OAKLAND, CALIFORNIA. –
When the COVID-19 pandemic hit the United States in mid-March, visits to doctor’s offices fell precipitously as people stayed home to protect themselves from the virus.
But the order to stay home has spurred people to seek medical help in another way: talking to a doctor by phone, email or video, according to a new study.
Now 30% of all outpatient visits are televised, compared to less than 1% in early March, according to researchers at Harvard University and Phreesia, a health-care technology company.
“That is a dramatic change,” said Ateev Mehrotra, a professor at Harvard Medical School and one of the study’s authors. “Those are the kinds of changes we expect in a decade, not weeks.”
Waiting for the telemedicine revolution
Electronic communication with a doctor is not new. With some specialties like dermatology and mental health, phone or video appointments are common.
In many rural US communities, which have seen a decline in the number of hospitals and doctors, telemedicine has been a lifesaver.
But when it comes to primary care, doctors, patients, and regulators have stuck with the way healthcare has been delivered forever: face-to-face meetings.
Some doctors say that much can be accomplished by video.
“Looking at a rash, looking at a spot on one arm, is perfect for telehealth, because we have video capabilities,” said Dr. Edward Lee, an internal medicine physician and chief information officer for the Permanent Federation, a consortium of eight people. medical groups serving the 12.2 million Kaiser Permanente patients and members.
“If I need to do an injection, if I need to do a minor procedure, I will not be able to do it by video or by phone,” he said. “And so, in those situations where there are urgent needs, we would take the patient to see us.”
Mehrotra, the Harvard professor, says that doctors and patients are embracing telemedicine now, out of necessity, but are also realizing its limits.
“Given what I’ve heard from doctors who have tried it, I have to think that this will accelerate growth in the post-pandemic period,” he said. “But I also hear from many doctors:‘ It’s great, but I like in-person visits. I can’t do the tests, I can’t do the full exam. “
Paying the same for video and in-person visits
Political decisions are also driving the adoption of telemedicine. Until the pandemic, government agencies and insurers paid less than half of their normal amount for telemedicine visits. Now they’ve increased pay for a TV so it’s on par with one in person, according to Kaiser Health News.
Federal regulators have also stopped enforcing patient privacy rules, so doctors can use popular apps like Skype, FaceTime and Whatsapp, according to Consumer Reports. The alternative for hospitals and doctors is to find a telemedicine company that offers secure video calls, a process that can be time consuming.
Mehrotra questions whether the widespread adoption of post-pandemic telemedicine is the right course for US health care.
But one place where telemedicine could go a long way, he said, is in rural areas of developing countries, places where access to medical care can be difficult.
“Telemedicine has great potential in that context,” he said. “It can save lives.”