Medical Tuesday Blog


May 22

Written by: Del Meyer
05/22/2017 6:18 AM 

Will Telehealth replace the traditional office visit?

Liam Woodard National Director, Academic Division |Top Contributor

82% of Young Adults Would Prefer Telehealth to In-Person

A new study from MDLIVE, a telehealth software provider, has found the vast majority (82 percent) of young adults age 18 to 34 say having a consultation with their physician via a mobile device is the best option for them.

Everet Taylor, MA, MPM, PMP© Clinical Project Manager at Independent Contractor

Very interesting! The 18 to 34 age group are not alone, I have met with seniors that rave over telehealth as well. The evidence of its value can be seen in the very rural areas once it gets there.

Ramsey Carol VP of Rehabilitation at Pinnacle Healthcare Inc.

As a PT with a disabled husband at home, telehealth would be an excellent option for his frequent physician visits! Often the working spouse must take off work, and assist with transport and this is taxing the spouse and their employer when a telehealth option could even be a 3-way conference and allow me to join that visit from my workplace, and my husband from the comfort of his home. If I can remotely monitor him at home via the internet, the physician should be able to as well for routine visits.

What is the biggest obstacle to Telehealth? How would we pay for it? –Editor’s comment

There are essentially two ways to pay for health care. One is to personally pay for it in a Free Enterprise fashion. As more physicians would do this and competition increases, the cost would decrease. It would then be affordable. The cost is estimated at about one-half our present health care costs.

The other method is to try to convince CMS, Medicare, Medicaid, Blue Cross, and Blue Shield, to pay for Telehealth. This would set up a bureaucracy in each of the above payment schemes with the cost being added to the basic cost of a physician responder who would conduct the medical interview and prescribe the treatment. This could only be done on patients calling their personal physician since having a valid medical file is a requirement of most licensing boards. In California, this is defined as having a recorded medical history and physical examination within the past one year. With the bureaucracy of numerous insurance companies, each would have to verify that this medical visit had occurred. This would create a huge burden on each physician’s office. In our studies on the time involved to provide this data, it would come to about one-half of an office visit charge or about 10 minutes.

With the advent of hospitalists, their obtaining medical data from our office on our patient’s admission plus our obtaining of the hospital medical data on our patient’s discharge, reviewing the medical information and incorporating this into the patient’s electronic medical records also takes about one-half of an office visit or 10 minutes of a 20 minute appointment. Since this is also not a reimbursable expense; it is a cost reduction in the physician’s income.

From the data obtained from physicians who do not accept insurance and thus eliminate billing, the savings is about 50%. From the patient’s perspective, having insurance, which eliminates market forced efficiencies, doubles the cost of health care which is painless to the patient.

The majority of patients, as well as physicians cannot remember the one and two dollar office calls of the 1950s and sixties, and thus can’t comprehend personalized health care. In the UK with the NHS now being nearly 60 years in existence, there are no physicians who have been in practice that long. Hence, to propose private practice efficiency would be considered pure lunacy, not only by the patients, but also by the physicians having no longer experienced such an efficient system.

The return to personalized private cost-effective healthcare is no longer a goal of current practicing physicians or the current patients or public. It could only happen if the initial startup funding was outside of the public or physician’s purse since the opposition would be nearly universal. Current physicians even in the United States would fear the risk.

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