Telemedicine: The Future Is Now

Meg Barbor, MPH

April 2017, Vol 7, No 4 - Oncology Practice Conference 2017


Orlando, FL—Telemedicine, or the remote diagnosis and treatment of patients by means of telecommunications technology, is now at the forefront of efficient healthcare delivery. This fundamental change in the delivery of healthcare focuses on bringing medicine to the patient rather than bringing the patient to medicine, said Richard J. Boxer, MD, FACS, Clinical Professor of Urology, David Geffen School of Medicine, University of California, Los Angeles, at ASCO’s first Oncology Practice Conference in March 2017.

Technology in Medicine

In 2015, approximately 1 million virtual physician visits were conducted in the United States, and that figure is projected to grow to 2.4 million in 2017. Overall, 72% of hospitals and 52% of physician groups already have telemedicine programs, and that number is growing rapidly.

“Employers want telemedicine. They want to keep people out of the ER [emergency department], doctors’ offices, and urgent care centers, because it’s inconvenient and terribly expensive,” said Dr Boxer. In addition, 61% of patients surveyed are open to using virtual healthcare services, and 16% have already used them, “which I think is a very high number,” he added.

Telemedicine should be in the armamentarium of every practice, said Dr Boxer, because it allows for remote, affordable care of patients in a convenient way.

“It is no longer sustainable to bring patients to medicine. Bricks and mortar are too expensive, and travel is too cumbersome and inconvenient. People want things now, and that’s all about technology,” Dr Boxer said.

Healthcare without Walls

Technology has reduced barriers to healthcare by allowing patients to receive affordable and accessible acute and specialty care. With telemedicine, specialists can offer their knowledge to patients in rural areas via video chat, allowing for the best care possible in places with limited access to healthcare. Remote second opinions can also be shared within and outside of the United States.

Telemedicine saves time and money in rural hospitals that have a dearth of specialists, given that approximately 25% of the US population and only 10% of physicians live in rural areas.

Furthermore, telemedicine reduces fragmentation of care and redundancy. For example, New York-Presbyterian Hospital conducts approximately 1.6 million outpatient visits annually, whereas telemedicine enables approximately 2.4 million consultations annually, noted Dr Boxer.

The provision of healthcare will no longer require admission to a hospital, and as technology advances, barriers to care will become even easier to surmount, as smartphone apps such as FaceTime and Skype will be used to communicate with patients.

Currently, approximately 200,000 consults are conducted monthly via telemedicine, but this number represents only approximately 1% of the potential number of consults that are possible via telemedicine.

“The minimum number of people who could possibly be helped using telemedicine is no less than 20 million per month,” Dr Boxer said.

The fundamental regulatory issue related to telemedicine is prescriptive, because physicians must have a license to prescribe in the state in which a patient lives.

In addition, drugs controlled by the Drug Enforcement Administration are strictly prohibited from being prescribed via telemedicine, unless at least 1 in-person assessment of the patient was conducted before the controlled drug was prescribed.

“Telemedicine is not just the way of the future. It is absolutely now,” Dr Boxer pointed out. “But although technology is evolving at light speed, people are not.” Patients still crave interaction and a real person to speak to, so a combination of efficient technology and a personal touch is ideal.

Mega Trends Equal Mega Opportunities

Physicians are seeing a decline in their independence, according to Dr Boxer. In 2000, 57% of physicians were classified as independent, and 17 years later, that number has dropped to 30%. In the next decade, there will be a predicted shortage of 50,000 physicians, based on the current assumptions of medicine being delivered through office visits.

“But if you give a smartphone to physicians who are retired, disabled, or stay-at-home moms or dads, we can essentially put them back online, and suddenly millions of slots of time are being filled again,” Dr Boxer suggested. “Doctors love taking care of people; they often just don’t like the hassles surrounding it.”

In 1900 there were 3.1 million Americans older than age 65 years; in 2030 there will be more than 72 million Americans older than age 65 years.

“Telemedicine will explode in the realm of home healthcare. All you need is a monitor, and someone will know your vitals,” Dr Boxer suggests.

“None of this makes healthcare better or worse, just different, and I see no scenario in the future of healthcare delivery that does not include telemedicine. The opportunities are endless, and the status quo has ended,” he declared.