A new telemedicine program at the University of Rochester Movement Disorders Clinic in Rochester, New York, supported in part by funding from the National Parkinson Foundation, is allowing patients with Parkinson’s Disease to see their doctors remotely via video-conference. This exemplifies a growing recognition of the important benefits to be gained by using “telemedicine” to allow patients to visit doctors and specialists remotely via teleconferencing.
According to a special report published by NPR on June 27, 2011, “People with chronic medical problems like Parkinson’s disease can have a hard time finding a specialist who can help them manage the disease. Some patients are turning to doctors hundreds of miles away to get the care they need. But they’re not driving to get to the doctor. They’re doing the medical version of telecommuting, despite the fact that many insurers won’t pay for it.”
For a detailed description of the importance to Parkinson’s patients of the ability to see the specialists they require via telecommuting, and for an account of the experiences of specific patients with the New York program, see the NPR Special Report: The Parkinson’s Doctor Will Video Chat With You Now.
As explained by NPR, “Remote access to medical care has been touted as the next great thing for almost 20 years. And telemedicine is now more widely used in some areas, such as linking radiologists and stroke specialists to hospitals. It’s been used to monitor patients’ vital signs remotely, and to provide long-distance psychiatric care.”
Available technology currently is adequate to support such telemedicine programs, and “Clinical trials of telemedicine have found that the quality of care is at least as good as with in-person visits,” according to NPR.
However, a primary challenge now is covering the costs for patients. At present, the cost of seeing a doctor via telemedicine programs such as these generally is not covered by insurance in the U.S.
Medicare covers such remote doctors visits only if the patient lives in what the Medicare program considers a rural area — which is very restrictive and excludes several smaller cities and towns, NPR reports.
Another challenge is that doctors in the U.S. are licensed state by state, and under the present licensure system, a doctor in one state cannot treat a patient in another state, unless the doctor is also admitted to practice and licensed in the patient’s state.
Canada, which has a shortage of physicians and specialists in rural and remote areas, has moved ahead of the U.S. in promoting and utilizing telemedicine. The Canadian system allows and encourages patients to visit their doctors and specialists remotely via video conferencing, with full coverage of the costs. A sidebar report entitled, The Canadian Connection, by Nancy Shute, which is presented with the NPR special report, explains that:
. . .
In patient surveys, 90 percent of patients say they like the Canadian approach to long-distance health care.
“It works. It’s green,” says Guttman [referring to Dr. Mark Guttman, a movement disorders specialist in Markham, Ontario]. “The savings in gas and emissions are huge. It’s time-saving for patients. And I think we provide at least equivalent services. And they like it.”
Perhaps the U.S. needs to “take a page from Canada.” We could learn from the Canadian system. If the U.S. and the States could establish laws and policies to overcome the barriers currently preventing the wider use of telemedicine in the U.S., patients could realize the benefits of seeing the specialist they require, even if the doctor is too far away to travel there for each visit. At the same time, the overall costs of medical care could be reduced.
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