Telemedicine and the Future of the Office Visit

Telemedicine is not a new concept; nevertheless, it took the COVID-19 crisis to generate widespread interest in telemedicine. In early 2020 there were widespread shutdowns of physicians’ offices and outpatient clinics and emptying of hospital wards and emergency rooms, even as intensive care units remained busy caring for severely ill patients. Telemedicine entered to fill the gaps left by empty examination rooms.

According to the New England Journal of Medicine, systems that had once performed 50 virtual visits per day started seeing 3000 patients per day by April 2020. Medical and Surgery outpatient clinics that had performed fewer than 1% percent of their visits virtually rapidly transitioned over 90% during the pandemic.

Will telemedicine fade away when the pandemic ends? One physician does not think so.

The virtual consultant

Long before the pandemic began, Dr. Rob Lamberts, a family physician in Augusta, GA, had already taken virtual visits to the next level. Dr. Lamberts is a direct care physician, which means he has a relatively small practice but remains in close contact with his patients when they need him. He communicates with his hospitalized patients using secure messaging. This allows Dr. Lamberts to function as a “virtual consultant,” serving as a trusted advisor to help his patients understand their treatment. Dr. Lamberts can monitor symptoms and even vital signs this way, allowing him to remain closely connected.

Dr. Lamberts believes that, after COVID-19, Medicare and the third-party payers must change their traditionally negative view of virtual visits. He hopes that this new perspective on telemedicine will help the public understand the benefits of telemedicine. “People don’t clamor for better care because they don’t realize how bad the care they are getting is,” says Dr. Lamberts. “The reason they don’t realize that their care is bad is that they don’t know how good it could be. Maybe people are getting a glimpse now.”

There are several reasons why physicians and health systems ought to consider integrating telemedicine into their care delivery models.

• Telemedicine facilitates care coordination through improvements such as better medication adherence and compliance.
• It increases efficiency by reducing no-show appointments.
• Finally, telemedicine can boost the quality of chronic disease care via remote monitoring technologies.

The future of telemedicine depends on how the incentives become aligned. If Medicare and commercial insurance companies reimburse virtual visits appropriately, many physicians would gladly integrate them into their practices, even surgeons who prefer hands-on visits.