What impact will telemedicine and digital technology prompted by COVID-19 have on the U.S. healthcare system? Will telemedicine continue to be popular after COVID? What types of medicine are feasible virtually versus what must be done in person? Abraham (Avi) Seidmann, Everett W. Lord Distinguished Faculty Scholar and Professor of Information Systems at Boston University Questrom School of Business explores these questions. Based on the Insights webcast The Crucial Digital Transformations of the American Healthcare Systems in the Post-COVID Era.
The pandemic has accelerated trends in how consumers seek out care. Consumers are gravitating toward solutions that more seamlessly and conveniently integrate medical care into their everyday lives. Social distancing guidelines have further fueled this shift toward digital and virtual care solutions. As the pandemic continues, and long after it subsides, these digital technologies will get better and better. After all, it is much easier to move data than to physically move patients or providers.
However, there are many obstacles the telehealth industry must overcome for it to be profitable and effective. One of the biggest dangers is the “trap of convenience.” Just because people like to use telemedicine does not necessarily mean that it is safe or effective.
A great example of this are dermatologists, who might have trouble examining cancerous or pre-cancerous cells through a computer screen. Cancerous moles or bumps could go undetected if dermatologists are expected to conduct visits virtually.
The second major challenge with telehealth is how to make it socially equitable. Patients need reliable Wi-Fi and a computer or cell phone, which too many in the U.S. still do not have access to. Leaving behind these patients deepens the inequalities in our healthcare system.
There is also the fear that digital medicine could become a winner-takes-all system because of its high fixed costs and relatively low variable cost. Similar to how Google dominates the search engine industry, a few large hospital chains could dominate the U.S. digital healthcare market if left unregulated.
Telemedicine works best when it can ease the barriers of accessing treatment or solve issues that traditional medicine could not. For example, demand for mental health services has soared during the pandemic. While this is likely caused by higher stress levels brought on by COVID, easier access to virtual counseling sessions could also be a factor. Individuals who typically could not take an hour of sick or unpaid time off each week to commute to a therapist’s office can now have a quick session during their lunch hour.
Telehealth could also address some of the high infection rates at nursing homes due to close quarters. “Aging in place,” or the concept that the elderly could receive medical services within their home, could be accomplished via digital health. Most of the U.S.’s medical costs are for patients 65 or older, so we need new technologies for this population.
Over the past ten years, my colleagues and I have looked at if telehealth can address the issues traditional medicine cannot by studying chronic care issues. While chronic care may not have the ER-like glory of acute care, health economists in 2012 reported the annual cost of chronic pain in the United States is as high as $635 billion a year, which is more than the yearly costs for cancer, heart disease and diabetes.
We investigate the use of telemedicine for treating patients with chronic care issues such as Parkinson Disease motion disorders, diabetic retinopathy, and chronic migraines. Our published studies found that telemedicine, when done right and with careful testing, can deliver equal or better outcomes as traditional in-office care.
If telemedicine truly is the greatest medical advancement of our generation, a great deal of social and business innovation will be required for telemedicine to scale. Startups addressing on-demand consultations to digital health coaching will rise to offer innovative solutions to consumers, creating an entirely new space outside the traditional healthcare industry.
In addition, providers will need to allocate significant budgets to the proper delivery of telehealth. They may experience large capital investments upfront, but they are likely to have a high return on investment quickly. The cost of care may go down as we reduce the need for large clinic buildings, parking garages, reception spaces, and waiting rooms.
Telemedicine does not necessarily require a provider at the other side. While many medical chatbots and avatars did not live up to the initial hype, we see now that industries like fintech, healthcare, and e-commerce are rapidly adopting the technology to free up busy professionals’ time and offer guided, personalized experiences to consumers.
Moreover, mainstream AI use in telemedicine is still five to seven years away. Substantial bottlenecks in data access and quality will take several or more years to address at scale. Substantial work in curating, labeling, and cleaning data is required to make datasets market-ready for healthcare applications. Once datasets are clean and algorithms work well, the ‘scale economy’ effect of AI in telemedicine will be far beyond our imagination.
If businesses and technology converge to solve some of medicine’s biggest issues using telemedicine, it truly will be the greatest medical accomplishment of our generation.
About Our Expert
ABRAHAM “AVI” SEIDMANN
Professor, Information Systems
Everett W. Lord Distinguished Faculty Scholar
Associate Research Director, Digital Business Institute
My current research and consulting activities focus on medical informatics, electronic commerce, online auctions, information systems, health care management, business process design, project management, and optimal resource allocation. I also conduct research on strategic manufacturing systems, information economics, stochastic processes, and performance modeling for capacity planning and pricing.