A recent Google-backed study indicates that "virtual house calls" can save money and hours of travel time for patients with Parkinson's disease, since a simple video chat allows doctors to assess tremors and other related symptoms. "Telemedicine" is a way of interacting that could have profound implications for our healthcare system, if it is scaled up to treat patients beyond those with Parkinson's.
"The vision is that anyone anywhere with Parkinson disease or another chronic condition—from autism to Alzheimer's disease—can receive the care she needs," lead author Dr. Ray Dorsey of the Johns Hopkins University School of Medicine's neurology department tells Healthline.
The study, carried out by researchers at Johns Hopkins and the University of Rochester Medical Center and published online in JAMA Neurology, followed 20 patients with Parkinson's disease who communicated with their doctors using web cams. Researchers found that the level of care these patients received was no different from those who had in-person visits.
The implication is that a virtual house call, which would allow a patient to be seen and treated from the comfort of his or her home, is just as good as an in-person visit when all that's required is a basic assessment and consultation.
Institutional Barriers to Telemedicine
The healthcare structure in the United States, however, is such that doctor-patient video chats pose a risk for insurance companies and hospitals. What if an urgent situation arises during the virtual house call, and what if a dire symptom of an illness goes undetected?
But if virtual office visits, text message prescription reminders, and other mobile technological advances were to catch on more broadly in the medical field, millions of dollars could potentially be saved by medical institutions and government agencies.
"To make this a reality, Medicare and other payers need to stop subsidizing care at high-cost, inconvenient institutions and start incentivizing low-cost, patient-centered care," says Dorsey.
Such a change would require advocacy and activism on the part of patients.
"As with any change, patients and caregivers will have to make their voices heard if they want to start receiving care on their terms, rather than the current institution-centered model," Dorsey said.
Innovation in Healthcare
Licensing and insurance reimbursement schemes would also need to change, as remote visits are not reimbursable under most plans and doctors cannot currently treat patients who are located in other states.
While the Internet and video chat services have revolutionized the way companies, families, and universities operate, most hospitals and medical institutions have yet to adopt the trend.
"Reimbursement and licensure issues are trailing innovation and, if anything, act as a hindrance," Dorsey said in a press release. "There's really a disconnect."