The availability of information technology has allowed us to get to a point where patient services can be offered virtually. In a sense, using the telephone and the fax machine to communicate with patients regarding their care, was also a form of telemedicine. Now, however, we can approximate much of the in person visit with imaging and other forms of physiological data collection. We can do this in real time with video chat technology or we can have images, and other information, stored and sent to us to be reviewed at another time. In addition to calling, doctors and patients can e-mail, or even text, each other essentially from anywhere on the planet.
Often when new technology is adopted, there is a hope that it will be the knight in shining armor that will improve outcomes, convenience and efficiency. Sometimes this is true. Telemedicine, particularly store-and-forward platforms, can be more convenient to use as the patient and physician can upload at any time or anywhere. Only data travels. But all tasks are not eliminated and it may create other problems.
Here are some things to consider as you set up:
1. Expectations: Unless you are sitting by the computer at all times, or ruled by your smartphone, just because the information can be transported instantly doesn’t mean you are available to do the consult at all times. Make sure patients know that. Establish clear expectations.
2. Undervaluing: So, is it really true that you don’t need an office or employees to do telemedicine? It just takes 5 minutes, right? Telemedicine is often offered as a convenience but sold at a discounted price. In other industries, convenience is usually sold at a premium. Is telemedicine competing with the in-office business that you still have to have—and that covers overhead? Do your telemedicine patients use your office resources? If your telemedicine service involves that use of resources, such as your office employees to do prior authorizations, then consider that in the pricing.
3. Inefficiency created by incomplete communication and interruption: With the popularity of texting, which allows people to contact someone instantly, increasingly people do not complete their communications. They can always e-mail and text again—but this can create delays. Poor quality communication makes it hard to complete a task. It might have been faster in person. Instead, using texting, the encounter gets dragged out. The doctor can’t complete the encounter and move on.
Telemedicine technology has the potential to be a great tool. We have to be mindful, however, as to how we use it. We just have to remember that, as with medications, we have to consider both the risks as well as the benefits when we adopt new tools.
