Welcome to the virtual house call, the latest twist on telemedicine. It's increasingly getting attention as a way to conveniently diagnose simple maladies, such as whether that runny nose and cough is a cold or the flu. One company even offers a smartphone app that lets tech-savvy consumers connect to a doctor for
Now patient groups and technology advocates are pushing to expand the digital care to people with complex chronic diseases that make a doctor's trip more than just an inconvenience.
"Why can't we provide care to people wherever they are?" asks Dr.
"Think of taking your mom with Alzheimer's to a big urban medical center. Just getting through the parking lot they're disoriented," he adds. "That's the standard of care but is it what we should be doing?"
Among the hurdles: While Medicare covers some forms of telehealth, it doesn't typically pay for in-home video exams. Plus, doctors who practice by video-chat must be licensed in whatever states their long-distance patients live. Some states restrict the kind of care and prescribing available via telemedicine.
About 40 percent of Parkinson's patients don't see a specialist, in part because they live too far away, even though research suggests those who do fare better, according to the Parkinson's Action Network.
When Matulaitis first was diagnosed in 2011, his wife had to take a day off work to drive him more than two hours to a Parkinson's clinic. Once he was stabilized on medication, Dorsey enrolled the
He's thrilled with the care.
"It's just the same as if you've ever done Facetime on an iPhone," explained Matulaitis, 59, who continues his virtual checkups with Dorsey a few times a year. "It allows the doctor to see the patient at a point where they are at their best."
Telemedicine is broader than a
But the virtual house call is gaining interest. Some insurers offer versions, such as
New guidelines from the
But does a virtual exam translate into better outcomes for the chronically ill?
"There's an evidence gap that needs to be filled," said
As for people seeking even a seemingly simple diagnosis, there are other questions such as how to avoid overprescribing antibiotics. Yes, a smartphone camera may spot signs of strep throat. But national guidelines urge a strep test before giving antibiotics, to be sure a virus isn't to blame.
"You have to be a touch more thoughtful when you're talking about new patient relationships," said Dr.
Then there's cost. The key is whether telehealth replaces doctor visits or adds to them, Dr. Ateev Mehrotra of
"Telehealth may be too convenient," said Mehrotra, urging that it be implemented in a cost-effective way that provides high-quality care.
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