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At ABCS RCM, we have noticed that the topic of Telemedicine is an increasingly popular trend in healthcare. In Ohio alone, Telemedicine (or telehealth) and other similar healthcare technologies look promising with the use of this technology expanding across the nation.

The Cleveland Clinic located in Cuyahoga County, Ohio, has implemented a telemedicine system known as the Telestroke Network. This network is able to treat about 1599 acute stroke patients annually and vital for individuals who live in areas where there is a shortage of highly specialized medical providers. Nationwide Children’s Hospital located in Columbus, Ohio (Franklin County) has created a Center for Telehealth that possesses telemedicine tools which are used in order to achieve an integrated virtual patient experience.

Both of these Ohio health systems are attempting to deliver healthcare to underserved areas that are typically rural settings or inner-city locations. This fact alone displays the benefits of telemedicine and similar technologies. 

The social benefits are potentially far-reaching, perhaps similar to the growth of access to clean water and electricity. However, healthcare is not an easily addressed issue due to the fact that there are opportunity costs that a society needs to address.

The history and characteristics of the U.S. healthcare marketplace may help to predict what could happen with telemedicine or telehealth. Healthcare always has to contend with the three attributes or principles:

[1] Decrease cost

[2] Expand access

[3] Increase quality

In the delivery of healthcare to a population, it often appears that these three healthcare principles are often in direct conflict with each other. In other words, is difficult, perhaps impossible, to maximize all three of these attributes as we explore how to deliver healthcare to our society.

As one changes, it always seems to have a direct impact on the other two attributes. For example, some people would argue that you can increase the quality of healthcare offering newer treatments, access to more highly-trained specialists, round the clock support, etc. However, this additional delivery of medical treatments will increase the overall cost of healthcare.

The State Medical Board of Ohio has clearly stated that the medical license for a physician practicing telemedicine is held to the same standard of care as a license for the healthcare provider who is delivering non-telemedicine treatments. In addition, Ohio public radio has pointed out that telemedicine sounds great in theory, but this new technology will not fix the problem with a shortage of healthcare providers (especially in behavioral health).

From the historical perspective, the growth of telemedicine and/or telehealth may mirror earlier technological and social trends. In many ways, this model is similar to the guns v. butter concept from basic economics. It is hard for a society to prepare for, and fight, wars while simultaneously offering social programs and supports to its population.

There are financial trade-offs or opportunity cost. Many economists would simply conclude that “there is no free lunch.”

Will telemedicine resemble the history of Medicaid in the United States? Telemedicine can greatly expand access to healthcare while controlling cost, which is a good thing. However, there are still a number of questions that remain unanswered. Here are a few of these unanswered questions:

  • Will the quality of this kind of healthcare remain at the same level as the traditional face-to-face consultation?
  • Will only lower-income people be encouraged to use remote or “dial-up” physicians?
  • Will middle and upper-income Americans see it as an inferior product/service?
  • Over time, will the remote delivery of healthcare increase the overall health of society? Much in the same way that the discovery of penicillin or the polio vaccine had a positive impact on public health.

There is a potential to create a tremendous amount of public good with this technology. Over the past 100 years, new technologies were invented and leveraged in ways that improved people’s lives: internal plumbing, electricity, semiconductors, etc. In the long-run, these technologies benefited citizens of all demographic backgrounds.

So, the question remains, what will be the historical path for telemedicine?

The answers depend on how rapidly this technology improves with artificial intelligence playing a major factor. This emerging technology will disrupt certain aspects of healthcare. The only thing is for certain, is that technological change will continue to disrupt the healthcare industry.

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