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Primary Care, Telehealth Technology Competes with Urgent Care

By Vera Gruessner

- More and more physicians have begun using telehealth technology to communicate with their patients, diagnose minor medical conditions, assign medications, and treat illnesses. As applications, remote monitoring tools, and new devices spread throughout the market, doctors continue to strive for better quality care and patient satisfaction, improved population health outcomes, and lower medical costs, which is the Triple Aim of Healthcare.

Telemedicine Services and Technologies

To learn more about the capabilities of telehealth technology and the biggest benefits of these tools, interviewed Dr. Seth Eaton who specializes in internal medicine at Medpeds LLC. “What are some of the most common illnesses or medical conditions you’ve treated using telemedicine tools?”

Dr. Seth Eaton: “There have typically been acute issues of a minor sort. These include a rash, an eye infection, a cough, or anxiety conditions. Telehealth technology has typically been useful for treating acute, minor conditions.” “What are the biggest benefits of telehealth technology in primary care? What are some disadvantages?”

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Dr. Seth Eaton: “The benefits for the practice is that it extends our office hours to meet patients’ needs that are valuable for the patients. We have an office with staff who have limitations due to both staff time, scheduling, and cost.”

“Telemedicine allows us to compete with the urgent care clinics that offer urgent care services but not with the primary care physician. Patients do prefer to have continuity care with their primary care physician, but our office is not open – we’re open a little bit late on some evenings – the hours many patients need to get attention.

“That’s the primary benefit of patient needs and allows primary care to compete with urgent care. That’s a big issue because urgent care is expanding in our area as well as elsewhere in the country and becoming a bigger competitor for primary care services so it’s a real issue for us in primary care.”

“Some issues are that there are some conditions in which a patient seen via telehealth may have to come back the next day to corroborate the condition. For example, when you look at someone and you see their breathing, it may look like they’re wheezing but you might want to listen to the patient as well with a stethoscope to confirm that it’s not something like pneumonia as opposed to just a wheeze. There are limitations that have to do with physical exams.”

“Many conditions that we see in primary care don’t require that kind of laying on the hands. Much of what we do in medicine at this point involves a careful history and careful observation, but there are circumstances where patients have to come in the next day to corroborate the impression.”

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Dr. Seth Eaton: “The real nice feature is the ease of use where it is essentially available to patients where they are on their phone or their iPad or computer. The other feature which we are very excited about is the ability to have more than one person on in the same visit. In particular, when we are doing meetings with – we’ve done some, but we want to leverage this more – family members. We are doing family meetings.

“For example, we’re planning on having conversations with Medicare patients to discuss issues such as advanced directives and living will. To have the opportunity to have family members who are living elsewhere be able to participate in the conversation would be a tremendous benefit to a successful conversation.”

“Medicare is looking in paying for that beginning in January. Right now, Medicare pays for that to some extent with Medicare’s chronic care management services, which we provide for patients. That’s something that’s paid for to some extent with Medicare now, but it’s going to be available to all Medicare patients in January. I see that as being a fantastic way to use that platform of multiple people in the same conversation in the same exam room remotely simultaneously.”

Eaton also discussed his primary care practice’s plan to upgrade new features of telehealth technology like the ability for greater interoperability among the various systems and data storage platforms.

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“I have not integrated that area of the program yet.  I plan on aligning it into my clinical process early fall.” “What advice would you offer other healthcare providers who are attempting to implement telehealth technology?”

Dr. Seth Eaton: “The most important limitation is to make sure you choose the right state because not every state pays for it as Maryland does. If the practice is in the state that pays for telemedicine such as Maryland, then it is really like any technology – it takes a little bit of publicity to get patients to accept it.”

“We started with a patient portal – the beta site for eclinical works patient portal in 2006. We had some trouble getting patients to both embrace and understand what the patient portal was. Now patient portals are so integrated into our lifestyle not just in medicine but it’s in banks and everywhere else. I think telemedicine will go through the same maturation process where you have some early adopters and some people who are not quite comfortable with the idea yet. The simple answer is: expect to start slow and ramp up slowly because it does take time to get patients used to it.”


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