Telemedicine

Telemedicine is being called a boom, and when a nurse shares that she can "see" 20 patients in a day, as opposed to 6 or 7 patients for the same treatment, the positive business results are obvious. Devices are being used to monitor conditions in the home, electronically reporting the results to the healthcare provider, resulting in longer-term, more accurate information as well as better care. Psychotherapists are providing telephone sessions. Webcams and other devices bring us together with care providers without either party having to go anywhere.

When travel is removed from an equation, the overhead drops and profits increase. Additionally, office space costs money. Companies with "troops in the field" commonly maintain less office space to account for them. If 10 employees are in the field, they may be able to share 5 desks at headquarters, resulting in less rented space, less heat, less water in the water cooler…and more productive time because those troops aren't clustered around that water cooler and can focus exclusively on the tasks they're being paid for.

Meridian Health in New Jersey was featured in a about telemedicine, and the positive results look to be good for business, good for the healthcare professional, and good for the patient. Now if we can only get somebody to pay for it.

Actually, insurance companies see promise in telemedicine, and the Center for Medicare and Medicaid Service (CMS) sees the value, determining that states can choose to include telemedicine as viable treatment alternatives that can be paid by Medicaid. Whether any states are actually paying for mental health or substance abuse treatment services will have to wait for another entry on this subject. The general outlook I see toward telemedicine is bright and positive, so if it's not in your life today you may be on the phone, using devices or communicating via the internet through secure connections soon.

If the Electronic Health Records (EHR) would require modifications to account for telemedicine in mental health and substance abuse treatment, they would be minor, like changing the location code for a service, and perhaps adding a telemedicine provisional statement in documentation of those services. These sorts of things and the training and quality control measures of the EHR shouldn't pose any problems for facilities considering adding telemedicine to their treatment arsenal.

With all the positive information I've run across, and the apparent willingness to pay for at least some telemedicine procedures, I felt compelled to dig up something negative to balance the scales.

The New York Times covered the negative side of the story. A recent article discusses how the technology might affect the doctor/patient relationship, decreasing the trust factor.

I'm a big fan of face-to-face connections. When I was in the sales profession, seeing somebody's eyes was the most effective contact in gaining a person as a customer, so I tend to agree with Dr Pauline W Chen's coverage in the Times story; trust is built stronger with personal contact. Today I find balance is necessary. In order to cultivate strong relationships and trust, I use all the communication avenues I can, and face-to-face contact is a key factor in those relationships.

A friend of mine uses the phone to connect with her therapist and gladly pays for the sessions out of her pocket, since they aren't covered by her insurance. She lives in Manhattan, and her therapist is on Long Island. Needless to say, the relationship started years ago, and after many sessions, the travel got to bee too much. She wasn't about to shop for another therapist, after spending years to find a professional she could relate with, open up to, and reap positive results.

Telemedicine certainly has a place in our world, and I'm sure I'll be discussing more on the subject as the "boom" continues. I'd love to hear about some practical application of telemedicine in the field.