Telemedicine Continues to Sink In—But to What Effect?

It’s undeniable that telemedicine is one of the most widely discussed, evolving topics in medicine today. What is less clear is how it is likely to affect the general public’s approach to healthcare and actual clinical outcomes, and what impact it will have on office-based settings (including urgent care). An article just published in The American Journal of Managed Care (AJMC) confirms that the ability to dial in for a medical encounter is resonating with patients, but other recent research appears to confirm fears that overuse of antibiotics could result. In the AJMC article, researchers relied on data from the Veterans Health Administration and the Centers for Medicare and Medicaid Services to assess patient experiences—not necessarily outcomes, however. They found that patients’ perceptions of quality of care were higher when they experienced shorter wait times before connecting to a clinician. Conversely, the authors of a study conducted by the National Institutes of Health and published in the journal Pediatrics concluded that antibiotics may be overprescribed for children who receive care online. In that study, 52% of children seeking care online for a respiratory infection got a prescription for an antibiotic, compared with 31% who got one during a primary care office visit. So, in short, the jury is still out. What is clear is that, as always, responsible antibiotic prescribing is in the hands of the provider. If your urgent care center offers telemedicine services, ensure that your providers are trained to resist the pleas of patients who say the only reason they’re using telemedicine is because they thought it would be easier to get an antibiotic. The threshold of proof that one is needed should be consistent whether the patient is online or in-office.