The rising popularity of telemedicine, including the growth of virtual clinics, may be a vital component of sustaining patient access to care, observers say.
According to the American Telemedicine Association, more than half of all U.S. hospitals now engage in some form of telemedicine, addressing patient needs remotely through the use of wide-ranging technologies. Growing numbers of patients receive primary care through telemedicine as well.
A Disconcerting Deficit
Those could prove to be timely developments, as the Association of American Medical Colleges projects that by 2025, the United States will experience a shortfall of 61,700 to 94,700 primary care physicians and specialists, eroding access to treatment.
Washington is among the states that have contended with the reality of too few physicians for too many patients.
“Shortages in counties in this area were really creating issues and challenges for patients to see a primary care physician,” says Ralph C. Derrickson, President and CEO of Carena Inc., a virtual care provider based in Seattle. “Patients were either not getting care, deferring care or having to travel great distances to get care.”
However, technological advances in medicine and society at large have revealed an opportunity to alleviate some of the pressure on physicians, while simultaneously getting patients the care they need.
“Don’t fear [virtual care]. Embrace it. Because it’s going to bring you back to why you went to medical school in the first place — to have the power to connect with patients on a personal level.”
— Randall Moore, MD, MBA, President of Mercy Virtual
Expanding Benefits of Virtual Care
Technologies that support telemedicine have existed for quite some time, though only in comparatively recent times has the healthcare industry begun to more fully perceive the scope of medical care that can be addressed through those technologies.
At the most basic level, all that telemedicine providers require is for a clinician and patient to have access to a computer, tablet or phone with the ability to connect to the Internet. With these tools at hand, physicians can conduct an examination similar to one they would conduct if the patient were in the exam room. In addition to audio and visual technology, many virtual care systems work with devices such as integrated stethoscopes and similar medical tools that facilitate remote examinations.
“Basically, the only things we can’t do virtually are touch and smell the patient, ... although, those [capabilities] are being developed as we speak,” says Randall Moore, MD, MBA, President of Mercy Virtual, a virtual care center based in Chesterfield, Missouri.
These efforts allow physicians to provide additional care by reducing or eliminating some nonclinical tasks.
“[Virtual care] can add time to a physician’s day by eliminating commuting time,” says Judd Hollander, MD, Associate Dean for Strategic Health Initiatives at Sidney Kimmel Medical College of Thomas Jefferson University. “If we’re going to travel four hours to get to a rural clinic and now we don’t have to, ... we can free up what we like to refer to as nonproductive time and change it into productive time.”
“I frequently give lectures to doctors on the topic of virtual care. I start by saying that they all already do this ... with friends and family. They treat them over the phone, through messages and using FaceTime. If they do this for the people they love, why not do it for their patients? If they don’t think it’s an effective way to provide care, then why are they doing it to those they care most about?”
— Judd Hollander, MD, Associate Dean for Strategic Health Initiatives at Sidney Kimmel Medical College of Thomas Jefferson University
Virtual care also reduces the strain on hospital resources by treating patients before their symptoms result in a costly hospital admission and may even expedite emergency, in-person care when a virtual encounter is not appropriate.
“Telemedicine is not for everyone and not for every [medical] complaint, but we’re big believers in making it available and letting people choose whether or not they want to use it,” Dr. Hollander says. “Some conditions you should never use telemedicine for — like a heart attack. However, ... if someone is having chest pain, they can call me in 15 minutes for a virtual appointment. It takes that same person three hours to decide to go to the ER. By treating remotely, I could potentially get them to the right place several hours faster than they would on their own.”
Working in Tandem
There are indications that virtual care supplements care provided during face-to-face medical visits. Derrickson notes statistics showing three-fifths of virtual-care visits with Carena providers take place after regular physician office hours or on weekends, for instance.
Telemedicine technologies are not altering the fundamentals of patient care nor undermining the vital role of physicians in delivering that care, according to Dr. Moore.
“The conversation isn’t about telemedicine and virtual care,” he says. “It’s about care. Front and center to all care is the doctor. If virtual care is just a part of care and doctors lead care, we’re firm believers that doctors will embrace this and really show the power of what can be done with this technology.”