It may surprise many that telemedicine has been around for over a century. With the invention and wide spread use of the radio and telephone in the early 1900’s , the medical profession began envisioning ways to reach more and more patients at a distance. In 1925, Hugo Gernsback wrote an article predicting that within 50 years, someone would invent a device called a “teledactyl” allowing doctors to not only see and talk to their patients through a viewscreen, but also examine them with spindly robot arms that allowed the doctor to remotely “feel”. (www.smithsonianmag.com) While Gernsback’s creepy version of telemedicine doesn’t appear to be available at present, other forms of telemedicine have been around long before the first mention of COVID-19. But, the pandemic situation in early 2020 has transformed this something of limited availability into necessary services for a much larger part of our population.
Earlier this month, the Coronavirus Preparedness and Response Supplemental Appropriations Act was funded with $100 million to allow health care systems to fight against COVID-19 and a portion of this funding is earmarked for telemedicine. Prior to this pandemic, Medicare regulations limited telehealth services to rural areas. However in response to COVID-19, those regulations were lifted with the passage of the Telehealth Services During Certain Emergency Periods Act of 2020. As of March 6th, all Medicare beneficiaries are eligible for telehealth services provided by doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers. Audio and visual capabilities for real-time communication will be required which is destined to create all kinds of frustrations at times, but when the technology works the telehealth sessions are considered the same as an in office visit and will be paid at the same in-office evaluation rate. (No spindly robot arms needed!) For more information, Medicare has published a CMS Telemedicine Fact Sheet that can be found at https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet.
But, assuming we can ever get back to some form of normalcy not considered a health emergency, will telemedicine remain a popular and allowed form for doctors to provide and patients to receive treatment? Currently, the policy changes are temporary and in direct response to the pandemic. Medicare states these policies remain in effect “for the duration of the COVID-19 Public Health Emergency. What will be allowed after this emergency is undefined…but the proverbial cat may be out of the bag. And, such things as ease of use, any cost savings, and effectiveness of treatment delivered telemedically will determine how hard it will be to re-bag the telehealth cat.