Technology has led to a paradigm change in all our walks of life – and healthcare is certainly one of them. There have been many technology advances that impact the practice of medicine over the last several decades. Everything from improved digital imaging options to electronic health records has changed the way that doctors and patients work together. The rise of telemedicine –or virtual doctor visits – as an option for patients, however, may be poised to change the way that patients interact with their physicians in a way that no other technology has ever done.
And the healthcare workforce is gearing up for it. While telephone visits have been shown to be an effective alternative to face-to-face visits for physicians, residents have not traditionally been trained to perform telemedicine. In a pilot program that took place at Christiana Care Health System, Wilmington, Del., from October 2016 through December 2018, medical residents-in-training learned how to effectively perform telemedicine skills.
The results of this pilot program were announced at the annual meeting of the Society of General Internal Medicine in Washington DC this month were very encouraging as they showed that residents were able to provide effective care for remote patients, while still providing the same quality of care as that during clinic visits. The objective of the pilot was to demonstrate the feasibility of adding telephone visits into the internal medicine residency practice. This feasibility was measured by templating, scheduling, and supervision as noted Dr. Laughlin, an internist at Christiana Care Health System in Newark, Del. Templating was a term used to describe the designing of the program. For example, the researcher templated 1-hour telephone visit blocks, meaning they designed this structure to integrate into the resident’s training program.
Each resident had 1 hour within the weekly schedule to conduct telephone visits. First-year residents were allowed to do one telephone visit during that hour, second-year residents could do two telephone visits within the hour, and third-year residents could do three telephone visits in that hour. The program’s second objective was to evaluate the resident experience of scheduled telemedicine visits. This included provider-patient continuity and patient ownership. The residents who were surveyed about their experiences said these telephone visits increased their patient ownership and allowed them to build rapport with patients. In terms of continuity of care, 65% were with the patient’s primary care provider and 26% were within the primary care provider’s firm.
Despite being a relatively new phenomenon, awareness of, and comfort with, the virtual option are increasing for both patients and physician practices. A recent study by the Healthcare Intelligence Network found that 74 percent of organizations were planning a telemedicine initiative within the next 12 months. In a separate study, Cisco found that 74 percent of patients are comfortable communicating with doctors via technology. Medical practices of the future would probably be working with several alternative visit types besides the traditional face-to-face. It is only fitting that doctors-in-training are beginning to gain skills to ensure that quality of the in-person visit is not lost over the digital encounter.