Telemedicine—‘’seeing” your doctor via video, telephone chat or phone conversation—has been around for decades, but boomed in 2020 as the pandemic kept us in lockdown. From February, 2020, right before COVID-19 was declared a pandemic, to April, 2020, telemedicine use in the U.S. increased by 78 times, according to a report by McKinsey & Company.
Now, as case counts decline and mandates lift, telemedicine use is not used as often, but healthcare experts say it’s here to stay—and should be.
During the past 2 ½ years, doctors providing telemedicine and researchers studying it have learned a lot about what it works best for and how to educate patients about getting the most out of virtual care. Among the discoveries:
Myths and fears about telemedicine don’t bear out, researchers from the University of Rochester Medical Center reported recently. The approach is effective, doctors don’t overuse it and the most vulnerable patients don’t get left behind, says lead study author Kathleen Fear, PhD, director of data analytics at the URMC Health Lab. The Rochester researchers evaluated the records of about 370,000 patients seen during the height of the pandemic, with about 1/3 of those having at least one telemedicine visit, and compared that 6-month period to a previous one and a following one. Telemedicine works, and often fills a gap in care, they found.
Telemedicine Applications: Telemedicine works better for some conditions and purposes than others, other researchers have found. Texas researchers compared how well telemedicine visits worked in comparison to real-life visits in 32 new patients with shoulder pain. It worked best for assessing range of motion limitations; it was least reliable for evaluating shoulder instability, says James M. Gregory, MD, associate professor of orthopedic surgery at the University of Texas Health Science Center at Houston, who did the study.
Other research suggests physical therapy via telemedicine for orthopedic rehab after surgery and other musculoskeletal rehabilitation works as well as face-to-face therapy. Other researchers conclude that telemedicine and other digital health options are especially useful for older adults, but that age-related issues such as dexterity, visual impairment and cognitive issues must be considered when developing and using the technologies.
The American Telemedicine Association, an industry group, explains additional benefits and approaches of telemedicine.
What Else to Know
Look at telemedicine as an option, says Gregory. “I wouldn’t force it on anybody who doesn’t want it.” His guideline for when to consider telemedicine: “If I can see it on video [such as observing the shoulder’s range of motion as he did in his study], it is going to be as good as in person.”
Telemedicine offers a great advantage for older adults with mobility issues, says Maximilian Hsia-Kiung, MD, medical director of the Massachusetts General Hospital Pain Management Department. It’s also appreciated by many who live a distance from the medical offices, he finds. Among other uses, he relies on telemedicine to help prepare a patient for an in-person visit. And, he says, don’t be surprised if your physician asks more questions than usual during a video visit. “Developing rapport is a lot harder over a video visit,” he says, when it’s the first contact with a patient. So the extra questions are meant to get to know patients better, and care for them better, Hsia-Kiung says.
Preparing for a Telemedicine Visit
To help you prepare, the National Institute on Aging offers step-by-step tips.
Coverage of telemedicine services varies by plan, not surprisingly. To find out if your telemedicine care is covered, check first with your insurance plan or with Medicare and ask if there is a copay or deductible. During the pandemic and the public health emergency, the federal government, state Medicaid programs and private insurers all expanded coverage for virtual health care services. The public health emergency is in effect until Oct. 13, but is expected to be extended past that date. Medicare Advantage plans may offer more telemedicine benefits than original Medicare. Some providers have reduced or waived the fee for telehealth visits.
Kathleen Doheny is a Los Angeles-based independent journalist, specializing in health, behavior, fitness and lifestyle stories. Besides writing for Senior Planet, she reports for WebMD, Medscape, Endocrine Web, Practical Pain Management, Spine Universe and other sites. She is a mom, mother-in-law and proud and happy Mimi who likes to hike, jog and shop.
Doheny photo: Shaun Newton
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