After running his own family practice for 23 years and as Chief Medical Officer for Walgreens for another 5 years, Patrick Carroll decided to put his medical expertise online. In 2019 he became CMO of the telemedicine website Hims & Hers.

He made the jump, as explained in a blog post announcing his appointment because he believed the health system didn’t put people first and that he knew there was a better way for patients and doctors there.

Dr. Carroll was also aware during a telephone interview that the supply decreased as the demand for general practitioners increased. With more people with chronic conditions and fewer doctors to treat them, telemedicine could be the prescription to fill the void. The goal is not for telemedicine to replace family doctors. Rather, companies like Hims & Hers would act like a relief valve for general practitioners by offering an alternative to quick, accessible episodic care at a reasonable price.

“We can support the GP with these acute episodic visits that we can do in a high quality way outside of a virtual care platform,” he says.

Telemedicine was baptized by fire last spring. When COVID-19 forced doctors’ offices to close across much of the country, people turned to online sites like Dr. Carroll for help. The number of telemedicine visits rose from 4% to 8% in December to an astonishing 70% to 80% in March.

“What was driving was access to care, comfort and awareness of the consumer and provider parts of the really high patient satisfaction levels with telemedicine visits,” he said. “I see what virtual care can do, we will not be the general practitioner. We can take care of the upper respiratory tract infection or the flu visit, the acute episodic care that makes up about 20% to 30% of the primary care visits. “

Telemedicine has a moment that has been in the works for years. Telehealth, which is often referred to interchangeably as telemedicine or virtual medicine and can only be speech or video and speech, has been around since the early 1960s. You could argue earlier. In 1925, a cover of Science and Invention magazine featured a doctor diagnosing a patient over the air and in the article discussed a video device that a doctor would use to examine a patient remotely.

Telemedicine is loosely defined as the provision of health services using information and communication technology for information exchange. Telemedicine falls under this umbrella. It connects patients with doctors, nurses, social workers, pharmacists and physical therapists, and others for a variety of clinical services.

Radiology and psychiatry were the first fields to use a virtual platform. They have recently been joined by help in hospitals and intensive care units. As recently as 2015, doctors who wanted to achieve and touch a level of visual clarity saw telehealth as more promising than practical.

Aside from the picture, other issues held telehealth back. Would private health insurers, as well as Medicare and Medicaid, pay for a virtual visit and how much (if government programs didn’t)? How would doctors split their day between face-to-face and virtual visits? Was telemedicine even legal?

But investors ignored these unanswered questions and instead watched what was happening on the ground. They saw small general practitioners in private practice who looked after patients via teleconsulting, and hospitals hired specialists to monitor patients remotely. Companies sold platform technologies, software solutions, and medical devices. Investors responded by pumping more than $ 1.5 billion into the sector in 2016. The analysis company Tracxn estimated that more than 700 companies worldwide operated under the flag of telehealth.

In the same year, Healthcare Trends answered one of these questions. It was predicted that health insurers would warm up to telemedicine. Telemedicine would expand globally at an average growth rate of 14.3% through 2020, allowing investors to raise $ 36.2 billion. Comfort, innovation and personalized health experiences would drive the market. However, the report cryptically stated that “there are other forces at work,” as many US states have enacted book laws that require insurers to cover these benefits.

No mention of a pandemic.

The coronavirus has made confetti out of all these predictions. IHS Technology said a few years ago that 70 million Americans would use telemedicine by 2020. Forrester Research forecast in April that U.S. telemedicine visits would hit 1 billion this year, fueled by 900 million COVID-19 cases.

In August, Tracxn reported that it had invested $ 3.8 billion in telemedicine over the past two years.

The fact that private health insurers, as well as Medicare and Medicaid, agreed to relax their rules on telemedicine payments at the start of the pandemic has undoubtedly accelerated the rise of telemedicine. If these payments stay the same, 20% of all primary care visits will likely be via telemedicine, says Mark Pauly, PhD, professor of health management at the Wharton School’s Leonard Davis Institute.

“But if they somehow crush it with lower payments for telemedicine visits, it could be due to a very small percentage of ‘the visits’,” he said.

Venture capitalists and private companies are banking on telehealth. So are some hospital health systems.

This is part 1 of a three-part series that discusses the growth, effectiveness and future of the telehealth system. Part II looks at two hospitals that have built their own systems. Part III looks at the future of telehealth.


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