By Vishal Mehta, M.D.
"Telemedicine" is a term that’s starting to surface more frequently. Most of us know that it’s out there and being used by some providers. We often hear about its use in specialties where access is a problem, such as psychiatry or neurology in rural areas.
But how will telemedicine affect the arthroscopic surgeon? Will it be used simply as a marketing tool to garner more patients, or will it truly be transformational and change the way that we deliver patient care? The answer to this remains to be seen and will be affected by the ease of use, adoption by patients, regulatory issues and whether it will be adequately reimbursed.
Firstly, it’s important to understand what telemedicine is. Oftentimes telemedicine is used interchangeably with "telehealth" and there is considerable debate about their exact definitions. Most consider telemedicine to be the delivery of traditional health care between a provider and a patient using technology, while telehealth is more encompassing and includes the administration and educational aspects of health care. For this article, the focus will remain on telemedicine and the interaction between you (the physician) and a patient. I will not be covering the growing field of remote patient monitoring, which is worthy of its own discussion.
With all the administrative and technology burdens already placed on us, why should we even consider incorporating telemedicine into our practice?
In general, there are several reasons. The clearest reason, and what I believe is the essence of telemedicine, is that it allows you to provide patient care without physically being present in the same room. This strategy became handy for me during my annual visit to Zambia, which was also my first foray into telemedicine. During that one-month period, I wanted to be able to interact with my patients back home that experienced problems that my PA’s, or partners, couldn’t or shouldn’t have to deal with. To remedy this, I set up a "virtual" clinic once a week where I would see these patients remotely using a web-based, face-to-face communication system. I found that this worked well. Patients checked into a virtual waiting room and, when it was their turn, my face appeared on the screen and we had a conversation. The initial limitations to telemedicine became clear to me as I could not physically examine them, however it was warmly received by my patients. Virtual clinics have now become a critical part of my time abroad and I have since decided to incorporate telemedicine into my own practice.
Also on my list of top reasons: efficiency purposes. I have many patients after simple knee arthroscopy and other procedures who do not wish to come back to the office. These are the kinds of patients I see benefitting from telemedicine visits where I can block out an hour of a day and see multiple patients back to back in a timely manner. It’s better for them (saves them time and money), better for me (frees up my office time and decreases utilization of costly resources) and ultimately better for society in terms of resource usage. Many of us do this already with athletes or other patients out of state where we simply check in with a phone call during their post-operative period; telemedicine improves upon that process and standardizes it.
An additional reason is to help grow your practice and attract new patients. Many patients are searching the internet, learning about their problem and seeing who can best take care of them. Making an online appointment to see a specialist initially sounds appealing, but what’s even more appealing? Clicking a button and being able to see a specialist from your own home! Today, we have become accustomed to these conveniences. Allowing a patient to connect with your practice from their couch will often end up leading to a traditional office visit at your practice. Patients want answers quickly, and telemedicine provides a way for you to connect and engage with these patients when they are looking for an expert. In this way, telemedicine can also become a viable marketing and patient engagement tool for your practice.
I have no doubt that telemedicine will, one day, become an important and sustainable conduit for us to interact with our patients. Done correctly, it will allow us to stay better connected to patients when away, free up office time and connect with those patients who would rather have their first experience from the comfort of their own home. Even though numerous challenges still exist, including but not limited to reimbursement issues and seeing patients across state lines, they are being quickly addressed. I would encourage anyone who is going to be in practice over the next five years to become familiar with the technology and view it as a tool for efficiency rather than another technological burden.