Employees don’t want to adopt telemedicine - just yet

25 October 2016
More and more US  employers offer their workers telemedicine - healthcare delivered remotely via phone, video or other technologies — as they gear up for insurance open enrollment. Telemedicine often is offered in addition to or as part of traditional insurance benefits. Some telemedicine companies bypass employers entirely, offering it directly to consumers, The Chicago Tribune states.

Companies looking to lower their health care costs and boost worker productivity increasingly are adding it as a benefit. If it catches on broadly with consumers, telemedicine could change the face of healthcare, altering the relationship between doctors and patients seeking relief from common maladies.

But so far, employees haven't warmed to the idea, either because they don't understand it, don't know it's available or because they're skeptical of getting a doctor's opinion via telephone. About 70 percent of large employers offered telemedicine as a benefit this year, but only 3 percent of employees at those companies used the services in the year's first half, states a survey of 133 companies, each with at least 5,000 employees, released by the National Business Group on Health.

All in all, telemedicine accounted for only about 1 million of 1.2 billion outpatient medical visits last year, according to brokerage and consultancy Willis Towers Watson.

Savings in time and money

Telemedicine offers savings in time and money for both employers and employees. The typical telemedicine visit costs consumers about $40 to $49, a fee that is sometimes covered by employers. In contrast, before insurance, a primary care doctor visit for something that could be addressed by telemedicine can cost about $110, an urgent care visit about $150, and an emergency room visit $865.
PowerReviews' 140 employees and their family members used the telemedicine benefit 51 times in the first half of this year, saving nearly $6,000 in overall health care costs, said Kira Meinzer, PowerReviews' vice president of human resources. So given the cost and time savings, why aren't more employees in Chicago and across the country dialing in?

"I think the first challenge is employees often don't know about it," The Chicago Tribune queotes  Lisa Mazur, a partner at law firm McDermott Will & Emery in Chicago who advises providers and technology companies on telehealth services. "They need to be educated on its existence."

 There are initiatives underway to make this happen. Jason Gorevic, CEO of Texas-based Teladoc, a large telehealth provider working with 275 Illinois employers, said his company works with employers to educate their workers through welcome kits, seasonal campaigns and posters in offices, among other things.

More obstacles

A lack of awareness may not be the only obstacle for companies to overcome. Employees may wonder whether a doctor can accurately diagnose them without seeing them in person. According to a study published in peer-reviewed journal JAMA Dermatology this year, researchers examining 16 teledermatology services found major diagnoses repeatedly were missed and prescribed treatments were sometimes at odds with existing guidelines.

Telemedicine advocates admit that such services aren't appropriate for all types of medical issues. People with potentially life-threatening illnesses or injuries still should go to the emergency room, and those with chronic conditions should be monitored by physicians. But many services tout the qualifications of their doctors and their usefulness when it comes to treating certain common conditions, such as pink eye, sinus problems and urinary tract infections.

Another step in building up trust: the AMA recently released new ethical guidance for doctors participating in telemedicine. "I think we've got lots of examples out there of seeing it done very well and other examples where there's room for improvement," said Jack Resneck, a professor and vice chair of dermatology at the University of California at San Francisco.

Nothing new

Telemedicine is nothing new. It has been around for several decades already. Penn Medicine associate CIO John Donohue sees the practice growing, just not as fast as some would expect or even demand. But there are reasons for that. Technological reasons for one. Even though delivering healthcare to remote locations is hardly a new concept, it was not easy nor cheap until the advent of the mobile device and fast internet connections. 

When time costs money and a visit to a doctor costs both, using telecare and telemedicine concepts can go a long way in saving on both time and money. When on average only 17 percent of the time used to visit a doctor is actually spent on the session itself, there is indeed a lot of potential in saving time here, not to mention a lot less disruption – e.g. for school and work. This 17 percent translates into 20 minutes,  according to a study by the University of Pittsburgh physician Kristin Ray and colleagues at the Harvard Medical School and the RAND Corporation.