OAKLAND, CALIFORNIA - When the COVID-19 pandemic struck the United States in mid-March, visits to doctors’ offices dropped precipitously as people stayed home to protect themselves from the virus.
But the stay-at-home order has spurred people to seek medical help in another way – talking to a doctor over the phone, email or video, according to a new study.
Now, 30% of all outpatient visits are televisits, up from less than 1% in early March, according to researchers at Harvard University and Phreesia, a health care technology company.
“That's a dramatic change,” said Ateev Mehrotra, a professor at Harvard Medical School and one of the study’s authors. “Those are the sorts of changes we expect over a decade, not over weeks.”
Waiting for the telemedicine revolution
Communicating electronically with a doctor isn’t new. With some specialties such as dermatology and mental health, phone or video appointments are common.
In many U.S. rural communities, which have seen a decline in the number of hospitals and doctors, telemedicine has been a lifeline.
But when it comes to primary care, doctors, patients and regulators alike have mostly stuck with how medical care has been delivered forever: in-person meetings.
Some doctors say a lot can be accomplished over video.
“Looking at a rash, looking at a spot on an arm, that's perfect for telehealth, because we have the video capabilities,” said Dr. Edward Lee, an internal medicine physician and chief information officer at the Permanente Federation, a consortium of eight medical groups that deliver care to Kaiser Permanente’s 12.2 million patients and members.
“If I needed to do an injection, if I need to do a minor procedure, I'm not going to be able to do that over video or a phone,” he said. “And so, in those situations where there are urgent needs, we would bring the patient in to see us.”
Mehrotra, the Harvard professor, says doctors and patients are embracing telemedicine now, out of necessity, but are also realizing its limits.
“Given what I’ve heard from clinicians who've tried it, I have to think this will accelerate growth in the post-pandemic period,” he said. “But I'm also hearing from a lot of doctors, ‘It's cool, 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
Policy decisions are also driving the adoption of telemedicine. Until the pandemic, government agencies and insurers paid less than half their normal amount for telemedicine visits. Now they have increased the pay for a televisit so it is on par with an in-person one, according to Kaiser Health News.
Federal regulators have also paused enforcing patient privacy rules, so that doctors can use popular applications like Skype, FaceTime and Whatsapp, according to Consumer Reports. The alternative for hospitals and doctors is finding a telemedicine firm that provides secure video calls, a process that can be time consuming.
Mehrotra questions whether widespread adoption of telemedicine, post-pandemic, is the right course for U.S. health care.
But one place where telemedicine might make huge strides, he said, is in rural parts of developing countries, places where access to health care can be difficult.
“Telemedicine has great potential in that context,” he said. “It can be life-saving.”