I believe telemedicine (TM) will be big for several reasons. First, the shortage of physicians and other practitioners and influx of newly insureds will lead to increased wait times and dissatisfaction with the system. Telemedicine offers an ideal combination with new technology to rural and small towns as well as poorer urban areas with lack of transportation. All 50 states allow TM in some form or another. Google ‘helpouts’ is a new video-chat platform that may allow medical consultation especially for primary care practices. Consultations will be mostly related to non-emergencies, mental health counseling, dietary and wellness programs as well as routine low risk problems such as colds, allergies or small injuries or wounds. About 12% of patient care could be rendered remotely in a recent report in HealthAffairs journal.
Comment: A major issue remains and that is whether it will be cost-effective. A study by the London Scholl of Economics reviewed cost-effectiveness of telehealth compared with standard care over 12 months in 965 patients with three long-term conditions: heart failure, chronic obstructive pulmonary disease or diabetes and found that pay-off in terms was marginal in terms of quality of life. Another issue is whether TM reduces workload for PCP’s. A study in the UK showed no significant decrease in workload. However, more studies need to be done and as technology improves it should allow more cost-effective care to more people.