Telemedicine has become part of traditional medical practice

 

I’ve been thinking a lot about (and experiencing) telemedicine recently, and then learned that one pioneer of telemedicine recently died.  In 1986, Dr. Ronald Weinstein, then located in Washington DC,  viewed a breast tissue sample that was in a microscope located in El Paso TX. Through his long-distance examination, he was able to conclude that the woman, also located in El Paso, had breast cancer that was spreading. Using an early version of the internet, Dr. Weinstein was able to remotely operate the microscope and view the enlarged images of tumorous cells. This process was from then on referred to as “telepathology”.

 

Telepathology has blossomed since then, with many pathologists working from home long before Covid encouraged many sectors to move to remote work. Telemedicine, a term I will use to refer to a patient and medical provider interacting without an in-person visit, has also come to be used widely long before Covid. In rural areas, especially, doctors and physicians assistants and nurse practitioners have long been handling many routine medical matters via telephone and video chats. One example is the Arizona Telemedicine Program that Dr. Ronald Weinstein founded and directed for 25 years.

 

Fast forward to March 2020 and the onset of the Covid pandemic. Telemedicine (sometimes referred to as “telehealth”) became a necessity in all communities to insure the safety of all involved. According to a recent survey, 90% of the health care providers in my medical network (University of Utah Health) provide some form of telemedicine services since Covid, compared to only 10% who did so prior to Covid. The professors conducting the survey also predict that the possibilities for telemedicine will only increase, as more wearable medical devices (think taking your EKG using your smartphone or watch) and self-testing protocols (think Covid home tests) are developed and come to market.

 

As of now, Medicare and other insurance companies provide coverage for telemedicine. This article suggests that improvements to insurance coverage are possible, but in general, lack of insurance coverage is not a current barrier to telemedicine use.

 

So, is telemedicine part of the medical school curriculum? I’m sure the technical aspects of the practice are. Pathologists undoubtedly learn about telepathology (remote reading of test results) in school. Some nurse training programs are including courses on the unique communication skills needed to have successful telehealth sessions.

 

But we also need fine minds focused on expanding the possibilities for the use of telemedicine. The University of Utah piloted such a course last semester, and plans to offer it annually as a full semester course and as a summer three-day intensive. It is a multi-disciplinary approach that covers the legal, ethical, service delivery and financial aspects of telehealth services. Students in the course are encouraged to think creatively about how the use of telemedicine can be expanded and further supported. Not surprisingly, this course is taught through IVC (interactive video classes).

 

All to say that telemedicine is here to stay. As with other virtual processes (think zoom meetings), the Covid pandemic has created the opportunity for expansion of telemedicine practices, and forced medical practitioners and patients alike to become comfortable with its use.