Since its inception, telemedicine has been viewed as a solution to many of the accessibility problems currently plaguing the healthcare industry. Patients suffering from minor illnesses can avoid the waiting room and have their conditions diagnosed from the comfort of their living rooms. Anticipated shortages in primary care physicians, and the high costs of insuring new Obamacare enrollees are two of the other issues that telemedicine helps to remedy. The concept is still fairly new, but with an estimated 10.5 million patients who are opting for “virtual visits” from their physicians, it is necessary to evaluate the current state of telemedicine providers and their quality of care.
Jama Internal Medicine recently published a study that assessed 8 telemedicine providers and the level of care given during virtual visits. These standardized patients were trained to exhibit symptoms from one of six common illnesses- ankle pain, potential strep, sore throat, sinus infection, low back pain, and urinary tract infections. Researchers had 67 patients complete almost 600 virtual visits over the span of a year, and here are the key findings from the data collected:
- Histories and physical examinations were complete in 417 visits.
- Key management decisions were adherent to guidelines in 325 visits.
- Rates of guideline-adherent care ranged from 206 visits to 396 visits from the 8 websites.
- There were greater performance variations in viral pharyngitis and acute rhinosinusitis (about 70% variance) than with streptococcal pharyngitis and low back pain (about 22% variance).
There was also secondary data that found that not many patients were asked to complete further testing, even when their conditions would usually deem it necessary. Not ordering urine tests for UTI’s, nor cultures for throat illnesses may have contributed to the 1 in 4 rate of misdiagnosis during the study.
Dr. Jeffrey Linder, researcher at Brigham and Women’s Hospital and Harvard Medical School wrote that,” There is a built-in barrier to getting testing, which led to worse care for ankle pain and recurrent urinary tract infections – for which the doctors should have ordered a test – and better care for low back pain – for which doctors should not have ordered a test.”
Being that there has yet to be a side-by-side study of virtual patient care to in-person patient care, complete conclusions cannot be drawn regarding which mode is most effective. Still, the statistical data presented on the current quality of telemedicine companies is something to be considered when developing ways to improve virtual care.
