Telemedicine Today

Early in my marketing life, I had the opportunity to work in the arrhythmia market, and after taking a month to learn how to spell it I was quite fascinated.  Perhaps the most interesting part was seeing how electrophysiologists could monitor patients who had received pacemakers using the telephone.  The physicians in medical centers could be making detailed medical decisions without the face-to-face contact you would expect with patients who needed continual care.

Looking through the health stories today, there is a barrage of information on telemedicine and how it could potentially change the way medical care is delivered in our country.  Is this really happening?  How many office visits are done over the phone?   How many physicians are involved in this type of practice?  How is the pharmaceutical industry dealing with this phenomenon?  For the last year or so, I have been troubled by the IMS report that doctor visits are going down in the US and this is blamed in large part on the economy.  It just seems to me that something else might be going on and perhaps telemedicine might provide at least a partial answer.

Perhaps a good place to start would be to look at the American Telemedicine Association (ATA) website for some basic information.  The first thing you notice is that the concept is quite broad in scope.  The arrhythmia type monitoring over the phone is one type of telemarketing and this is being done extensively in a number of areas.  The consultation with an expert over the phone, especially for a second opinion, is becoming popular with some major medical centers involved.  Note that this could also be as simple as having patients in rural areas talk with physicians even for primary care type visits.  I guess this is also how the folks advertising drugs over the Internet must work.

To prove that telemedicine is becoming “mainstream” check out what is happening at Walmart.  This story about a young cardiologist starting a practice in a Pennsylvania store shows how simple the process could become.  Note how inexpensive he is able to price the visit and how much is offered for that price.  In a separate article, Walmart talks about their commitment to telemedicine and the investment they are making in video networking to make this happen.

When you start to dig through all the websites you will see there are organizations, journals, regulations, support help and a plethora of other information sources for this topic.  Take a look.  I can see where this concept could really catch on for a number of reasons.  The obvious first reason would be to expand access for those who can’t easily get to physician’s office.  Those in rural parts of the country or around the world seem to be the first who are benefitting.  Being able to get a second opinion or consultation with medical centers like Hopkins, Mayo or the Cleveland Clinic without having to travel seems very valuable and would have benefits over even seeing someone else in your hometown.  Diversity of thinking and experience is very important for the more complex cases.  Think about the time and cost savings that could be a result of not having to sit in an office waiting to be seen.

What could this all mean for our industry?  Like so many other innovations, we could treat it like business as usual.  We could send reps into the office where the physicians are located and try talking with them.  My bet is eventually these physicians will not have real offices and will provide these services from a “secure” location.  Since they don’t require samples, there is no need to send reps in to collect signatures.  A second level of service would be to develop Apps for certain diseases that could help the telemedicine team work with patients in a specific therapeutic area.  If nothing else, companies should at least have a team of people studying this issue and plotting strategy for the future.  If this trend is not aggressively pursued, it would seem that it would hurt the branded products.  Prescribing will all be done electronically with formularies that tend to hurt branded products.  There will be little opportunity for prior authorization work and forget about the easy use of co-pay cards.

Perhaps telemedicine could provide a huge opportunity for the industry.  Why not set up systems to actually become part of the care team.  Companies could actually have a medical team available that could help the physicians deal with patients in real time.  They could even have their own telemedicine clinics.  Companies could provide live patient care advocates who could come in once a prescription is written.  This would work best for complex diseases where it is critical that the therapy is properly used.  There really are so many possibilities once the walls are torn down and not really needed any longer.

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