Guest posting by Allyson Knapper
Despite popular belief, having insurance does not guarantee access to care. This is especially true for the 72 million people who live in rural America, where their only options for care are small regional hospitals that often lack updated technology and have a shortage of specialists. In the last few years these hospitals have been faced with even greater strain, as the passage of the Affordable Care Act has expanded the patient load of these hospitals without providing the proper means to care for them. In order to address the issue of a lack of medical resources in these communities, many have turned to Telemedicine, which is the use of electronic communications to provide remote care to patients. While studies have shown that this technology can be used to alleviate physician shortage and catch problems through remote monitoring, I believe that this is only a partial solution, one that presents three major problems of its own:
1. The Technology Requirement
In order for a patient to take advantage of all that Telemedicine has to offer, they must have a computer with high speed internet access. This requirement leads to a new form of health disparities, as 76% of the people who don’t have broadband live in rural areas.1 As a result members of the target population will still continue to be medically underserved.
2. The limitations of treating a patient from a distance
While studies have shown that some services such as physical therapy and mental health counseling provided remotely can be just as effective as the in-person office visits, there is still a limit to what can be done online, especially in the case of emergency situations. Yes, Telemedicine can be used to identify abnormalities, but its advantages stop there. Since many illnesses require a doctor to treat their patient in person, it can be argued that Telemedicine serves as a Band-Aid and doesn’t truly address the underlying issue–that these communities lack the medical resources that are needed in an emergency situation.
3. The desire for in-person interaction
People are resistant to change, especially when for years they have been used to doing something a certain way. In my opinion, this will be the greatest challenge to Telemedicine. A study published in the Telemedicine and e-Health Journal showed that 50% of patients who participated in a study on remote health monitoring preferred office visits.2 When questioned why, they stated that they missed interacting with the doctors and feared an increase in misdiagnoses. This shows that even if Telemedicine becomes a wide-spread option, people may fail to take utilize it.
All things considered, Telemedicine has the ability to provide care to millions of patients who otherwise wouldn’t have it. But I believe that this technology shouldn’t be the only form of care available in rural communities, but instead should be used as a supplement to traditional medical offices. I am curious to see how others will respond to Telemedicine as it becomes more widely used.
1. http://www.hcn.org/issues/46.2/rural-americans-have-inferior-internet-access
2. http://online.liebertpub.com/doi/abs/10.1089/tmj.2012.0064?journalCode=tmj