Telemedicine in primary care

Telemedicine in primary-care
Telemedicine in primary-care

HealthDay News -- Primary-care practitioners need to consider the operational and legal issues surrounding the integration of telemedicine into their practice, according to an article by Mark Crane in Medical Economics.

“Many primary-care [providers] worry that the rapidly-growing field of telemedicine is just too complicated and time-consuming to implement in their already busy practices,” wrote Crane. “But physicians who have started offering telemedicine in their practices say there is no need to reinvent the wheel.”

Although some health-care providers argue telemedicine discourages face-to-face consultations between patients and providers, Crane disagrees, stating that telemedicine can strengthen the primary-care clinician-patient relationship and can help manage urgent requests when the office is closed.

Getting started in telemedicine does not have to necessitate a huge outlay. According to Medical Economics, although basic web cameras are inexpensive, software systems need to be encrypted and Health Insurance Portability and Accountability Act-compliant. Integrating telemedicine into practice also raises operational issues, such as when to see patients, scheduling, and guidelines for use.

Legal issues also face physicians using telemedicine, and these include physician licensing, malpractice liability, online prescribing, informed consent, and credentialing and privileging. In some areas, telemedicine is slow to grow, but the advantages for patients mean it is likely to grow significantly. Areas where telemedicine can help include mental health follow-ups, urgent care visits, and management of chronic conditions.

Demand for telemedicine is growing. Teledoc, the nation's largest teleheath provider, is estimated to complete 200,000 consultations in 2014. One primary-care practice is Seattle operates 24/7 virtual clinic, where medical care is delivered by phone and webcam, and a quarter of consults result in emergency department, specialist, or primary care referrals.


Clinicians should be able to answer the following questions when getting started with telemedicine:

  • How do you expect the telemedicine program to tie into your regular in-person practice?
  • Are you planning to extend your practice and open satellite offices staffed by mid-level providers?
  • What type of clinic hours will you devote to telemedicine?
  • What time would you save by implementing telemedicine?
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