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Is This Growing Field The Future Of Medicine?

Discussion in 'General Discussion' started by Mahmoud Abudeif, Jun 30, 2021.

  1. Mahmoud Abudeif

    Mahmoud Abudeif Golden Member

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    Virtual care is more than just telemedicine. From remote patient monitoring to wearable devices and more, this technology-enhanced approach to care is helping clinicians prevent disease and ensure it doesn't reappear after it’s been treated. It's also streamlining record-keeping and allowing patients to access care with unprecedented frequency and ease–from just about anywhere with an internet connection.

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    Virtual care is more than just telemedicine. From remote patient monitoring to wearable devices and more, this technology-enhanced approach to care is helping clinicians prevent disease and ensure it doesn't reappear after it’s been treated. It's also streamlining record-keeping and allowing patients to access care with unprecedented frequency and ease–from just about anywhere with an internet connection.

    Increasingly, medicine is taking place in a virtual landscape, from telehealth appointments to wearable, digital health-tracking devices and more.

    Let’s take a closer look at the potential of virtual care, its requirements for equitable delivery, and how soon it might become the standard for extending care beyond the clinic’s four walls.

    What is virtual care?

    Virtual care isn’t new. Certain forms of it have been used for decades, helping physicians connect with patients in rural areas and deliver care remotely. But, as highlighted in a recent review published in the Journal of Medical Systems (JMS), the pandemic hastened its adoption across medicine. With stay-at-home orders in place, virtual care became a useful tool for protecting patients and clinicians from COVID-19.

    Within the first 2 weeks of lockdown, the number of telemedicine services across the United States increased by roughly 86%. These services ranged from triage and screening to consultations and treatment. Many of these benefits persist. Patients can be educated from afar; their health information can be stored and accessed virtually; therapies and drug reviews can be conducted remotely, and so on.

    The authors of the review note that virtual care stands to “maximize the efficiency of healthcare delivery,” and some of the few studies measuring the efficacy of virtual care have reached similar conclusions.

    For example, a recent review published in Telemedicine and e-Health, which analyzed 272 articles, found that most focused on cardiovascular disease and wireless patient monitoring devices. This specialized approach to telemonitoring appeared to “maximize patient care and effectiveness of treatment.”

    Prevalence and future projection

    While virtual care isn’t ubiquitous yet, there’s reason to believe it will be soon. “The horse is out of the barn for virtual care,” proclaimed Frank McGillin, CEO of The Clinic by Cleveland Clinic, in an interview with Healthcare IT News.

    The pandemic has eliminated many of the barriers to virtual care by necessity, from provider and consumer reluctance to lack of infrastructure, McGillin said. He cited one survey, which found that more than half of patients plan to continue using telehealth once the pandemic is over. High-volume specialties like cardiology and pediatrics have seen the number of providers that offer virtual care increased tenfold—and 92% of physicians plan to continue offering virtual care as an option.

    “At The Clinic by Cleveland Clinic, demand for virtual second opinions for complex diagnoses has doubled in the past year. Across the industry we're also seeing increased interest in virtual appointments in cardiology and oncology, two specialties where innovation is occurring at a rapid pace,” he said.

    According to one estimate, the US market for remote patient monitoring technologies is likely to reach $1.9 billion by the year 2026. Another estimate projects the worldwide market for all digital health applications involving telehealth and remote monitoring could be worth roughly $2.6 trillion by 2025.

    The 2020 Physician and Consumer Survey, published by Amwell, found that the percentage of physicians using telehealth increased from 22% in 2019 to 80% in 2020. The survey also found that the number of patients who experienced a virtual consultation with a clinician tripled from 2019-2020, and that 91% of patients reported being “very” or “somewhat” satisfied with the visit. According to an article published in JAMA Network in February, an estimated 1.6 million virtual care visits were conducted in the United States between January and March of 2020.

    And this wasn’t limited to patients with premium health insurance. Since the beginning of the pandemic, the Centers for Medicare and Medicaid Services (CMS) added 144 virtual care services, including emergency department visits and initial inpatient and nursing facility visits, among others—all of which are covered by Medicare. According to CMS data, more than 24.5 million of the 63 million Medicare beneficiaries and enrollees have received a telemedicine service during the pandemic.

    “Across health plans, behavioral health dominates telehealth claims. That's a trend that is likely to continue after the pandemic due to the availability of mental healthcare on demand and the comfort of receiving care from the privacy of home–both of which impact the patient experience,” McGillin said.

    Concerns and issues to overcome

    Of course, there are challenges and barriers to universal virtual care access. According to the Amwell survey, some physicians have raised concerns over insurance reimbursements following virtual care delivery, and others are worried about its clinical appropriateness. A recent survey published on our PhysicianSense blog revealed similar concerns.

    Authors of the JMS review wrote that “several physicians had concerns regarding patient privacy policies, or whether telemedicine assessment was acceptable or met the needed standards for a complete medical examination.” What’s more, some hospitals and clinics may not have the resources or infrastructure to properly manage virtual care, and not all patients have access to the requisite technology.

    New laws and regulations, as well as upgrades to infrastructure, are needed to help establish virtual care as a standard part of medicine, the authors concluded.

    Finally, as we move further into a world of virtual care, physicians must ensure they use it to enhance, not detract from, the doctor-patient connection. While virtual care facilitates medical practice remotely, safely, and efficiently, clinicians should pay attention to emotional cues that may get lost through screens and devices, in order to provide the most appropriate care.

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