In theory, at least, telemedicine has a lot going for it, like convenience, convenience, convenience. Who wants to be stuck for hours in traffic and in waiting rooms for a visit with a primary care physician (PCP) that lasts, on average, about 20 minutes? Who wants to miss a day or half day of work? (Hmmm.)
Patients given the choice of visiting their PCPs via telemedicine are generally happy with the experience, according to a survey published as a letter in the April 30 edition of the Annals of Internal Medicine. Researchers with Kaiser Permanente Northern California surveyed 1,274 patients who’d scheduled a telemedicine visit with a PCP from September through December 2015. Ninety percent were confident in the quality of the care provided, 93% felt that the checkup met their needs, and—perhaps most telling—92% felt that the provider was familiar with their medical history. Those concerned that telemedicine will erode the doctor–patient relationship may be surprised that 84% of the patients felt that the experience strengthened their relationship with PCPs. (Seventy percent of the visits took place with patients’ own PCPs.) Kaiser Permanente Northern California began making telehealth visits widely available to members in 2014. Members can go to kp.org and communicate face to face with physicians on a mobile phone, computer, or tablet.
The researchers said that though telemedicine has been touted as a valuable tool, there has been “scant” evidence about how the technology would work in primary care. (For more on this, see our interview with Mary E. Reed, one of the authors of the letter.)
But, to not coin a phrase, curb your enthusiasm about the findings in this cross-sectional, self-reported survey published on April 30. For one thing, the data were collected in 2015, the equivalent of a thousand years ago in the fast-changing landscape of technology. In addition, the patients were fairly educated (58% had undergraduate or advanced degrees) and economically secure (38.1% had annual household incomes of more than $100,000). They were also in excellent or very good health to begin with (48.1%).
Jay Portnoy, MD, the medical director of telemedicine at Children’s Mercy Hospital in Kansas City, Mo., who was not involved in the survey, told Reuters that some medical conditions might be better suited for treatment via telemedicine.
“The most common issues dealt with include colds, rashes, behavior issues, and common issues that are embarrassing such as hair loss, erectile dysfunction, birth control, and so on,” said Portnoy, talking about telemedicine in general.
Telemedicine won’t replace in-person checkups any time soon, Michael Barnett, MD, of the Harvard T.H. Chan School of Public Health, told Reuters. “We are a long way from that because many people prefer in-person care, and technology is still a barrier for many of the sickest patients who don’t use the internet or smart phones.”