How Telemedicine Can Work For You

How Telemedicine Can Work For You

Cost effective and convenient—here’s how you can benefit from telemedicine.

Healthcare may soon be as close as your fingertips. Telemedicine, which connects patients and physicians in different locations, is becoming a timely, cost effective option for healthcare, especially for those with specific health or geographic challenges.

Telemedicine options for routine care
Web-based, on-demand providers provide healthcare practitioners, including specialists who can discuss, diagnose and, in some cases, treat and prescribe medications for conditions without an appointment and without the hassles of travel, parking, waiting or missed work.

Telemedicine is less expensive, too. Many visits are about half the cost—even if you call after hours or on the weekend—of a typical office visit. Health insurance and Medicare cover some telemedicine services. Check with your provider to see what they cover.

Providers offering telemedicine are required to provide the same standard of care for telemedicine as for in-person care and to adhere to industry standards and guidelines. Furthermore, all telehealth providers must comply with HIPAA regulations (the Health Insurance Portability and Accountability Act of 1996) to protect health data privacy and security.

If you have a life-threatening emergency however, such as chest pain or a laceration, skip telemedicine and seek immediate care at the emergency room or urgent care center.

Beyond routine care
There are several areas in which telemedicine really stands out, in some cases, making the difference between life and death.

Psychiatry. Telemedicine and psychiatry go together like, well, peanut butter and chocolate. “You only need a laptop on each end. You don’t need any other equipment, just a secure connection,” says Travis Hanson, JD, MS, executive director at The F. Marie Hall Institute for Rural and Community Health at Texas Tech University Health Sciences Center in Lubbock.

Half of the counties in the U.S. do not have a psychiatrist, so broad swaths of the country are without psychiatric support, says Scurlock. Tele-psychiatry is a big application with a big future, he says.

“As there’s less stigma about [mental health] and people are more open about their problems, tele-psychiatry is really filling a growing need.”

In fact, in the Hudson Valley region of New York, Scurlock’s hospital is providing pediatric tele-psychiatry to several school districts. The teen suicide rate is high here, Scurlock says, and there’s often a six-month waiting list to see a psychiatrist in person. Teens already FaceTime, so they’re comfortable with the technology. The program’s been so successful, some of the parents are opting to participate as well.

Triaging accidents. West Texas, where Hanson lives, is extremely rural, with oil fields and long stretches of empty highway. When an accident occurs, help is often a long way off. Texas Tech is implementing a next generation 9-1-1 project, equipping ambulances (six so far) with mounted cameras and portable backpacks.

“The emergency medical services team uses telemedicine while the ambulance driver is onsite so the emergency room physician can see what’s happening, rather than relying on radio traffic alone,” Hanson says. This helps the emergency medical services team triage patients and to know where to transport them based on their injuries.

Stroke. “Strokes are increasingly common as the population ages,” explains Corey Scurlock, MD, medical director of the eHealth program at Westchester Medical Center in New York. They require immediate medical attention at a hospital.

“Luckily, we have life-saving medications and life-saving procedures. However, they need to be done in certain time windows and those time windows are pretty short.” If you’re in a large city, chances are there’s a neurologist [who treats strokes] on staff at your nearby hospital. People who live in rural areas, however, are often not as fortunate.

“With [provider to provider] telemedicine, we can provide a neurologist to a patient as soon as they hit the emergency room,” Dr. Scurlock says. Once a patient is at the hospital, the measured average time for a telestroke consult is about 12 minutes, he says. The local emergency room doctor or nurse, who’s trained in performing neurological exams, can quickly do a CT scan and send the imaging to the remote neurologist who determines the best treatment for the patient.

The key to success with tele-stroke is adhering to pre-determined protocols for stroke care. Much of what goes into telemedicine is making sure processes and provider education is in place, so when telestroke care happens, it happens consistently and efficiently, says Scurlock.

Wave of the future
Telehealth utilization is up significantly over the past five years, Scurlock says, and is rapidly growing. One of the biggest barriers is getting private insurers and Medicare to cover telehealth services. But, even that is changing. For example, Congress recently passed the FAST Act (Furthering Access to Stroke Telemedicine), expanding Medicare coverage for tele-stroke services starting in 2019.

“Telehealth puts patients first,” says Scurlock. “Patients like to have convenience. What could be better than this? It’s a way for patients to really get the care they desire with minimal inconvenience.” Telemedicine is not a replacement for bedside care, he adds, but it can supplement in-person care.

Medically reviewed in May 2018.

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