Your Guide to Telemedicine

It’s no surprise that most of us avoid going to the doctor if we can.

This is partly because health insurance rates are still too high. Whether you have a high premium or a high deductible, it seems like the logical choice to avoid the doctor’s office or emergency room unless it is a true emergency. Since healthcare costs for emergency visits tend to be high, you’d likely consider another option if you could. 

However, the problem lies in when you need medicine. This usually dictates that you have to go to the doctor to a get a prescription. So whether it’s an emergency room visit or just a check-up, you still have to go. 

What if you knew about a different kind of service that was more convenient, less costly, and involved direct contact with your doctor without ever leaving your house? 

It’s called telemedicine, and it’s changing the way we think about doctor-patient interactions and healthcare costs.

What Is Telemedicine?

Telemedicine is essentially a diagnosis and treatment of a patient through technological means.

Back in the 1950s, this included transmitting the information verbally over the phone or even images through a television. This practice was generally reserved for people who lived far from medical care in remote areas. 

Today, technology has completely transformed telemedicine so that anyone who desires an easier way to access care at a lower cost can take advantage of this service. Telemedicine is changing medicine rapidly—with greater access to the Internet and more technologically adept patients, people can connect with their doctor without getting stuck in a waiting room first.

The Pros and Cons

Like any other medical service, telemedicine has its pros and cons.

The Pros

1. Empowers patients. Telemedicine helps patients to feel more in control of their health and empowers them to better manage their wellness. This not only results in better outcomes but can create a stronger doctor-patient relationship. 

2. See a specialist sooner. For people who have rare or undiagnosed illnesses, seeing a specialist is often necessary. Having access to telemedicine allows either you or your hospital to instantly connect with a specialist you need. This means you won’t have to travel to another state or even country to visit the specialist, and you can get critical medical care sooner, which could be imperative in a life or death situation. 

3. Easier to follow-up. How often has your doctor asked you to come back in for a follow-up appointment and you’ve neglected to go? With telemedicine, it’s easy to connect with your doctor and follow-up. This makes it easier for you to ask questions, talk about how things are going, and better care for yourself under a physician’s instructions.

4. Connect more often. For people who routinely avoid the doctor, telemedicine offers a painless and private way to connect in your home. You can still get expert medical advice without a physical exam and without leaving the house.

5. Extend access to care. For populations who can’t get care or areas that have trouble accessing care, telemedicine offers a solution. It extends care to people who need it the most. Through accessing physicians and engaging patients, telemedicine is an attractive choice for many people.

6. Reduce healthcare costs. Telemedicine may help reduce the cost of your healthcare, as telemedicine can often be less costly than using health insurance. It also may help reduce avoidable emergency room visits.

The Cons

1. Get a random doctor. If you’re using a service that connects you with a random doctor, this person won’t know you or your medical history. In addition, getting a prescription could be difficult.  The most effective telemedicine happens when you can connect with your own doctor.

2. No physical exam. Some people argue that a physical exam is necessary for a proper diagnosis. With telemedicine, there’s no way your doctor can examine you over the video feed. With the demand for telemedicine, patients may begin using this as a way to avoid in-person visits and therefore get the care they want, but not the care they actually need.

3. Trouble getting reimbursed. Insurance companies are constantly changing their policies. You may or may not get reimbursed—talk with your insurance company beforehand and prepare to pay these expenses out-of-pocket. 

4. The convenience fee or subscription. The doctor may or may not charge you a convenience fee for his or her services. You may have to pay this fee out-of-pocket. You should be informed of any costs before the visit begins.

5. Using secure software and equipment. Some people may need to be trained or gain access to secure software before taking advantage of telemedicine, making this an additional cost to both patients and healthcare facilities.

Appropriate Use of Telemedicine

Telemedicine should not replace in-person visits with your doctor; rather, it can be used for health conditions that are not life-threatening but still urgent. A list of common conditions that are ideal for telemedicine treatment include: 

• Upper respiratory infections
• Hypertension
• Allergies
• Urinary tract infections
• Rashes
• Diabetes
• Lower back pain
• Asthma
• Bronchitis
• Behavioral or mental health

Telemedicine should not be used in situations where an in-person exam would be required for a proper diagnosis, nor should it be used if your symptoms are severe or in the event of emergencies. 

There is also a list of medications that are restricted from being prescribed through telemedicine consultations or visits. As you can imagine, these lists include chronic pain medications among others. These will require that you see your doctor in-person in order to obtain prescriptions.

For other prescriptions, prescribing is generally not a problem as long as the doctor you’re seeing has an established relationship with you.

In addition, the technology and video service that you use for your telemedicine video chat with your doctor needs to be secure. Although it would be simple to hop on Skype to talk to your doctor, Skype is not HIPPA compliant. In order to prevent breaches and security risks from patient medical information, having a secure service is imperative.

Your Options for Telemedicine 

Telemedicine companies were born from demand—people who want easier access to doctors and care that’s convenient for them. Since people have more access to computers and video chats than ever before, telemedicine is quickly becoming a popular option among patients.

There are a few different options for how telemedicine works. These include: 

• Companies that offer 24/7 access to care through a doctor that’s working as a contractor for the company (these often include apps such as Heal)

• Telemedicine companies that work with hospitals and clinics to access specialists when necessary to review x-rays, scans, etc. without the need for travel.

• Companies that allow you to visit with your regular doctor via a video chat.

There are many companies that provide telemedicine services. You will need to find the one that best suits your needs. Whether you’d like a company that just provides medical advice without knowing your medical history, or to connect with your regular doctor, there is a telemedicine company for you. 

Insurance, HIPPA, and Telemedicine

Although the benefits of having health insurance are huge, navigating telemedicine in conjunction with insurance isn’t always simple. Whether or not you’ll get reimbursed isn’t always a direct answer from your insurance company.

However, there is a trend towards getting reimbursed more easily with fewer restrictions on telemedicine care. In fact, private insurance companies are often obligated to pay you for telemedicine services the same as they would an in-person doctor visit.

For Medicare and Medicaid, it’s a little different. For Medicaid, your reimbursement will depend on state law. For Medicare, they’ll only cover telemedicine under certain circumstances.

 For patients who don’t have insurance, they can pay for telemedicine directly. This will either be in the form of a fee (often called a convenience fee) for the visit, or a subscription fee (by the month or the year) for the telemedicine service. 

Some patients who have health insurance with a high deductible find telemedicine an attractive option. This is because they’re happy to pay the convenience or subscription fee just to have access to a doctor when they need it, and not have to pay higher medical bills when they don’t. The telemedicine option is often cheaper for them. 

Conclusion

Telemedicine has advanced rapidly in the last few decades, but it still has a way to go. In order for telemedicine to be widely available and even more successful, insurance companies need to reconsider their restrictions and reimbursement policies on telemedicine. 

Since the U.S spends more on healthcare than any other developed nation, the demand for telemedicine solutions and access to care will propel this field forward with even more advancements and convenience for patients to take control of their care and better engage with their doctors.