Physician Focus: Telemedicine

Program Highlights:

  • Telemedicine makes care more convenient and accessible for patients by reducing barriers to care and delivering care where patients are.
  • Telemedicine includes multiple means, such as video platforms, text messaging, patient portals, and health “apps” that allow two-way connections between physician and patient.
  • The pioneering field for telemedicine has been mental health, with other specialties building on what has been learned in that specialty.

Technology has been rapidly changing the practice of medicine, and one of the fastest growing areas is telemedicine, defined as the exchange of information via electronic means to improve a patient’s health.

“Doctors have been connecting with patients for decades over the telephone,” says Adam Licurse, M.D., “but what’s happened in the last five to ten years is that, while the phone calls are still happening, now there are all sorts of new technology-based ways to connect to patients - video platforms, portal-based methods through electronic medical records, text messaging, and various connective devices.”

Dr. Licurse, a primary care physician and Associate Medical Director of Brigham and Women’s Physicians Organization and Partners Population Health Management, joins psychiatrist Steven Locke, M.D., Chief Medical Officer and Co-Founder of iHope Network, as a guest on the October edition of Physician Focus to discuss the emerging practice of telemedicine, its impact on physicians and patients, and its promise of improving health care delivery. Hosting this edition is Dale Magee, M.D., a past president of the Massachusetts Medical Society.

“The reason why providers are getting excited about telemedicine is that it is much more convenient for patients. Access is improved, and barriers are reduced,” says Dr. Licurse. “It’s a way to meet patients where they are, in a more tailored, more engaging way.”

An advantage of telemedicine is that it facilitates physician-patient communication, but it can also address a major concern in health care: provider-to-provider communication. “What telemedicine allows,” says Dr. Locke, “is the ability to capture information during an encounter in a standard way to provide it back to the referring clinician as part of a collaborative care process.”

He also says that telemedicine can be effective for patients with multiple conditions. Individuals with diabetes or congestive heart failure, for example, are known to have higher rates of depression and associated disorders such as anxiety or substance abuse. Those conditions can compromise the outcomes of the care they receive and interfere with the patient’s participation in their own care.

“If we can identify people who are at high risk for depression,” says Dr. Locke, “then we can provide accessible, easy affordable treatment to them and also share that information with their primary care clinician, so that it really is a partnership, a three-way partnership, and sometimes a four-way partnership if the family is involved.” By providing care in such a way via telemedicine, Dr. Locke suggests that we can not only get better mental health outcomes but also better medical outcomes as well.

Both physicians agree that telemedicine carries much promise.

Yet both agree, also, that telemedicine raises concerns. Is the quality of “virtual care” equal to an in-person visit? Can it increase disparities in care with certain populations that may not have access to technology? And what impact can “virtual care” have on the all-important physician-patient relationship?

However these concerns are addressed, one thing seems certain: telemedicine has its advantages, and it represents a new frontier in the delivery of medical care, one that seems likely to grow.

Watch the above video for more conversation, including discussion about how the field of mental health has acted as a pioneer in telemedicine, how telemedicine can help to ease the stigma that prevent patients from getting care, and additional dialogue about the concerns clinicians still have with the application of telemedicine in patient care.



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