Telehealth expansion eyed beyond the pandemic

Consultation via laptops, tablets, phones ‘almost a modern-day house call’

Washington — Telehealth is a bit of American ingenuity that seems to have paid off in the coronavirus pandemic. Medicare temporarily waived restrictions predating the smartphone era and now there’s a push to make telemedicine widely available in the future.

Consultations via tablets, laptops and phones linked patients and doctors when society shut down in early spring. Telehealth visits dropped with the reopening, but they’re still far more common than before.

Permanently expanding access will involve striking a balance between costs and quality, dealing with privacy concerns and potential fraud, and figuring out how telehealth can reach marginalized patients, including people with mental health problems.

“I don’t think it is ever going to replace in-person visits, because sometimes a doctor needs to put hands on a patient,” said Seema Verma, head of the Centers for Medicare and Medicaid and the Trump administration’s leading advocate for telehealth.

Caveats aside, “it’s almost a modern-day house call,” she added.

“It’s fair to say that telemedicine was in its infancy prior to the pandemic, but it’s come of age this year,” said Murray Aitken of the data firm IQVIA, which tracks the impact.

In the depths of the coronavirus shutdown, telehealth accounted for more than 40% of primary care visits for patients with traditional Medicare, up from a tiny 0.1% sliver before the public health emergency. As the government’s flagship health care program, Medicare covers more than 60 million people.

A recent poll of older adults by the University of Michigan Institute for Healthcare Policy & Innovation found that more than 7 in 10 are interested in using telehealth for follow-ups with their doctor, and nearly 2 out of 3 feel comfortable with video conferences.

But privacy was an issue, especially for those who hadn’t tried telehealth. The poll found 27% of older adults who had not had a telemedicine visit were concerned about privacy, compared with 17% of those who tried it.

Those who tried telehealth weren’t completely sold. About 4 in 5 were concerned the doctor couldn’t physically examine them, and 64% worried the quality wasn’t as good.

“After the initial excitement, in the afterglow, patients realize ‘I can’t get my vaccine,’ or ‘You can’t see this thing in the back of my throat over the computer,’’’ said Dr. Gary LeRoy of Dayton, Ohio, a primary care doctor and president of the American Academy of Family Physicians.