Telemedicine is here to stay

Like in other areas of our life, where the pandemic accelerated pre existing trends of technology changing the way we live, telemedicine came into its own with the start of the pandemic.

This was fueled not only by need, but by the implementation of several changes in regulatory, licensing and reimbursement policy by government and healthcare providers. Licensing restrictions were loosened such that doctors licensed in one state could now provide telemedicine care to patients in other states. Insurers, including the government started reimbursing telemedicine consults whereas previously they did not.

The concept of substituting, a trip to and from the doctor’s office, and waiting in waiting and exam room, with a simple telephone call or video consult is very appealing. It is also very cost-effective medical care.

The current challenge in telemedicine is to define the scope of practice that can be safely and effectively provided by telemedicine, and integrate this area of practice into the overall healthcare system.

Urgent Care Telemedicine – The Scope of Practice    

The purpose of this posting is to discuss the acute medical problems that can best be diagnosed and treated via telemedicine.

To do this, it is first important to understand the types of medical problems that usually cannot be properly evaluated with telemedicine.

  • Problems where a physical exam is needed to diagnose and manage the problem
  • Problems where imaging or lab tests are needed to properly evaluate and manage the problem
  • Symptoms where the cause is not known and the symptom can be associated with serious or life threatening conditions such as chest pain, abdominal pain, severe headaches or dizziness
  • Patients that appear to be moderately or very ill. These people are best seen, examined, and vital signs checked in person
  • Treatment failures

So what are the medical problems best amenable to telemedicine urgent care?

Problems where the symptoms are generally not associated with serious outcomes and where the history alone can usually make a correct diagnosis. Often  these conditions may be recurrent medical conditions that the patient is familiar with, has had before, and knows the diagnosis and treatment.

Examples of some conditions that often can be diagnosed and treated via a telemedicine consult include:

  • Most Upper Respiratory Infections including COVID. Telemedicine, may in fact, be the preferred method of receiving care in patients with positive COVID tests
  • Sinusitis, Bronchitis including asthma
  • Cold Sores
  • Uncomplicated bladder infections in women, yeast vaginitis
  • Rashes (best to take photos and upload to platform as the resolution on a video screen is not of diagnostic quality)
  • Temporary prescription refills (not controlled substances)
  • Evaluation of any medical problem that you are unsure about need for care or type of care.