Has Telemedicine arrived?

I stumbled on this link from a relatively well known blog on economics, and was surprised to see this quoted. This paper appears like a “survey” and then a report on the “findings”, so the robustness of data collection and the responsibility for the accuracy of the data lies solely with the authors. Since this is paywalled and I don’t usually link to these qualitative studies (usually), I can’t recommend this. If you do get access, you can sound it off in the comments. I have highlighted the key takeaway though.

Busting Three Myths About the Impact of Telemedicine Parity | NEJM Catalyst

Using data collected from this large academic medical center, UR Health Lab explored whether vulnerable patients were less likely to access care via telemedicine than other patients; whether providers increased virtual visit volumes at the expense of in-person visits; and whether the care provided via telemedicine was lower quality or had unintended negative costs or consequences for patients. The analysis showed that there is no support for these three common notions about telemedicine. At URMC, the most vulnerable patients had the highest uptake of telemedicine; not only did they complete a disproportionate share of telemedicine visits, but they also did so with lower no-show and cancellation rates. It is clear that at URMC, telemedicine makes medical care more accessible to patients who previously have experienced substantial barriers to care. Importantly, this access does not come at the expense of effectiveness.

Telemedicine assumes two people sitting across each other in front of the camera with a perfect connections at both ends. Alternatively, the practise of medicine delivered through a phone call isn’t what would qualify as an ideal scenario. You could be calling a call centre with the menu options instead. Telemedicine (at scale) through “chatbots” and generative/intelligent & meaningful AI is still a distant dream. The only thing holding back is the general disagreement about reimbursements. I’d definitely ignore the papers around “digital healthcare”, which involves sending SMS (yes, text messages) as “reminders”. The published papers end up showing positive correlations with “follow-ups” for their funding agencies, through similar levels of poverty (or indicators) are universally present in the inner cities and “underprivileged communities”. Health care intervention will require a pre and post intervention outcome (and long-term studies around prevention/adherence to curative protocols) or showing a positive correlation with the reduction in triage visits for similar problems/flareups of chronic conditions.

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