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Reforming Delivery
Let’s Get Telemedical

Here’s one way telemedicine can make health care better: A Rhode Island hospital is using Google glass to connect patients with skin problems to off-site dermatologists, Kaiser Health News reports:

In the study, researchers instead had the physicians connect via Google Glass, enabling the specialist to see on his or her office iPad or computer what the ER doctor was seeing in person. The ER doctor was able to communicate with the dermatologist, and both physicians could ask questions of the patient in real time.

“You’ve rolled the first and second visit into this one visit. You have the specialist at the bedside, and if you get better, you don’t need to have follow-up,” said Paul Porter, a physician in the emergency department of Rhode Island Hospital and study author. “There’s nothing more frustrating [for the patient than] to be seen, leave with diagnostic uncertainty, and have to go somewhere else. … People don’t want that answer.”

Telemedicine means, as Porter points out, cutting out unnecessary visits to specialists, which will save money for patients (and taxpayers). It means that patients in areas with few doctors can get medical care without traveling long distances.

But telemedicine will also enable something even more important than all of the above: ongoing remote monitoring. Chronic conditions are a huge driver of costs in U.S. health care—especially if they are poorly managed. The easier it is for health care providers to keep an eye on patients on an ongoing basis, the less likely it is that patients will need to take a pricey trip to the hospital because some important symptom was missed between visits to the doctor. If a patient misses a medication, for example, a remotely enabled provider might know immediately and thus be able to take appropriate steps to remedy it. The more we make use of technology enabling remote monitoring and tracking, the more the U.S. health care system will save across the board.

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  • Boritz

    “Telemedicine means, as Porter points out, cutting out unnecessary visits to specialists, which will save money for patients (and taxpayers)”

    Porter points out nothing of the kind. Rolling two visits into one can easily be configured to roll all of the billing into one as well, and combining two necessary visits into one isn’t the same as cutting out unnecessary visits.

  • Kevin

    I’m not sure this will reduce costs, though it should make for more effective (and perhaps more cost effective) care. Until we figure out how to turn 75 year olds into 25 year old, medical costs will probably rise as we figure out new (and more expensive) ways to keep 75 year olds alive.

    I also think that cost control is much more likely to follow from competition (where the health care consumer bears the cost) than from technology, including telemedicine. In the absence of competition, better technology will only increase demand, which if there is no effective cost control via competition, will increase overall health care spending.

    So cheer for telemedicine to improve the quality of health care, but if you want to control costs a way has to be found to bring back competition and tying expenses to consumer choices.

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