The Expanding Role of Telemedicine

By Mitchel Schwindt, MD - December 26, 2017

Telemedicine Becoming More Effective and Prevalent

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Being part of the telemedicine evolution over the last six years has been an exciting component of medical practice. Several decades ago, I witnessed a pilot project connecting rural hospitals to tertiary centers. This facet of practice is the new norm, and patients expect the same level of service as in larger health systems.

A friend and colleague supervises a massive telemedicine service across 100 hospitals and ten states - and growing. Based on current data, the telemedicine ball is just beginning to roll. The evolution is exciting and has evolved even over the last 12 months. The following are a few examples.

Beyond Sniffles - Chronic Disease

New CMS rules promise to promote and incentivize telehealth further. At least that's what the headlines tell us. The explosion of wearable technology, phone apps, and the savvy patient or family member will change the face of chronic disease.

The future of medicine will be proactive in detecting subtle changes and preventing diseases altogether. The platform of telemedicine makes all this possible.

Imagine a doctor monitoring BP and glucose remotely through a wearable device. He receives an alert due to a trend of elevated BP and glucose and intervenes before a patient falls down the slippery slope of diabetes and kidney disease. The ability to keep the proverbial horse in the barn has the potential to save billions of dollars and more importantly, countless lives.

Mental Health

Getting access to a mental health provider is as likely as winning the lotto in some geographic locales. The addition of psychiatric services is a much-needed aspect of telemedicine, and several prominent leaders have embraced this concept.

In the future, look for expanded access and more readily available appointments for mental health care. Hopefully, the days of waiting weeks or months to see a practitioner will be gone.

Emergency departments frequently are backed up awaiting consults for psychiatric patients. Telemedicine can solve this roadblock.

More Than Video

While in-person visits have been the standard for centuries, a tide of change has already washed over the general public’s perception of medical care.

Let's be realistic. Do all complaints require an in-person visit with its attendant dead time trapped in the waiting room?
--NO

Many common ailments are remedied by a phone call. Put aside the legal concerns for a moment and focus on patient care and convenience, combined with a medical expert on the other end carefully listening for clues suggesting that a traditional appointment is necessary. Bug bites, runny noses, ear pain, and the common cold do not require a $200 office visit.

Integration with Tradition

As telemedicine rolls across the landscape, numerous institutions have integrated telemedicine with traditional medicine. Patients are given a choice of what type of appointment they desire. While some prefer a face-to-face intimate encounter, other patients place a premium on time and elect for a short phone or video encounter to follow up on medication changes, monitor for side effects, or adjust a care plan for ongoing back pain.

Specialty Access

Patients are much more inquisitive and utilize the Internet to do their homework. Let's give them credit for their efforts. With the power of video consultations, patients can demonstrate ROM for joint problems, show practitioners home readings for common metrics, upload wearable data, and partner to create a more robust treatment protocol.

Specialists already participate in advanced care such as telestroke emergency department consultations, dermatology consults, and orthopedic opinions. This will only expand as providers, patients, and administrators alike realize the real potential of telemedicine.

In the age of exponential change, the scope of telemedicine will quickly grow and innovate, and entrepreneurial health care workers will undoubtedly find more novel ways to harness telemedicine.

Mitchel Schwindt, MD

About Mitchel Schwindt, MD

Dr. Mitchel Schwindt is a board-certified emergency medicine physician who practices in a variety of clinical settings. He completed his residency at Butterworth Hospital in Grand Rapids, Michigan. As part of Michigan State University, Butterworth was renamed Spectrum Health, and is one of the busiest level 1 emergency and trauma centers in the United States. He served as chief resident his final year. While there he was inducted into Alpha Omega Alpha, a prestigious medical honor society. He also devoted a significant amount of time working as a flight physician (helicopter) for an aeromedical company. Dr. Schwindt has served on many committees and steering groups related to health care, quality and process improvement and was a former trauma program medical director. He serves as a volunteer physician for local sporting and martial arts events. He is a consultant and medical advisor to several dental groups and has developed protocols and policies related to medical issues in the dental practice. Wellness and nutrition are a passionate interest for Dr. Schwindt. He writes extensively on the subject and has published several related books. He is a member of the A4M – The American Academy of Anti-Aging Medicine and is currently pursing a functional and sports medicine fellowship. In his free time, he enjoys competing in triathlons, skiing, water sports, time with family, foreign travel and pursuing entrepreneurial activities.

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