Some physicians are questioning the role of telemedicine in care, wondering if "no-touch" services work in all cases.
"There are many subtle factors that contribute to a rapport between the physician and patient," Michael Brabeck, M.D., associate professor of medicine at New York University School of Medicine, tells James Lebret, an attending physician at NYC Health + Hospitals/Bellevue, in a recent post for Medscape. Those factors, such as physical touch or direct eye contact, can't be done when the visit is virtual, Brabeck says.
According to Ameet Bakhai, M.D., deputy director of research at Royal Free London NHS Trust hospitals, providers will have to learn how to best use telemedicine without losing the human element in patient care, as well as figure out the best ways to capture and analyze data without hampering clinical care.
Telemedicine does have its benefits, Lebret notes in his post; for instance, patients who live in remote areas or are constantly on the go can more easily receive care though virtual visits. In addition, he writes, the quality of a virtual visit can be just as good as an in person one, it just depends on the situation and the patient's needs.
Practices will have to consider which circumstances lend themselves well to care through telemedicine, and which don't, he says.
Nathaniel Lacktman, partner and head of the telemedicine practice at law firm Foley and Lardner, says providers can think of telemedicine as an extension of their services. They can use it as a tool for referrals, he adds.
"You won't reject an outpatient with diplopia just because you don't have a CT scanner," Lacktman tells Lebret. "You'd say, 'I'm going to refer you for the appropriate scan.' Any practice worth its salt will have processes in place for referrals."
However, Karen Rheuban, M.D., former president of the American Telemedicine Association, tells Lebret that there needs to be a standard of care between organized medical practices and telemedicine companies, and that virtual visits should always have referral support.
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