Society of Certified Senior Advisors: Is Telemedicine Right for You?

Telemedicine is becoming more popular. But why would you want to use the service?

While there is a common misconception that older adults are reluctant to use new technology, 2017 data from the Pew Research Center suggests that the idea is becoming outdated. Those on the younger side of old age have Internet and broadband use rates nearly equal to the population as a whole. Nowhere is this becoming more obvious than in the realm of health care, where telemedicine can improve the efficiency, cost and outcome of medical care.

What is telemedicine, you ask? The term is applied to any form of medical care that is delivered remotely, via a technological instrument such as a telephone or computer. It’s a growing industry. Recent research expects an increase of 14 percent in its adoption rate each year over the period spanning 2014 to 2020.

Health care technology is still in its infancy, but recent iterations have expanded into behavior monitoring and smart home applications. However, the bulk of services are delivered as expedited consult services and post-discharge health maintenance. Older adults have proven accepting of these services, but what do doctors think of this new way of delivering medical opinions? One pair of physicians detailed why they view telemedicine as a better service than most doctors initially think.

Greed Enters Telehealth

Whenever a new technology enters the marketplace, fraudsters are never far behind, especially when big government payouts are part of the package. Such is the case with telemedicine and Medicare.

The federal agency paid out more than $1.2 billion in bogus claims after five companies pushed medical braces on unsuspecting Medicare beneficiaries and charged the government. The telemedicine providers convinced people to get knee, back, shoulder and wrist braces without any evaluation, and channeled the orders through over 100 companies.

“The international call center allegedly paid illegal kickbacks and bribes to telemedicine companies to obtain DME [durable medical equipment] orders for these Medicare beneficiaries,” the U.S. Department of Justice release noted. “The telemedicine companies then allegedly paid physicians to write medically unnecessary DME orders. Finally, the international call center sold the DME orders that it obtained from the telemedicine companies to DME companies, which fraudulently billed Medicare. Collectively, the CEOs, COOs, executives, business owners and medical professionals involved in the conspiracy are accused of causing over $1 billion in loss.”

The companies were Video Doctor USA, AffordADoc, Web Doctors Plus, Integrated Support Plus and First Care MD. Charges have been filed in New Jersey, South Carolina, Florida, Texas, Pennsylvania and California.

Remote Physicals

Aditi Joshi and Judd Hollander, a pair of physicians at JeffConnect, have been examining patients for years. Recently, they’ve added telemedicine to their repertoire for physical exams. The duo perceives skepticism from others in the medical community, but they argue that remote exams are much more effective than commonly thought.

Compared to a traditional exam in the office, the two write, “[Remote exams] are more cost effective, give information that cannot be gleaned from invasive testing and are a check on our increasingly low threshold to order a battery of tests.” They also argue for the use of remote physical exams on the basis that “the great majority of an examination is possible through video” and the alternative may be no exam or one by telephone only.

Renowned 19th century doctor William Osler remarked that 95 percent of the diagnosis is in the patient history. Joshi and Hollander write, “He might have loved telemedicine, where we listen to and observe our patients.” Also, the close, uninterrupted video conference allows doctors to see the patient in the home environment … something they would never discover in an office visit.

Benefits for Older Adults

Telehealth offers benefits to all sections of the population, but its greatest advantages may be for folks who are older. Let’s take a look at what elders have to gain by using the technology to receive medical services.

Less waiting. Retirees may have several health issues, and sitting around in the offices of specialists, as well as their primary care physician, is not on anyone’s list of pleasurable activities. Telemedicine is as close as your computer.
Lower costs. Doctors usually charge less for a remote health visit than one in their office. In addition, you don’t have to pay for gas or put miles on your car like you do for an office visit.
Works for those who don’t drive. Many seniors are house-bound or dependent on relatives and friends to get around. Telemedicine can take place right in the home, at any time and in any weather.
Access to specialists. Older adults in rural communities may have trouble getting to specialist who are not available locally. Chronic conditions can impede travel, barring many elders from receiving timely care.
Reduced hospital readmissions. Many hospitals are starting to use real-time data monitoring for patients discharged with heart failure, chronic obstructive pulmonary disease (COPD), a heart attack, pneumonia, or a hip or knee replacement. Nurses become aware of potential problems immediately, and can contact the patient to prevent further decline. The University of Virginia Medical Center in Charlottesville adopted such a system and noted a resulting readmission rate of only 10 percent, compared to a national average of 17.5 percent.
Staying out of the hospital longer. Patients who are monitored remotely after discharge can stay out of the hospital longer through quicker response and intervention, according to recent studies. One such study showed that if all hospitals used remote monitoring for heart-failure patients who are sent home, about a half-million readmissions could be prevented each year.
Better quality of life. In one study, a two-month telemedicine program for cardiac patients resulted in less depression and anxiety. The patients also had 38 percent fewer hospital admissions and 31 percent fewer readmissions than a control group.
Longer aging in place. Telehealth keeps older adults out of the hospital and in their home, according to data from one Pennsylvania nonprofit that runs senior living communities. The percentage of residents that moved into nursing homes was reduced from 20 percent to 12 percent when the nonprofit used monitoring devices that alerted nurses immediately by text when a fall had occurred.
Lower stress for caregivers. Whether in a community living setting or in the home, older adults may need a caregiver to help out. Telemedicine can relieve some of the stress associated with caregiving in two ways. First, telemedicine offers caregivers better access to providers for guidance regarding care. Second, it helps relieve caregivers of time spent readying their charge for doctor visits and driving to the physician’s office and back.

Like online banking, telemedicine appears to be here to stay, and that’s a good thing for America’s older adult population. Increased access to medical care and quicker response times lead to better health outcomes. Furthermore, older adults are increasingly comfortable with electronic communication. The next time a winter storm is howling outside and you have a doctor’s appointment, call the office to see if it offers remote appointments. It may save you time and money while providing a valuable service.