Telehealth, E-Visits Gaining Steam as Cost-Effective Senior Care Method


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Substantial growth is projected for the field of telehealth as the government tries to control skyrocketing healthcare costs, and a new study supports remote patient monitoring through virtual doctors visits as an effective, cheaper method than an in-person office visit.

Telehealth is expected to reach 1.8 million patients by 2017 up from 2012’s estimated 308,000 patients being remotely monitored worldwide by their healthcare providers for congestive heart failure, chronic obstructive pulmonary disease, diabetes, hypertension, and mental health conditions, according to a new report from InMedica analyzing the world market for telehealth.

Virtual doctors appointments can be more efficient and cheaper than traditional office visits, says a new Mayo Clinic study comparing care between the two methods published recently in the JAMA Internal Medicine, and they may be more beneficial for seniors.

With Internet capabilities enabling “e-visits” where physicians and patients interact virtually rather than face-to-face, Mayo Clinic researchers decided to examine the differences between virtual consultations and those that take place in offices for two conditions, sinusitis and urinary tract infections (UTIs).

Patients using the e-visit method can log into a secured personal health record Internet portal and answer a series of questions about their condition. The written information is then sent to the physicians, who can make a diagnosis, order necessary care, and put a note in the patient’s electronic medical record.

Advantages of virtual doctors visits include convenience and efficiency, as patients can avoid travel and time expenditures, along with lower costs, the researchers found. Virtual consultations with doctors may be especially useful for seniors, who are prone to infections such as UTIs and for whom doctors visits may pose significant interruptions to daily life.

“Because they have more chronic illnesses, seniors are more likely to need to go to the doctor more often,” says Ateev Mehrotra, MD, MPH Associate Professor of Medicine, Division of General Internal Medicine, Health Policy Researcher, RAND Corporation. “My own instinct is that e-visits for management of chronic illness could be very beneficial for seniors.”

Use of telehealth technology is still a developing concept in senior care, but it’s gaining steam.

Nearly 17% of senior living providers pointed to teleheath/remote patient monitoring as a future area of investment in a September 2012 Ziegler-CAST Technology Spending Survey. A majority (70%) indicated plans to invest or increase investment in electronic medical records (EMRs) and another 29% are looking into video conferencing for residents and clients.

Outcomes for remote monitoring are still somewhat mixed. While the Mayo Clinic researchers’ findings refuted some concerns surround e-visits, they supported others, including higher prescription rates.

The number of patients receiving follow-up care was similar to those making office visits, and half of e-visit users reported willingness to use an e-visit for a subsequent illness within the next year and appeared generally satisfied with the virtual appointments.

Additionally, data collected from the study suggests that e-visits could lower healthcare spending. Using Medicare reimbursement data and prior studies, the researchers estimated costs of UTI visits in a virtual or office setting. While antibiotic prescription rates were higher among e-visits, particularly for UTIs, the researchers found that the lower rate of testing for the infection among e-visits outweighs the higher rate of prescriptions.

In total, the estimated cost of a virtual doctors visit for a suspected UTI was $74, versus $93 for office visits.

“When physicians cannot directly examine the patient, physicians may use a ‘conservative’ approach and order antibiotics,” say the researchers, although they added that the high antibiotic prescribing rate for sinusitis for both virtual and office visits was a concern “given the unclear benefit of antibiotic therapy for sinusitis.”

The researchers did acknowledge the limitations of their study, but concluded that the results of their research “highlight key differences between office visits and e-visits and emphasize the need to assess the clinical impact of e-visits as their popularity grows.”

Written by Alyssa Gerace

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  1. says

    Telehealth no doubt is going to be an important part of our healthcare system in the future, the technology coming to market today is just unbelievable. That is not to say it doesn't have its drawbacks or concerns. This new and advanced way of treating patients can be very helpful, but it is not the cure-all. We cannot just look at the Telehealth technology from a savings stand point, the quality of care must be first and foremost on the minds of every one in the chain of this new technology.

    There should be more and more in-depth studies being done to utilize all the new technologies that are coming to market. We need to make sure we bring these new technologies to the population as a great and quality tool of our healthcare system that will save everybody involved both time and money.

    It is easy to see how the money savings would be of great interest to everyone from the doctor to the patient, but there is no real substitute for a face to face meeting of ones doctor. Can a doctor really tell through a video camera what the patients needs really are? Can he sit there in his office and really observe the patient when the patient is sitting in their living rooms? The answer to these question is NO. Telehealth is just one tool in the doctor’s arsenal that can be used for better treatment in follow up and monitoring situations. This can save both time and money in those settings.

    We here at the Alzheimer's Research Association believe in new technology to help with the care of Senior Citizens, as a matter of fact we research most of the new technology and bring what we find to our members to help them with their Caregiving duties, but as we have found, most new monitoring technology such as telehealth is only as good as the people that are involved with it. Everyone in the chain must be committed to following the rules and guidelines, and the quality of care.

    There will be more and more advancements in new technology coming to market over the next few years. All of us involved with it must be committed that quality of care comes first. The monetary savings will come as a natural process, and it will come, but it can't be the only thing we think about.

    Joe Lucido
    Alzheimer's Research Association <a href="” target=”_blank”>

  2. says

    I do believe this type of medical care is closer than we think. I was a telephone advice nurse for many years and we would do a computer telephone triage of a patient's symptoms and prescribe according to the results of the triage. We were all RN's and practiced under the doctor's orders. If the UTI fell into the triage appropriately, we could order the antibiotic for the patient without their having to see a doctor, get a urine culture and go to the pharmacy. This saves everybody time and money, because the triage model told us just what to do. Believe me, patients are very happy to have this option.

  3. says

    We can achieve/do successful outcomes with this technology. However this is because our Telehealth program is based upon the combination of utilizing the best of technology and human interaction between the Telehealth provider, the patient and all providers. A solid company who understands patient care and technology, offers specific solutions based upon patients' needs-clinical, personal and social- will more than recoup any investment is this technology and increase patient satisfaction.
    The other area that has excellent results is medication adherence solutions which is not being given the attention it deserves.

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