Everything old is new again: Telehealth brings care delivery back to the patient

Our industry has been deeply engaged in spirited debate, dialogue and discussion these past several years – most of it centered on the future of healthcare.

And if there’s anything this discourse has revealed it’s that everything old is new again.

In other words, the best way to reform and transform healthcare is to borrow from the past – specifically, to find our way back to patient-centered healthcare. Ironically, the most effective way to accomplish this is with forward-looking technologies and attitudes.

Consider how care delivery has evolved in past decades. Traditionally, physicians took care of patients locally and even in their own homes. But over time, the principal location of care shifted to large, urban facilities, requiring patients to travel significant distances at great expense and inconvenience. Simultaneously, the “hometown doc” no longer serves as the primary caregiver; specialists practicing from secondary and tertiary centers housing expensive diagnostic and therapeutic equipment now play the marquee role. Combined, these changes have driven up costs, while leaving concerns about access and quality largely unaddressed.

A return to patient-centered care, delivered locally by clinicians with access to comprehensive health information, holds the promise of solving many of these problems. Accomplishing this, however, requires that healthcare adopt new reimbursement and care models that value quality rather than quantity, countering the acknowledged shortcomings of a fee-for-service structure. And we must explore options to motivate medical school graduates to choose primary care over the often more lucrative specialty practice.

Even these strategies aren’t enough, however. We must also adopt a forward-looking attitude, change our traditional concept of how medical care should be delivered and embrace a new culture supported by new technologies. The capability to see and treat patients where they are – rather than where the specialists are – is not a pipedream. It’s reality. Telehealth is at the core of this paradigm shift, enabling long-distance diagnostic services, video-assisted surgery, remote rounding and virtual patient visits.

It’s a model I champion as the medical director with the Center for Connected Medicine, and have actively implemented in my surgical practice at UPMC. For the past two years, in fact, I have run a 30-bed rural health clinic and conducted more than 170 patient encounters virtually – patients I’ve seen, diagnosed, scheduled for surgery and conducted post-operative follow-ups with through video and teleconference.

Virtually without exception, these patients have been enthusiastic about the convenience, my attentiveness and the quality of care – and embrace telehealth as the next logical step in the way their doctors treat them. They are more engaged in their care, and appreciative of the time and money they save. I estimate telehealth saves each patient an average of $110 and four hours of driving per visit. Plus, they don’t lose wages or productivity by missing a day of work.

As an industry, we are on the brink of significant change. It’s an exciting place to be, and I look forward to sharing ideas and observations about tele- and mHealth through this column on a regular basis.

Andrew Watson is the medical director for the Center for Connected Medicine in Pittsburgh.