Improved patient outcomes. Telemedicine is not an outright replacement for traditional medicine. Rather, telemedicine has been used where it successfully supplements or augments existing services or where it achieves something that previously was not possible. In other words, it tends to be used where it makes patients better off. Various telemedicine programs have shown improvements in clinical outcomes, including reduced readmissions, earlier diagnosis and treatment of conditions, and earlier detection of problems through closer monitoring. For example, in the Better Choices, Better Health diabetes self-management program tested by researchers at Stanford University, patients with diabetes achieved better self-management of their hemoglobin A1c levels, improved medication adherence, and other clinical benefits through a “virtual coach,” a type of telemedicine that uses videoconferencing and messaging via a mobile device to connect patients with clinicians.
Reduced healthcare costs. Although it can be hard to fully measure and evaluate the effect of telemedicine on the cost of care owing to the heterogeneity of telemedicine programs, objectives, and outcomes, a survey of the literature on cost effectiveness found that telemedicine can reduce costs for patients and providers. Patients can see savings in the form of decreased travel, reduced waiting time, and reduced costs owing to reduced morbidity. Providers can see savings in the form of reduced hospital stays and avoided hospital readmissions. For example, patients with heart failure who use telemedicine services have reduced all-cause hospitalization, cardiac hospitalization, all-cause mortality, cardiac mortality, and length of stay.
It would take many more pages of testimony to cover all of the diverse examples in the academic literature, let alone the self-reported experiences of hospitals and health systems that can be found in white papers, vendor case studies, and conference proceedings. What I have just covered is offered as merely an indication of the main benefits, with one example in each area from the academic literature.
Security Risks with Telemedicine
Telemedicine, like all modern information-based technologies, is susceptible to security risks. All telemedicine technologies work by communicating health information over a computer network. Patients using digital home blood pressure readers to send readings to their primary care physicians do so over the internet. Patients sending photographs of skin conditions to their dermatologists do so over the internet. Physicians consulting with one another via videoconferencing do so over the internet. All of these transmissions run the risk of being intercepted, hacked, or compromised in some way, just as online banking information and other transactions over the internet are also susceptible.
The reason why health information is an attractive target owes to the rich personal identifiers that are present in a medical record. In a medical record, Social Security Numbers (SSNs) are linked with a birth date, an address, and other identifying information, and are of greater quality and reliability. Cybercriminals can use patient and provider identifiers to divert medical equipment or prescriptions, to file fake claims with insurers, and more. This is why, on the black market, a medical record is worth far more to identity thieves than an SSN or credit card number alone.