Telehealth: The Ultimate in Convenience Care

Healthcare organisations are gearing up to absorb the largest number of patients newly insured by the patients since Medicare enrollees have started signing in 1966. And consumers have granted convenience medicine a place in the market changing health care. One study compared traditional office visits to e-visits in four primary care practices for two conditions: sinusitis and urinary tract infections. The patients in the study used their doctors for both types of visits. The researchers found equivalent rates of follow-up, indicating the equal rates of misdiagnosis or treatment failure. They found similar patient satisfaction rates. But they also found a trend toward higher rates of antibiotic prescriptions due to e-visits, leading them to speculate that, without a hands-on examination, doctors can use a more conservative approach and be quicker to prescribe an antibiotic.

Other studies suggest that much of the electronic visits with primary care physicians provide care at low cost with results of similar quality to traditional trips to the office of the doctor. They are useful for common disorders, short-term illnesses and health advice, not most serious or chronic illness and patients who need hands-on examinations, lab work or imaging tests are referred to doctor’s clinics or emergency rooms for care.

But the health care system, in general, is moving toward less fragmented care, and all new players need to work with the established systems and doctors if they provide consistent, efficient care for patients. "I live in Nevada. Some of my patients live 300 miles from anywhere," says Dr Daniel Spogen, a board member of the American Academy of Family Physicians. If one of his patients has had a consultation with a telemedicine provider, that he wanted to see the medical records. "The ability to increase accessibility for patients can really be a benefit of using telemedicine technology," he says. "What's very important is that it does not work independently, but serves as another arm to obtain global information on that patient."

Research shows that when patients get their care from multiple doctors who do not communicate with each other, the services are duplicated and the quality of care goes down, adding to the overall cost of health care. Ideally, a record of each medical encounter outside must be shared with the primary care provider of a patient. But only the patients themselves may approve the transfer of their medical records. Schoenberg says the American Well doctors strongly encourage patients to allow to share the records with their doctors. "We have a long way to ensuring that a complete documentation of the encounter is transferred to the primary care provider," he says. "But if a patient says no, we cannot force it."

Medicine will always have need of hands-on expert care to listen to a heartbeat, collect a urine sample, or feel a lump. But sometimes people do not need to drag their achy bodies in a car, drive for 45 minutes, and sit in a waiting room with other sick people for half an hour only to be told their cold symptoms are normal and will run their course.

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