Telemedicine is a set of communication tools used by patients who are isolated from their physicians by distance or time and lack of access to health care services of all types, including for chronic condition management. As telemedicine bypasses the need for providers and patients to meet in person, its main advantage lies in creating opportunities for different types of provider-patient interactions that do not require traditional in-person visits. In this article, Dr. Joel Arun Sursas looks at whether telemedicine is as effective as traditional in-person care.
Practical Conflicts Between Telemedicine and Usual Care
The increasing use of telephone and other communication technology for telemedicine treatment is undergoing continuing scrutiny by insurance managers, Medicare administrators, and other entities responsible for monitoring and controlling medical costs. It is still typically required that services that have normally been handled by in-person contact between physicians and patients continue to be delivered that way in order to be covered. 
While some telemedicine applications have been understood to not involve ordinary patient interaction, such as teleradiology and telepathology, technological advances in communications are calling for more study and analysis of the effectiveness of modern telemedicine techniques, both as to patient outcomes and overall cost reductions.
Efficiency Advantages of Telemedicine
- Greater Access to Healthcare For Patients
Almost every group of patients can point to a set of limitations on their ability to effectively manage in-person medical treatment. Some patients live in remote areas and have difficulty traveling to and from their doctor’s office regularly. Others are homebound under most circumstances and find the travel to their doctor’s office very difficult or unsafe. Almost all working patients find it difficult to take time away from work to visit their doctor. As technology improves and patients generally find conferencing and online medical management software more accessible, telemedicine will greatly reduce the challenges and stress involved in accessing healthcare. 
- Cost Savings Through Advanced Communication Technology
Telemedicine availability significantly reduces the huge expense of non-essential ER treatment and ambulance-based transportation for many types of normal and non-emergency treatment. Cloud-based data analysis and monitoring services that can access patients remotely have the potential to greatly reduce ordinary healthcare treatment costs. Providers can also approach telemedical techniques to reduce overhead and can explore the possibility of working from home during set parts of their workweeks. 
- Stronger Patient Engagement and Better Patient Outcomes
Patients who are given the opportunity to engage in telemedicine treatments are likely to keep more appointments and use the available technology to stay more involved in their day-to-day treatment. Patients are able to use telemedical platforms to ask more questions and provide important diagnostic information to providers faster and more directly. Patients find treatment options are provided more quickly and have been shown to suffer less stress and anxiety about their treatment plans when telemedical treatment is available. 
Greater Access To Specialists and Enhanced Referrals
Patients who live in rural and remote areas find traditional care by specialists to be especially difficult. Many patients might enjoy shorter commutes and wait times for certain types of specialist appointments related to specific diseases and chronic condition treatments. Treating physicians are also very likely to enjoy the opportunity to broaden their choices when referring patients to preferred specialists located in other parts of the country. 
Efficiency Disadvantages of Telemedicine
- Hardware, Software, and Training Requirements
Telemedicine involves the expense of purchasing and implementing hardware and software systems that are not used in typical treatment settings. Staff training and possibly new staff hiring is also part of telemedicine implementation. After the initial startup expenses are absorbed, however, overall staffing requirements are likely to decrease, as individual nurses and doctors will be able to monitor more patients from a single location more effectively. 
- Reduced Care Continuity Compared to In-Person Treatment
Some larger telemedicine systems will contemplate the assignment of random providers for some highly on-demand services. The difficulty in obtaining records quickly for on-demand services and other continuity issues can negatively affect treatment processes and outcomes. Additionally, the lack of regular in-person consultations can affect the overall experience of patients who prefer face-to-face consultations even when a physical exam is not necessary. 
- Developmental Delays in Coverage and Reimbursement Rules
It is a virtual certainty that technology will always develop more quickly than administrative and regulatory processes that are expected to adapt accordingly. Healthcare providers will always need to take caution to ensure that they are exercising best practices when working with new telemedical advances and that they are working in ways that their services will be covered and reimbursed by insurance and governmental providers.
As the world of medical treatment continues to battle budgetary constraints and cost containment, the demand by patients and providers alike for telemedical advances will continue to increase. The interaction of developing technologies and systemic changes in healthcare delivery will increase the need for comprehensive studies of the effectiveness of telemedicine and the very likely unanticipated changes in how technology affects patient needs.