By:  Kelly Brenna, SPHR, Vice President, Benefit Services

To start with, telemedicine is not new.  In fact, it has been around since the late 1960’s and was primarily developed for NASA and the Nebraska Psychology Institute (using closed-circuit television). 

As technology and science progressed and medical care costs rose, new ways to treat medical conditions were needed.  Although the technology improved and the need arose, the average healthcare consumer did not jump onto the telemedicine revolution as quickly as one would think.  Our path to healthcare had always included going to a physical building, sitting in a lobby, meeting with a nurse and then seeing the doctor.  Old patterns die hard and there was also the skepticism that telemedicine/virtual care would not be as good as getting physically in front of a doctor.

Over a decade ago, stand-alone telemedicine programs started to develop.  These programs were purchased separately from the employer’s group medical program.  The goal was to provide fast, efficient, and effective care for healthcare consumers at all times of the day and night.  Telemedicine treated general medical conditions such as:  urinary tract infections, pink eye, sinus infections, congestion, flu, poison ivy, and other widely-known conditions.  These conditions could be treated over a telephone, computer connection or video conference, with the doctor sending a prescription to the caller’s local pharmacy.  The cost of this care varied from no copay to copays up to $60 (plus prescription costs) for the healthcare consumer.  Consumers who used this care came away very satisfied and touted the savings of time as well as the ability to talk to a doctor quickly.    Insurance carriers soon took note and either developed their own telemedicine programs or aligned with already established programs. 

Over the past five years, telemedicine has expanded far beyond general medical conditions.  Services now include: mental health visits, dermatology, nutrition, back care, chronic condition care, second opinion diagnosis review, smoking cessation, and other areas of specialty care.  The care continues to evolve.  There are currently four clinical application methods of telemedicine:  1) real-time interactive mode, 2) store-and-forward mode, 3) remote monitoring, and 4) communication via telephone.

In March 2020, the COVID pandemic struck.  This became a game changer for telemedicine.   With healthcare consumers unable to physically sit with their doctor, virtual medicine visits became the norm.   Whether we liked it or not, we were forced to try telemedicine for some ailments.

In my discussions with Teledoc, a National telemedicine program, their 2020 statistics indicated that 60% of visits during 2020 came from first-time users.  Of those visits, 90% were non-COVID related.  The largest area of growth was in males, ages 18-30. 

As we have all read or heard on the news, COVID has had a profound and direct impact on mental health.   In 2020, Teledoc stated their mental health visits were up 79% for men and 75% for women.  Generation Z had the largest growth in mental health visits, resulting in 14% of total visits.  While these visits used to be conducted over the telephone, over 60% of the visits were done via video, from the patient’s home.  I personally know of several people who have used telemedicine visits for their mental health.  They have expressed how much they enjoy being able to keep the confidentiality of their visit intact.  Meeting with their counselor virtually, in the comfort of their own home, has helped them through these very trying times. 

Many believe that telemedicine is for the younger healthcare consumer.  In fact, telemedicine is being used daily for the elderly.  Using telemedicine technology to remotely monitor health, such as through the use of smart surveillance cameras and analytical software, can benefit elderly clients by notifying their caregivers of changes in activity, falls, or lack of movement. This type of care can reduce costs, potentially keep these older individuals in their own homes longer, and help physicians to more easily tailor treatment according to a patient’s choices and availability of services. 

With the continued advancement of technology, virtual visits will become something many healthcare consumers will opt for.  There are currently apps that can monitor our blood pressure, oxygen levels, blood sugar, sleep, and much more.    All of this technology, combined with the need for healthcare consumers to get to the care they need faster, will only increase the role of telemedicine. 

It is vital to note that telemedicine is not for all care or conditions/diseases and this article is not intended to state that.  Physically going to see a doctor for many conditions will not go away.  However, the reasons we physically go to “see” a doctor will lessen over time.  The healthcare industry will work to improve on delivery systems and identify new and better ways to charge for services.  In the past year, due to COVID, virtual visits with your doctor may have been an option for you.   That practice will most likely continue long after the pandemic wanes.

Overall, telemedicine can provide access to care wherever you are.   Whether you live in a rural area, urban environment, or are on vacation, telemedicine can provide access to services and will have you covered for many conditions.  With the expansion of care and the fact that most healthcare consumers have a mobile phone or access to a computer, telemedicine will continue to grow. 

In conclusion, as healthcare consumers become more comfortable with the care provided by telemedicine, “seeing” your doctor on your telephone (or computer) may become your “new normal”. 


The American Journal of Accountable Care