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Pioneers in Telemedicine: Susie Larson, MD

Functional Medicine clinician Susie Larson, MD, is embracing new technology in a way that few clinicians are, by incorporating telemedicine into her practice. She describes what she perceives to be the benefits of this new system in the video below:

Dr. Larson is a pioneer in this area. Despite its potential to improve access to care and the quality of care while reducing costs, the use of telemedicine among physicians remains low. According to a study in Health Affairs that analyzed 2016 data, only 15.4% of physicians worked in practices that used telemedicine for a wide spectrum of patient interactions, including e-visits.1 Many of the 3,500 practitioners evaluated reported that they use telemedicine for patient interaction (diagnosing or treating patients, following up with patients, and managing patients with chronic disease) and healthcare professional interaction (specialty consultations and second opinions) via videoconferencing, remote patient monitoring, and storing and forwarding data. Nonmetropolitan areas were more likely to report use of telemedicine, as were clinicians in larger practices.1

A 2016 survey funded by the NIH (which analyzed responses from 3,000 patients treated via telehealth at a CVS Minute Clinic) concluded that between 94 and 99% were “very satisfied” with telehealth, while one-third of respondents preferred the telehealth experience to an in-office doctor visit.2 Data also suggests that 60% of millennials support the use of telehealth to replace in-office visits.3 71% said they’d like to see their providers use an app to book appointments, share health data, and manage preventive care.3 With a population of 83 million, millennials now comprise the largest segment of today’s workforce.

What’s more, a recent Harris Poll survey found that 23% of people have delayed seeing a doctor because it takes too long, while an additional 13% have delayed a doctor visit because they are too busy.4 A study published in 2015 in the American Journal of Managed Care by researchers at Harvard Medical School concluded that the average doctor visit took 121 minutes; 37 minutes of travel time, 64 minutes of waiting time, and just 20 minutes of face-to-face time with physicians.5 The use of telemedicine could potentially change the trajectory for this evolving state of health care.

In some respects, telemedicine may change the physician-patient relationship by allowing more direct patient involvement in the decision-making related to their health.6 One way that information technology can promote patient-centered care is by providing a mechanism—like patient portals—for a patient to provide the clinician with critical information about him or herself, including functioning and well-being.7 Patient portals have also been shown to be a useful intervention platform for patient coaching and education focusing on chronic conditions, such as diabetes and heart disease, or on health risk factors such as hypertension and smoking.7 In a 2012 study, bedside nurses reported that telemedicine also improves the quality of clinical practice, patient health, and the professional workload.8 New trends in the industry include patient data collection and data analytics for patient self-monitoring, mobility and cloud access, enhanced security, better investment opportunities, and improved healthcare apps.9

References

  1. Kane CK, Gillis K. The use of telemedicine by physicians: still the exception rather than the rule. Health Aff. 2018;37(12):1923-1930. doi:10.1377/hlthaff.2018.05077
  2. Polinski JM, Barker T, Gagliano N, Sussman A, Brennan TA, Shrank WH. Patients’ satisfaction with and preference for telehealth visits. J Gen Intern Med. 2017;31(3):269-275. doi:10.1007/s11606-015-3489-x.
  3. Wesson M. The state of the connected patient 2015. Salesforce Blog. https://www.salesforce.com/blog/2015/02/the-state-of-the-connected-patient-2015-infogrpahic.html. Published February 18, 2015. Accessed December 6, 2018.
  4. The Reis Group. Survey finds significant gaps in doctor-patient conversations. EurekAlert! https://www.eurekalert.org/pub_releases/2018-10/trg-sfs100918.php. Published October 10, 2018. Accessed December 6, 2018.
  5. Ray KN, Chari AV, Engberg J, Bertolet M, Mehrotra A. Opportunity costs of ambulatory medical care in the United States. Am J Manag Care. 2015;21(8):567-574.
  6. Ruiz Morilla MD, Sans M, Casasa A, Giménez N. Implementing technology in healthcare: insights from physicians. BMC Med Inform Decis Mak. 2017;17(1):92. doi:10.1186/s12911-017-0489-2.
  7. Snyder CF, Wu AW, Miller RS, Jensen RE, Bantug ET, Wolff AC. The role of informatics in promoting patient-centered care. Cancer J. 2011;17(4):211-218. doi:10.1097/PPO.0b013e318225ff89.
  8. Mullen-Fortino M, DiMartino J, Entrikin L, Mulliner S, Hanson CW, Kahn JM. Bedside nurses’ perceptions of intensive care unit telemedicine. Am J Crit Care. 2012;21(1):24-31. doi:10.4037/ajcc2012801.
  9. University of Texas School of Biomedical Informatics. What are the latest trends in telemedicine in 2018? Forbes. https://www.forbes.com/sites/quora/2018/07/31/what-are-the-latest-trends-in-telemedicine-in-2018/#5d4095506b9e. Published July 31, 2018. Accessed December 5, 2018.

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