One Delaware doc on telemedicine in the First State: 'The future is now' - Delaware


Jun. 28, 2017 12:13 pm

One Delaware doc on telemedicine in the First State: ‘The future is now’

But billing and legal issues remain, says Nemours surgeon Alfred Atanda.

Telemedicine can augment traditional healthcare and streamline the patient experience, writes Dr. Al Atanda.

(Photo by Flickr user Andy G, used under a Creative Commons license)

This is a guest post by Alfred Atanda, a pediatric orthopaedic surgeon and sports medicine specialist at Alfred I. Dupont Hospital for Children.
I first used telemedicine in August 2014 when I  performed a surgery on a 17-year-old male who lived about 90 miles from our hospital.

A week later,  I learned he was having trouble adjusting his post-operative brace. His father asked if I could help him via FaceTime. I agreed and successfully showed him how to adjust it. I soon realized that it wasn’t necessary for he and his father to drive 90 miles for me to do in person what I had just done on FaceTime. I quickly realized that many other patients could potentially receive the same kind of care I provided him.

Most people probably think of telemedicine in an on-demand sense, such as the technology popularized by apps like Teladoc, MDLive, and Doctor on Demand. I primarily use telemedicine for established, scheduled patients.

Telemedicine works very well to evaluate patients for encounters focused on information transfer. This means simple follow-ups, routine post-ops, surgical discussions, wound checks, brace checks and MRI/lab-result reviews can all be handled through telemedicine.

For both patients and providers, the only hardware requirement for telemedicine visits is a device with internet access, a camera and a microphone. Laptops, desktops, tablets, phones and carts or kiosks can be used. Devices with these requirements are very common, ensuring access for most patients.

Good, right? Let’s weigh the downsides.

Pros and cons

For patients, telemedicine has two major benefits: convenience and significantly less waiting time. Other benefits include:

  • no travel time or expense
  • no parking hassles or fees
  • less time missed from work or school
  • less contact with other sick individuals

Hospitals and departments also benefit when patients are served via telemedicine. These benefits include lower direct labor costs (no staff is needed to evaluate the patient) and less utilization of resources (such as paper, clinic space, or electricity).

However, we have noted a few drawbacks to telemedicine.

Patients who are not “tech savvy,” for example, may find the technology somewhat challenging to use. In addition, some patients may prefer face-to-face discussions and interactions with their providers. The biggest concerns for hospital systems and orthopaedic departments tend to be billing and legal issues, as well as the staff learning curve.


The future is now

Although I don’t think telemedicine will replace traditional, in-person clinical visits anytime soon, I do believe that it can be used to augment traditional healthcare and streamline the patient experience.

As the healthcare landscape continues to evolve and the emphasis on value and satisfaction continues to grow, telemedicine may be used by providers to control costs and resource utilization, while keeping patients satisfied and delivering quality care. Most patients spend a tremendous amount of time getting what they need on mobile devices. It’s only a matter of time before health care is routinely delivered in that fashion as well.



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