, blood sugar readings, or other chronic disease markers, so that remote caregivers can review real time data for problems and offer quick solutions; store and forward models that enable providers to collect and share information, such as lab results, with other physicians at remote locations; and interactive telemedicine, which uses video conferencing to enable physicians and patients to communicate in real time.

Like everything else, there are pros and cons to telemedicine. The primary advantage is convenience, since patients don’t have to miss work for medical appointments, travel, or have associated expenses such as child care in order to visit a doctor’s office.  Elderly patients or patients who are house-bound with mobility issues can “see” a doctor without leaving home.  Patients who live in rural or medically underserved areas can get access to needed services easily and quickly.  Primary care doctors can provide their patients with specialist consultations easily as well, regardless of where they live, and quickly answer questions using video chat technology.  Small hospitals can outsource radiology services so that X-rays and other radiological techniques can be read by specialists, even if not on site.  Also, telemedicine has the possibility of reducing burgeoning health care costs by avoiding unnecessary ER visits.

But there are also some disadvantages. Providers worry that eCare may reduce face to face interaction and that clinicians will not be able to do physical exams often essential to delivering good care.  Organizations have to incur expenses to acquire the appropriate equipment and train staff to work the equipment.  Not all insurance pays for telemedicine and different states require providers to prescribe medication only after seeing the patient.

Nonetheless, it does not seem controversial that eCare is the wave of the future. Certainly younger patients, born into the world of smart phones and YouTube, will be very comfortable with high tech medicine.