Is Telemedicine Going to Disappear?

Is Telemedicine Going to Disappear?

As a 40-year veteran of telemedicine, I have begun to think lately that the term which has defined my life work is about to disappear.  This is not necessarily a bad thing, but a couple of recent events have led me to this conclusion.

Forty years ago, I was working for NYNEX Science and Technology.  We were looking for clients who would best take advantage of the high speed (T1 and T3) transmission capacity we had.  We initiated a trial with four Boston teaching hospitals in different aspects of collaboration over the transmission of medical images.  For me, it was a project which launched a career.

Telemedicine has been around since the invention of the telephone (phone calls to your doctor) and reached its height of popularity during the Covid pandemic.  From August 2019 to August 2020, telehealth claims increased 3552%, from 0.17% of medical claims to 6.07%. Telehealth use peaked in April 2020 and has declined since then; however, use remains above pre-pandemic levels. 1

“Just like digital/wireless/mobile health eventually will just be called “health,” telemedicine will soon just be another part of medicine.”  So said Dr. Jay Sanders (in 2016), widely known as the “Father of Telemedicine.” He’s been involved in the field since his residency at Massachusetts General Hospital in the late 1960s. 2

So, will the term disappear?

A recent listing of the most popular Telehealth Specialties (per Epic) reveals some interesting insights: – (I continue to use Telehealth and Telemedicine interchangeably.)

Specialties

1. Mental health: 36.8%
2. Infectious disease: 10.6%
3. Obstetrics: 10%
4. Transplant: 9.9%
5. Neurology: 9.5%
6. Gastroenterology: 9%
7. Endocrinology: 8.9%
8. Pain medicine: 7.6%
9. Allergy/immunology: 6.4%
10. Surgery: 6.4%

– Teleradiology, as a Telemedicine/Telehealth specialty, has disappeared from the list. However

The Global Teleradiology Market Size was Valued at USD 8.6 Billion in 2023 and the Worldwide Teleradiology Market Size is Expected to Reach USD 29.8 Billion by 2033, according to a research report published by Spherical Insights & Consulting.4

It is not too difficult to imagine that Mental Health, as a telehealth specialty (tele-psychology, tele-psychiatry, tele-social work…) will no longer be considered special, rather a just part of the practice of medicine.

My recent attention has turned to Telemedicine for Pain Management, and I think the potential is significant.5

Recent Events

Recent news that Walmart is shuttering all 51 health centers along with its virtual care services came on the heels of recent media reports that Optum also was exiting the telehealth business.6

Two public telehealth companies have seen their share price decline significantly in the past year with Teladoc down over 50% and Amwell down 80% with the prospect of being delisted.

Christian Milaster, tireless champion of telehealth and CEO of the consultancy Ingenium, put it succinctly:

“the reason why these ventures failed is because in our current environment it is freakingly difficult to make money in healthcare – virtual or not.”

The Good News

Awareness – In the beginning of the pandemic (March 2020) when a patient went to The TeleDentists where I was CEO, it was often their first telemedicine encounter.  Two years later, they had mostly had a positive first experience with a doctor over the Internet and talking with a dentist was much more natural.

Telemedicine becomes part of the general practice of medicine and is an integral component of these upcoming critical advances:

• Remote Patient Monitoring (Wearables and Mobile Apps)
• Artificial Intelligence (generative AI in Healthcare)
• SDOH and Big Data Integration
• Virtual Assistant and Symptom Checker Chatbots

Telemedicine has also found a critical role in the ability to write prescriptions and therefore “sell” medical products over the Internet.  Some of these have become very controversial such as the ability to prescribe abortion pills and weight loss drugs.  Other products such as contact lenses, contraceptives, erectile dysfunction medication, and hair replacement all seem to have growing audiences.

The Future of Telemedicine

The benefits are too big to ignore as telemedicine can help solve some of the biggest problems facing the healthcare industry.  These benefits include:

Addressing workforce shortages

Labor cost savings

Increasing access to care

Decreasing provider burnout.

Perhaps it just won’t be called Telemedicine.

NOTES

1. https://revcycleintelligence.com/news/telehealth-billing-leveled-out-in-august-but-still-up-3552
2. https://medcitynews.com/2016/03/father-of-telemedicine/
3. https://www.beckershospitalreview.com/telehealth/10-most-popular-specialties-for-telehealth-per-epic.html
4. https://finance.yahoo.com/news/global-teleradiology-market-size-worth-190000287.html
5. https://institutesofhealth.org/telehealth-for-chronic-pain/
6. https://www.fiercehealthcare.com/health-tech/how-walmart-and-optum-exiting-telehealth-signals-major-shift-virtual-care-market