"Years ago, it was a common practice for doctors to make house calls to ill or injured people in the community. But as large medical centers evolved as the population grew, patients were required to travel to where they could receive medical care. The emergency room and outpatient care were created to solve the need for on-demand care. However, in a more modern age, technology has enabled more people the ability to receive health care and support from home—through telemedicine.
The Emergence of Telemedicine Benefits
Telemedicine has it’s origins in mandatory nurse care hotlines that HMO health care plans required to control costs by screening patients. Health care plan members now have the ability to skip the expensive trip to the ER by simply picking up the phone or engaging with a live doctor anytime via VOiP systems or some other live web-communication system. In just minutes, individuals can see and talk to a real physician who can (in many cases) diagnose and recommend a treatment plan, including calling in prescription drugs or ordering lab tests.
According to the National Business Group on Health/Towers Watson - Annual Best Practices in Health Care Survey, by the year 2020 nearly all companies offering group health care plans will offer telemedicine as part of their offering. Currently (2017), 56 percent of the companies that work with this group offer telemedicine to employees, ranging the gamut from preventative care to mental health care.
Telemedicine has become a critical component of employee benefit design, giving employees greater access to medical support from wherever they are connected via smart phones, laptops and tablets. Employees often use their telemedicine benefits to deal with minor illnesses, or when treating common health conditions like rashes, burns, and cuts.
For these reasons, more employers will offer telemedicine.
Pros and Cons of Telemedicine Benefits
The ability of human resources to refer employees to health care providers to support wellness and immediate care for illnesses or injury can be critical. But it also involves being more cost-effective in terms of managing benefit dollars. Most of the time, telemedicine has positive results for both employees and employers. There are also some potential negatives to using telemedicine as opposed to standard health care services.
Some of the key benefits of telemedicine include:
Convenient access to care: Employees can simply login to a web-based communication system from any device or call a toll free hotline to speak with a physician. Most telemedicine lines also include a live nurse who can answer questions and determine the nature of the health concern. A doctor then talks with the plan member, conducts a review of their health background and concerns, symptoms and can actually perform a visual exam of the person via video conferencing. If the health need is emergent, the doctor can advise the patient where to receive immediate care. If not, such as in the case of a head cold, allergies, low risk injuries or mental health worries, the doctor can call in a script for medication and provide instructions on care.
The care is available any time of the day or night, and from where the plan member is—so they can even access care when on vacation or at work.
Better access to health care services: One particular benefit of telemedicine is the ability for employees who live in remote regions or those where doctor’s offices are limited, to access the proper care. This is especially important if the group health plan doesn't have enough participation or if participation changes in a specific region. For those who live in rural areas, rough terrain, or during emergency situations when they cannot get to a nearby hospital for care, a telemedicine doctor can instruct the plan member on what to do to protect his or her health until they can get to a physical medical office. This is also great for those employees who work long hours or cannot take time off from work for doctors appointments, including those with chronic health conditions.
Little to no wait time for medical attention: Outside of emergency care, most consumers of health insurance products must wait for weeks and even months to get in for care. This is often the case with specialists as well as even for routine medical care like physicals and immunizations. Many people just don't have the patience or the ability to wait that long to talk with a doctor about a pressing health concern. Telemedicine appointments can happen immediately with some plans, which can take place virtually. A doctor can go over a patient’s digital health record to coordinate care with their regular physician and recommend a course of action or arrange for follow up care sooner. This can be a matter of life and death in some cases, such as symptoms of cancer, heart and lung problems.
Health care costs are reduced: In most cases, the use of telemedicine services helps to reduce the cost associated with using insurance benefits. The average cost of a virtual telemedicine visit is around $50, while a visit to a primary care physician can cost between $800, an ER visit is $650. This is according to UnitedHealthcare data from a 2016 study. Obviously there is a huge difference in cost, but also the care level is a lot less involved. But for a consumer with frequent health care concerns, this can add up to major cost savings over time.
Possible Negatives of Telemedicine
On the flip side of telemedicine, there are some negatives to be aware of before utilizing them. Here’s a rundown:
Delay of proper medical care: Despite the warnings, sometimes people just don't seek medical care until it’s too late. The use of telemedicine is not an adequate substitute for seeing a doctor in person, getting the proper lab tests, and begin examined physically. A potential negative for telemedicine is that a plan member may not know how to describe his or her symptoms to the virtual doctor (who has no prior relationship or knowledge of the patient) and end up with a misdiagnosis.
Not being utilized by plan members: There are also many who argue that despite the benefits of telemedicine, the regular utilization of this service is very low. The RAND Corporation published a study in the journal Health Affairs that shows 88 percent of use of telemedicine is by new utilization. Only 12 percent of the use of telemedicine is by regular health care users who substitute virtual care for in-person care with their doctors. This also factors into the costs of telemedicine. If members don't use these benefits instead of emergent care and other costly visits, they don't benefit them cost-wise.
Getting Plan Members to Take Advantage of Telemedicine Benefits
While the positives of telemedicine far outweigh the negatives, the only way that employees and employers can realize any true benefits is by using them for the right reasons. The mistake that many benefit administrators make is assuming that just because they offer telemedicine that plan members will excitedly participate. When rolling out telemedicine benefits, a great deal of education and instruction needs to be communicated to employees. For example, the HR team will want to share how to access the telemedicine application, where to find information about submitting claims, when is the best time to use this service, and what to do if immediate care is needed. Employees should be warned near to substitute telemedicine for proper emergency care or that provided by their regular primary care physician.
As the study above indicated, the use of this benefit has been mostly through new utilization, that is people who otherwise would have put off a visit to their doctor or who may have just tried a home remedy. Those who still continue to use their regular benefits and are reluctant to use telemedicine can be encouraged to do so for minor health concerns. A great time to launch an educational campaign around the use of telemedicine can be during the cold and flu season. Employees with chronic health concerns, scubas diabetes or pain management may also benefit from telemedicine. In some cases, the telemedicine service can also augment other types of benefits such as mental health benefits, addiction recovery, and more.
What Does the Future Bring for Telemedicine?
As more health care consumers turn to online resources to learn more about their health conditions and how to stay healthy, the use of telemedicine can only increase in popularity. It just makes sense from a convenience standpoint to be able to talk to a medical provider in minutes rather than wait for weeks for an appointment and then spend more time and money on expensive medical tests. There are even companies that offer low cost telemedicine benefits in place of other high-cost health care plans.
Since the Affordable Care Act, health care premiums have jumped nearly 99 percent, which means health care consumers are looking for ways to afford their medical care. In the future, employees will likely have greater access to their personal health data which they can access anytime they wish to speak with a virtual physician. More self-pay and flexible plans will likely add telemedicine as a regular offering, to replace nurse hotlines and other directories of health information.
Due to the advances in machine learning and data management, human telemedicine doctors will soon be replaced with computerized avatars that will react to the responses of patients, diagnosing and issuing treatment plans based on their directories of health data. This will essentially make telemedicine as handy as accessing a mobile app and inputing a digital fingerprint to initiate the process. Documentation will be automated to the health care center and insurance companies simultaneously to further streamline care."
Written By: Tess Taylor