Telemedicine: Telemedicine can improve quality and efficiency of treatment, but barriers remain

An "antiquated" third-party payment system in which providers have little incentive to innovate is the primary barrier to more widespread adoption of telemedicine, according to a report from the Dallas-based National Center for Policy Analysis, a nonprofit policy research group.

Telemedicine, a mode of consultation in which doctors and patients correspond via the phone or Internet, can improve the quality and increase the efficiency of patient care, but several barriers must be lowered for it to realize its full potential, says the report.

Telemedicine can be of particular benefit for patients with chronic ailments. Telemedicine is often a more-convenient treatment option for patients and makes it easier for them to follow physicians' instructions. For example, patients can use an electronic device to monitor their vital signs at home and send data via the Internet to self-report their health status to physicians. 

A study of patients with congestive heart failure found that those who used remote monitoring required rehospitalization only half as frequently as those who depended on traditional office visits, according to the report. 

As more and more patients report difficulty in seeing their doctors, telemedicine becomes an increasingly effective means of consultation, according to the report. According to a study of medical care access between 1997 and 2001, one-third of patients reported problems in meeting with their primary care physician and nearly one-quarter reported problems taking time from work to meet with a physician.

"Although lawyers and other professionals routinely consult with their clients by telephone and by e-mail, very few doctors currently consult by telephone and less than one-in-four communicates with patients electronically," according to the report.

Citing research in the Journal of American Medicine, the report says that patients usually want more information about their medical conditions than they get from their doctors. The research showed that during a 20-minute office visit, physicians on average spend less than one minute planning treatment, and doctors fail to ask patients whether they have questions about half the time.

Aside from the health system's lack of incentives for providers to create innovative services, state laws that prevent physicians licensed in one state from practicing in another also act as a barrier to the adoption of telemedicine, the report says.