In this post I link to and excerpt from the Medscape* Telemedicine: Can It Help Your Practice? Making Video Visits Successful for You and Your Patients Chapters 1 and 2:
*MEDSCAPE PHYSICIAN BUSINESS ACADEMY
Initially designed to serve patients in remote areas, telemedicine has evolved into a daily tool in today’s evolving healthcare world. Technology innovations and broader acceptance from payers and patients has made this a viable tool for many physicians. The course will cover:
- Understanding the fundamentals of telemedicine
- Evaluating the pros and cons, from payments to privacy
- Reviewing regulatory and legal issues tied to video visits
- Setting up technology for ideal patient care and adequate reimbursement
- Providing a step-by-step checklist for creating your telemedicine program
What Is Telemedicine?
Telemedicine has great promise in healthcare, but acceptance has been slow. Here’s what to understand to get started.
[Good brief introduction]
Effective and Important Ways to Use Telemedicine
Telemedicine has various applications, depending on location, specialty, and other factors.
Connecting Patients to Care in Rural Areas
Telemedicine was originally intended for rural areas and still plays an important role there. About one fifth of Americans live in rural areas, and these patients are often hundreds of miles from the care they need, making telemedicine an absolute necessity.
[However], Medicare coverage of rural patients has been limited, even though it is more extensive than for Medicare patients in urban areas. Basically, Medicare only covers telemedicine for rural patients in shortage areas, but these patients can’t connect from their homes. They have to go to a nearby doctors’ office, hospital, or other facility to use telemedicine. (There is a new Medicare telemedicine program that allows very short visits for patients in the home, which will be discussed later.)
Mixed Reactions At Medical Practices
Telemedicine can actually help small practices thrive. The convenience provided by telemedicine helps physicians compete with walk-in clinics and urgent care centers. Even these outlets are turning to telemedicine as an option for patients. In 2018, for example, CVS introduced telemedicine offerings in its MinuteClinics.
Whereas many private practices hold back on telemedicine, the field is flooded with companies that link patients in video encounters with doctors who have never met their patients.
Some of the biggest companies are Amwell, CareClix, Carefree MD, Doctor on Demand, iCliniq, MDLive, MeMD, MyTelemedicine, Teladoc, and TimelyMD, and there are many more.
Physicians can be hired by these companies or earn extra money by working for them in their off hours. Doctors can work for several companies at once because they don’t require doctors to sign noncompete agreements.
Many of the patient encounters occur via video, but some of these companies also arrange for asynchronous telemedicine that uses text, images, and other data, which is particularly useful in such specialties as dermatology.
One challenge is that in video visits, treating physicians’ diagnoses are often based entirely on what the patient is telling them. They may not be able to refer to the patient’s record, and because patients are usually on their smartphones or computers, there are no diagnostic devices available.
According to one report, doctors are paid just $15-$30 per video visit, so the way to make money is through volume. Physicians can boost volume by working for several companies and—because doctors have to be licensed in the states where the patient is—obtaining medical licenses in a few large states, such as California, Texas, New York, and Florida. (Payments for telemedicine will be discussed in a later chapter.)
How Doctors Are Using Telemedicine
- Treating minor injuries and ailments
- Behavioral health
- Patients with chronic conditions
- Heart patients
- Cancer care
- Elderly patients.
Telemedicine is catching on. It has long been essential in rural areas, and now it is gaining traction in hospital systems and large practices in urban areas. Telemedicine companies are thriving. But this trend has yet to penetrate most small and medium-sized practices outside of hospital systems.