It looks as if telemedicine is a technology whose time has come.
In 2012, only 14 percent of large employers offered access to telehealth for select services. In 2018 — just six years later — 95 percent offer telehealth for minor, nonurgent services, in states where it is allowed, according to a survey by the Washington-based National Business Group on Health.
“We’re a mobile society. We are a consumer-driven society. We have to get our health care when it’s convenient for us, not when it’s convenient for the health care provider,” according to Jeffrey Levy, a Houston-based insurance broker.
In part, telemedicine has spread because of the shortage of medical personnel in the United States. The country faces a shortfall of between 29,500 and 37,800 physicians in 2018 and a projected shortfall of between 42,600 and 121,300 physicians by the end of 2030, according to a report by the Washington-based Association of American Medical Colleges published in April.
Telemedicine has been around for a while but it is becoming increasingly popular “now that access to primary doctors is getting tougher and tougher and people have busy lives,” said Tracy Hassett, President and CEO of university group captive edHealth in Providence, Rhode Island.
What is Telemedicine?
Telemedicine uses document sharing, teleconferencing, smartphones, mobile wireless devices and other computer-mediated means to assist patients in their care. In many cases, it’s more efficient and economical for healthcare professionals to use technology to communicate with patients. Using synchronous video calls, healthcare professionals can identify and resolve healthcare issues and send prescriptions electronically to the pharmacy.
As acceptance and implementation increase, the advantages and disadvantages of this technology are becoming more apparent. Over time, many of the advantages will increase and, hopefully, the disadvantages will decrease.
Advantages
• Access to care in rural areas. Injured workers in rural areas often don’t have good access to medical facilities. They spend a great deal of time traveling to hospitals and clinics for medical treatment. Some injured workers may have to travel more than 20 miles for an office visit or physical therapy session. Traveling long distances can hinder injured workers in receiving timely medical attention and keeping follow-up appointments, and may further delay recovery and return to work.
• Reduced Waiting Time. When injured workers speak with a virtual physician or healthcare professional, hospital or clinic waiting room time can be significantly reduced. The Centers for Disease Control (CDC) indicated that the average wait time in an emergency room is two hours. This includes 30 minutes of wait time and 90 minutes to be evaluated and treated. Having access to a virtual physician can increase efficiencies and allow better use of resources and time.
• Cost Savings. Telemedicine can mean significant cost savings. The average cost of a medical claim file is between $5,000 and $7,500. The average cost of an emergency room visit can be several thousand dollars. These costs don’t factor in follow-up visits, physical therapy sessions, and possible diagnostic testing if required. Telemedicine services for non-complex issues on average can cost as little as $99 for the initial visit and $69 for a follow-up visit.
Disadvantages
• Patient Choice. Telemedicine protocols do not typically accommodate injured workers who want to select their treating physician. Only one physician is usually on call for evaluating injuries via video chat. This poses a problem in states where workers comp laws permit patient choice.
• Quality Outcomes. There has been limited research to address the quality outcomes of telemedicine, including from the malpractice insurance community. Current research has only focused on cost control and access to care. More research is underway.
• Trust. Establishing relationships and building trust with treating physicians are vital for an injured worker’s speedy recovery and return to work. Although online communication is familiar to anyone who uses Facebook, Twitter, and other electronic media, critics argue that it’s too impersonal. Obviously, the impact of intangibles such as a physician’s “bedside manner,” among other advantages of in-person care, would be lost with strictly telemedicine care, though this seems less troubling in many instances to some people, millennials in particular — who seem to be more comfortable with transactional relationships in other consumer situations.
• Regulatory Issues. There are also regulatory issues with telemedicine, most importantly the issue of physician licensing in multiple states. Currently, physicians are only authorized to treat patients in the states where they are licensed. Telemedicine will eventually enable physicians to provide medical treatment in multiple states. Ways to accommodate these situations are now under review throughout the country and we should see some resolution in the next few years.
Telemedicine is here to stay and it is being used increasingly to handle workers’ compensation claims.
For more information on how telemedicine can play a part in your workers’ comp program, please contact us.
