Telemedicine is considered the fastest-growing segment of the health care market. Defined as the use of telecommunications software to diagnose and manage medical disease, telemedicine can be implemented through modalities such as video-conferencing software, mobile applications, and wearable devices. While telemedicine has been around for decades, a recent boom in utilization has occurred as physicians and health systems invest in the technology and payers increasingly provide reimbursement.
Among the many areas of telemedicine, a key opportunity exists for urologists in video visits, or “direct-to-consumer” telemedicine. Video visits (also called virtual visits, televisits, or evisits) have increasingly captured the attention of many physicians as an alternative to the traditional clinic visit. A video visit occurs when a physician conducts a medical interview or counseling session with a patient using video-conferencing software, such as Skype. At the University of Michigan, members of our faculty have used video visits as a way to expand capacity in our ambulatory care clinics without compromising quality of care.
National trends in telemedicine
While telemedicine has existed for decades, legislative and policy changes have facilitated the growth of video visits in a new way—directly from the patient’s home. Until recently, most commercial and government payers required that video visit patients be located in a health professional shortage area and that the visit be conducted from an approved medical facility. As one can imagine, these burdensome requirements once dampened the growth of video visits.
However, in the last several years, many of the nation’s largest commercial payers (eg, Blue Cross Blue Shield, Aetna, and UnitedHealthcare) have started to reimburse providers for conducting video visits with patients located at home. In addition, Medicare has waived some of the burdensome restrictions for physicians at health systems that participate in alternative payment models.
The Department of Veterans Affairs (VA) is widely recognized as a national leader in telemedicine. VA hospitals spent $1.2 billion and conducted two million telemedicine consultations in 2016 (Federal News Radio [May 8, 2017]; bit.ly/VAtelehealth). Investment in telemedicine at the VA has been supported by multiple studies that have demonstrated high levels of patient satisfaction and convenience (Urology 2015; 86:255–60).