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."
