Telemedicine Brings Otolaryngology Care to Patients in Underserved Areas

As with other aspects of our lives, the focus and usability of TM is changing rapidly. In addition to videoconferencing between physicians and patients and store-and-forward technology, programs and applications have been developed to use diagnostic tools remotely and perform real-time monitoring.

“Today, most of us have advanced teleconferencing capabilities in our pockets,” said Stephen McCallister, CPHIT, CPEHR, an independent consultant with MGMA Health Care Consulting Group in Seattle. “Even if a physician isn’t going to talk to a patient through their smartphone, Skype and other technologies are familiar, and people are comfortable using them.”

Physicians note that the adoption of technology by patients may soon be a driving force in TM. “Patients are going to start driving telemedicine in ways we never anticipated,” said Dr. Kokesh. “The big difference is that everyone has a telemedicine device in their pocket. They are going to expect that their doctors participate with them in TM.”

Medicine has been slow to embrace changes taking place in other areas. For example, who would do business with a bank that did not offer automatic tellers and made you go to their offices to get your money? Convenient access to the physician will be an important consideration for patients.

Societal Changes Driving TM

In addition to technology, societal changes may play a role. For example, employers often put vacation and sick time in the same bucket of hours, forcing many patients to sacrifice vacation time in order to visit a doctor’s office. More recently, employers are starting to see an advantage in TM services for themselves.

Dr. Holtel, an otolaryngologist in San Diego, where there is a large

managed-care population, said employers are increasingly interested in providing clinical services through TM connections at their facilities so that employees can “see” a doctor and return to work faster.

Reducing patients’ need to physically visit a physician’s office will become increasingly important as the U.S. population ages and smaller practices fold into larger, urban-based ones, say some TM service experts. “In order to preserve market share, we need to lessen the burden of patient access to the practice,” said Nina M. Antoniotti, RN, MBA, PhD, director of TeleHealth Business at the Marshfield Clinics in Marshfield, Wis. “If TM’s only job is to alleviate patient difficulties in accessing a practice, that alone is a good enough reason to implement it.”

Overall, the general direction of medicine is seen as favorable to the use of TM. The aging U.S. population means there will be more patients and fewer active physicians, which could mean the need for remote treatment options to cover larger areas of the country. If practices continue to consolidate, TM may become a viable option in suburban or smaller urban areas.