Will The Covid-Induced Telemedicine Scramble Change Primary Care Forever?

COVID-19 has induced a hike in telemedicine adoption, and its application to primary care is expected to last forever.

The healthcare providers in the U.S. have been investing paramount efforts in making more services available via telehealth for years. However, the real value of telemedicine has only been realized in the wake of the coronavirus pandemic, with strong dictates of social distancing and economic lockdown. COVID-19 has essentially paved the path for an inevitable telemedicine revolution, pushing it forward by a decade, if not more.

Telemedicine has always been deemed inadequate in delivering quality care due to the lack of in-person contact. Primary care has always rested on the assumption that telemedicine would be unsatisfactory and inefficient because it lacks in-person contact. This myth has been exposed to the outbreak of the COVID-19 pandemic; it’s safer, more convenient, and much faster than the traditional primary care delivery models.

The convenience factor is the most widely celebrated facet of telemedicine. Connecting with your physicians via video conference, or even text messages is something that the country had failed to internalize until the onset of the public health crisis. From the perspective of the healthcare providers, primary care delivery has now become more convenient, thanks to telemedicine.

There is a lot of experimentation taking place right now in practices trying to deploy telemedicine as their mainstream care delivery strategy. All facets of primary care are potentially impacted by the COVID-induced telemedicine scramble, such as the following:

Chronic Disease Management

The bulk of primary care work relates to managing chronic diseases such as hypertension, obesity, diabetes, heart disease, fibromyalgia, and depression. While many of these conditions are well-suited for telemedicine, the majority of the patients suffering from these illnesses lack access to a computer and internet or have difficulty using technology. This, then, makes in-depth periodic hands-on assessment and care delivery much more complicated. Nevertheless, telemedicine successfully delivers ‘life-coaching’ care in many cases. However, a continuous provider-patient relationship remains the most critical component for chronic disease management through telemedicine.

Minor Illnesses

The majority holds the view that primary care relates to treating minor, episodic illnesses such as minor sprains, colds, and rashes. Since it is an as easy money-making option for the providers, delivering care for minor illnesses over telehealth visits has attracted considerable interest in the providers. However, technical limitations of connectivity and video quality could potentially complicate and fragment care delivery through telemedicine.

Referrals

To facilitate appropriate referrals remains another essential function of primary care. Since many patients lack the basic understanding of which specialty does what, primary care physicians can guide them through for referrals, depending upon their needs. For instance, a diabetic patient suffering from arthritis pain need not travel 200 miles to see an orthopedic surgeon. Instead, he can be referred to a podiatrist for a telehealth visit. Interestingly, you do not always need a physical examination to know where to refer a patient.

Public Health

The most critical application of telemedicine is perhaps in managing public health. Especially in the context of the COVID-19 pandemic, telemedicine has embraced a decisive role in public health. Providers can deploy telemedicine for several activities such as sending out health reminder messages through patient portals, providing screenings and follow-ups, and educating patients and spreading awareness. However, given the current state of a public health crisis, primary care visits are bogged down with mandated public health issues that fail to fit into the 15-minute office visits adequately.

Payment Reforms

It has always been difficult to digest the fact that in-person visits are not the only service that the doctors deserve payment for. An equal amount of effort is required in delivering telemedicine services as needed for in-person visits. Six months into the pandemic, we have realized that telemedicine is not so different from in-office visits, except for its reliance on technology. Hence, the payment reforms that have been enacted during this public health crisis must be made permanent and shouldn’t be reverted. 

Interestingly, the findings are equally relevant to other specialties. For instance, addiction doctors are better able to prescribe medications to treat opioid dependency after thorough telehealth visits. Similarly, podiatrists can treat diabetic patients using video-enabled conference calls. Hence, today physicians across the country are delivering convenient and accessible care through telemedicine software, which was once only thought to be feasible in person.