Sometimes it seems that the terms Virtual Visits and Telehealth are a bit like fusion energy. It is the technology of the future, and always will be. In other senses, these care platforms have been in place for many years now, often hyped, and yet not quite breaking into the mainstream. The popular sentiment is that consumers are demanding care to be delivered via their mobile devices, but does the evidence support this? Where is the physician voice in these conversations?
Certain elements of telehealth are well-embraced by the community to the point where they have become the standard of care. Rural hospitals are quite dependent on telespecialists from tertiary care centers to provide expertise for management of conditions as diverse as burns, stroke, retinal disease, and cancer. On the opposite side of the spectrum exists firms that offer stand-alone telehealth firms that have established their own physician groups and are successfully marketing their products directly to consumers.
Where are traditional physician practices in all of this? One point of confusion for the average physician is the value proposition of offering videoenhanced phone calls with a complete stranger, as opposed to voice-only calls within the context of an established physician-patient relationship. The vast majority of physicians have always been available via phone for their patients, whether it to review recent lab results and make medication adjustments, or handle a weekend emergency.
Formal studies of “telemedicine” have rarely done a heads-on comparison of these disparate scenarios. A Cochrane Collaborative meta-analysis published in 2010 attempted to compare telemedicine against face to face visits, and found little benefit. A later literature review published by the Agency for Healthcare Research and Quality (AHRQ) in 2016 suggested some mild benefits for chronic diseases such as diabetes and heart disease. Most of these telehealth studies assumed a longitudinal care team relationship with the patient, rather than episodic.