Updated on March 31, 2022.
Chances are that in recent years, you’ve interacted with a healthcare provider (HCP) via phone, video, text, email, or through an online portal instead of physically visiting an office. That option is called telemedicine or telehealth, and it represents a huge change in the way health care works.
The COVID-19 pandemic saw an immense rise in telemedicine visits, as hospitals and lawmakers scrambled to make the service available and to reduce infection risks from in-person visits. A 2021 analysis by McKinsey concluded that telehealth had grown 38 times compared to before COVID-19.
Originally created for people living in "doctor deserts" (places lacking enough HCPs, facilities, or other health resources), telemedicine is now used under a variety of circumstances and in a number of ways. Connections made with phone calls or live video chatting are called synchronous (because they happen live, in “real time”), and connections through email or texting are called asynchronous or "store and forward."
The approach can be handy for checkups or quick questions. Many HCPs interact with patients through an online portal. Patients can communicate with the provider’s office and request refills, and clinicians can send test results.
Telemedicine can help with follow-up after hospitalization, too. A hospital may send you a kit with tools like a blood pressure cuff, pulse oximeter, or scale, all of which can link to a digital device like a smartphone, tablet, or computer. Once you take your measurements, they can be sent to a remote care team.
Convenience and safety
Telemedicine can be helpful because you don't have to drive long distances, sit in waiting rooms, or miss hours of work or family responsibilities to attend an appointment. With remote visits, you have more flexibility. You can do these visits from your home, your car, even at the office.
With a typical HCP visit, you would need to schedule follow-up appointments to see how you’re doing. With telemedicine, HCPs can answer a patient’s questions as well as check up on their status after a visit or hospital discharge—all from a distance and in many cases more quickly.
Telemedicine is also gaining popularity for its ability to help individuals with mental health needs. For a mental health visit, an HCP might schedule a video call or text back and forth with a patient.
“There's a shortage of behavioral health professionals, and it's often difficult to get people to go to those visits,” says Joseph Polizzi, DO, a family physician with Trinity Health in Michigan. Telemedicine removes some barriers that prevent mental-health patients from seeking help, like lack of transportation and accessibility to clinics.
The technology could also be helpful for those living with chronic conditions such as diabetes, according to Dr. Polizzi. For example, if check-ins are remote, a nurse care manager could check in more frequently with a person with diabetes.
Finally, telemedicine reduces people’s exposure to infectious diseases, including COVID-19.
A large 2021 study called the COVID-19 Telehealth Impact Study spearheaded by the American Medical Association polled nearly 1,600 HCPs and over 2,000 patients. The researchers found that the majority liked telehealth and wanted the option to continue, though many physicians also had misgivings about technology challenges for patients and other potential snags.
A 2022 BMJ Open study in which interviewers talked with 82 patients and 58 HCPs in the Netherlands also found that, by and large, both groups were satisfied with follow-up consultations by phone during the pandemic.
The drawbacks of telemedicine
Not every health problem lends itself to telemedicine, though. Sometimes an HCP needs to see you in person. In a 2022 publication in BMJ Case Reports, doctors in the United Kingdom described the case of a woman who had seen her HCP remotely about a fever several times over the course of several months. She turned out to have a heart infection, which was not diagnosed until she had a stroke. (Fortunately, she made a good recovery.)
“There are a lot of things that we're not quite comfortable diagnosing remotely,” says Polizzi. Many diseases and conditions cannot be diagnosed from a distance, and something like strep throat, for example, will most likely require additional testing. If that’s the case, the HCP will ask you to come in person for an examination, plus the necessary labs and tests.
There can also be technical issues like poor connections or phone service glitches that might affect your remote visit. Telehealth can also be challenging for older people. And with asynchronous telemedicine, you’ll also miss out on the often-valuable face-to-face communication with your clinician.
Concerns like these, alongside worries about reimbursement, liability, and how to integrate telehealth with the electronic medical record, mean some HCPs are less than enthusiastic about telemedicine. McKinsey found in a 2021 study that many doctors still prefer in-person care, with about half saying they’d like to limit their telehealth time to a couple of hours a day, and nearly a third saying they would rather not do telemedicine.
Telehealth is still evolving. Its ideal roles, its challenges, and how it can be most effective are still being studied. But it seems likely to remain with us. The American Telemedicine Association contends that telemedicine “has gone from being a side feature of the healthcare system to an expectation.”
