The Pros and Cons of Telehealth for Specialists

The basic goal of telehealth is increased access to care. The technology brings doctors to patients wherever they are, by using the power of our Internet connectivity and computers to establish remote visits with patients.

Over the years, telemedicine applications have been applied to a variety of primary care and specialty practices, as well as in hospitals, and in other ancillaries such as physical therapy.

But it’s in the specialty practice that we believe telehealth can have the biggest positive impact for patients and doctors. This article will look at the benefits and drawbacks of telemedicine for specialty providers.

The Association of American Medical Colleges suggests that there will be extensive shortages of both primary and specialty providers over the next decade. While primary care is expected to have a shortfall of around 49,000 providers, it’s far worse for specialty providers, where the shortage will hit more than 70,000. The irony is the U.S. population is only growing; the same study suggested by nearly 11% by the same timeframe. At the same time, the volume of older patients will continue to strain an already teetering healthcare system.

Part of the problem is that the number of clinicians providing specialty care is smaller and their practices tend to cluster in more populated areas. From the practical perspective of access to care, it’s clear that the emphasis on traditional office visits will only exacerbate the provider shortages that are on their way. With a rising set of chronic conditions like COPD and diabetes, access to specialty care for people living in rural settings becomes a crucial issue for the routine care necessary to manage their diseases. If the wait times for specialty providers continue to rise, the quality of care for these patients will decline.

The website, Costs of Care, describes a scenario that happens all too often today:

Each month, William G. takes a day off work, driving 20 miles to have his hypertension monitored at a local VA clinic. Between fuel costs, lost pay, and co-pays, the Vietnam-era veteran estimates his visit costs him about $70 – a lot of money for a man getting by on social security and a convenience store salary. Each month, he debates the choice between essential healthcare and essential income.

Now imagine if this patient were able to dial in for a telemedicine visit, saving the $70 each month? That’s a savings of $840 a year that might mean the difference between skipping medication because he can’t afford it and receiving the treatment that could extend his life.

“Telestroke is one of the most successful applications of telemedicine, bringing the experience of stroke experts to hospitals lacking appropriate stroke expertise.”

AHA/ASA Scientific Statement

Healthcare Informatics reported late last year on a national study of hospitals and health systems that showed one-half of these clinical providers are using telehealth applications to increase patient access to their specialty clinics. The virtual visit is being used in a variety of specialty areas, including:

• For post-surgical routine check-ups when the patient lacks mobility.
• For psychiatry, especially in rural settings where travel to cities is time-consuming, expensive, and stressful.
• For COPD patients that use home monitoring devices to record and transmit daily biometrics to clinical teams.
• In rural ERs for stroke victims to receive an immediate diagnosis from video telestroke consultations.

It’s the last bullet that we should examine for a moment. The American Heart Association and American Stroke Association have long studied the effects of telemedicine on patient care. They issued a scientific statement two years ago that served as ringing endorsements of telehealth applications for stroke victims. Key to the diagnosis includes real-time transmission of CT scans, interpretation of images, and diagnosis of ER patients. Their studies of telestroke applications yielded findings that showed faster treatment and better outcomes. As in all applications of telemedicine to date, patient and provider satisfaction remains high.

While this is one example of telehealth in a specialty setting, the benefits of the technology can also be applied to everything from dermatology, pediatrics, orthopedics and oncology. The Northwest Regional Telehealth Resource Center lists the following benefits of using telehealth in the specialty practice:

• For patients, the cost and time spent traveling or taking time off work or school are reduced. The patient doesn’t have to contend with winter weather and the possibilities of slipping on ice or encountering bad weather. Click here to find out more about what patients say about telehealth.
• Providers can increase patient volumes while facilitating more efficient workflows in their practice. They can more easily communicate with other providers, improving the continuum of patient care. Clinical overhead costs are substantially reduced. Studies show telehealth also cuts down on no-shows, especially for routine care.
• Communities also benefit from more access to specialty care for residents.
• Businesses benefit when workers take less time off work to travel to a remote on-site visit.
• Telemedicine can reduce hospitals readmission penalties.
• Payers enjoy lowered costs by lessening readmissions and complications.

While these benefits have been proven to hold true across many specialties, there are still potential drawbacks that we must examine.

Any time new technology is added to a practice, there can be hiccups in implementation. But because telemedicine has been around for decades, many of the difficulties inherent in go-live are reduced significantly. However, we typically suggest some restructuring of workflows to better facilitate telehealth programs. Your providers and staff will need to be trained in the telemedicine application.

With that said, telehealth is not meant for every patient nor every visit. Some patients simply will not grasp the technology and the same can be said for some clinicians. In some instances it could reduce in-person consultations; some patients and providers simply will see telehealth as impersonal when compared to the traditional on-premise visit. Too, providers will experience a learning curve tied to maximizing the interaction.

But the point of telehealth, really, is to open up more options for patients and specialty providers. At OrthoLive, we are committed to providing orthopedic providers with a simple, affordable telehealth option to offer to their patients. We are standing by to walk you through our telehealth application, which has been proven to improve convenience and access for patients while cutting costs and improving revenue streams for physicians.

Contact us to help you weigh the pros and cons of telehealth for your practice.