Why it's time to embrace telehealth

Alex Marsh, MD: ©Reperio Health

In the year 2025, we’re still stuck in the past. For all our talk of a “telehealth revolution” and “click-and-brick”, a surprising amount of health care investment continues to fund old models of brick-and-mortar facilities. This doesn’t have to be the case. The future has finally been built, and it’s time for the health care industry to evolve.

Traditional brick-and-mortar care has stuck around far longer than anyone expected. In 2020, at the height of the pandemic and the rush to telehealth, more than 77% of private equity deal volumes were still for physical clinics and outpatient services. Major multinational corporations spent billions on in-person primary care over the past decade. And while the use of telehealth peaked in the second quarter of 2020, it has now flatlined at about half that rate.

Why was American health care unable to kick the brick? It was pretty simple — there wasn’t really anything to replace it. I’m a physician practicing in rural North Dakota and I’ll be the first to admit that, for years, a telehealth appointment was little more than glorified FaceTime. Without the essential context of a patient history or vitals, it was hardly health care.

Today, that’s changed. Telehealth now has the tools and the capability to bring down health care costs, expand access, make information actionable and useful, and even fix physician burnout. But it won’t reach that potential without a real change. The health care industry needs to stop investing in brick-and-mortar. It’s time for the real telehealth revolution to start — for the sake of clinicians and their patients.

Let’s start with my fellow physicians. I get it. It’s difficult for us to accept the reality that, after years and years of education and medical training, our patients don’t always need us to be there in person. And when we get out of the way, telehealth can help expand access for all patients, as has been well-documented (even though we have more work to do in rural communities).

Telehealth can also help patients get more comprehensive care by bringing together a wide variety of data sources. That means we no longer have to practice “piecemeal medicine” and can catch conditions before they require a visit to an emergency room. We can save patients — and their health plans — enormous costs.

This isn’t abstract. I just recently had a patient in the ER. Her blood sugars were so significantly elevated, without any prior diabetes diagnosis or treatment, that I had no choice but to admit her to the hospital to correct her blood sugar and kidney injury. She and her family are suffering more, and our health care system is spending more, because she didn’t have the chance to get this diagnosed and treated earlier. Our patients deserve better.

We deserve better, too. I know physicians are loath to focus on themselves, but we have to. Physicians are more than 80 percent more likely to experience burnout than US workers in other fields, and our patients rely on us to show up sustainably, day after day. And here’s what we all too often forget: our families do, too. Practicing medicine shouldn’t force our health care workforce to choose between our patients and our loved ones, and as physicians, we need to stop assuming this is just another requirement of the job. In a nation already facing a shortage of physicians, we can only do that by embracing flexible models of care.

Virtual care like this can also help us feel more accomplished in our work. We already know that clinicians using telehealth can see more patients who have access issues. But thanks to innovations in data sharing unlocked by the national alliance of Qualified Health Information Networks (QHINs), they can get an even better picture of their patient’s health than merely relying on that patient’s memory of every condition and medication they had before. That means more patients and more detail. And with AI as an adjunct (and not a replacement), physicians can identify patterns they might have missed or expand their list of potential diagnoses. This is the best way to provide better medicine to more patients without burning out our health care workforce.

The future isn’t just on the way. It’s here. I recently had the opportunity to participate in a partnership between a company I work for, Reperio Health, and The Partners Group, a top benefits firm in the Pacific Northwest. We provided employees of TPG a kit that had all the necessary equipment for a full, preventive care screening — all of them FDA-cleared, CLIA-waived, and Bluetooth-enabled devices. In less than an hour, right in the living room, a patient could test everything from BMI to a cholesterol panel. They got the results of those tests instantly on a mobile app, and then had the option to connect virtually with a clinician to discuss the results and lay out a treatment or care plan.

Here’s what we found:

Patients loved it. More than 80% said they preferred this virtual service to an in-person visit. That’s a strong indicator of consumer demand.

But perhaps most importantly for our work as physicians, nearly one in every four patients found a condition that had never been diagnosed. That meant answers for a TPG employee and their family. It meant a care plan that can help them avoid costly and complicated care. It meant they would be less likely to show up in my emergency waiting room with a condition that’s worsened so much that I have no choice but to burden them with the cost of admission and medical management. But most of all, it meant telehealth finally works.

The future of care delivery is here. We should make sure every patient can be a part of it.

Alex Marsh, MD, is a practicing emergency physician in North Dakota and the Chief Medical Officer of Reperio Health.