The US spends more of its gross domestic product (GDP) on healthcare than other high-income country in the world, yet it ranks last in providing access to care, administrative efficiency, equity, and healthcare outcomes, according to an analysis by the nonprofit Commonwealth Fund 2021.
The rankings are based on surveys conducted in 2017, 2019 and 2020 of nationally representative samples of patients and primary care physicians in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the UK, and the US. About 5,500 people were included in the US samples.
The telehealth challenge:
On the one hand telehealth promises convenience, better health access equity and significant cost savings for payers and payer organizations. Even conservative estimates point to anywhere from 20-25% of all healthcare will be delivered via some kind of telehealth solution within 5-10 years. At the same time however, the adoption of telehealth seems disconnected from one of the most basic of medical pillars - the physical examination. With the majority of dollars in our healthcare system spent on the elderly, physical examination is absolutely essential to properly care for these sicker and more complex individuals. Medical schools are still requiring expertise in physical examination, particularly physical exam skills in the elderly to ensure appropriate diagnosis, management and outcomes. Nursing schools are also teaching that every medical consultation requires a physical exam. This fact has not changed, nor is expected to change any time soon. Yet, at the moment, over 90% of payer offerings in telehealth are limited to an audio/video connection with no physical exam. This is problematic since every medical consultation requires a physical exam. The only exception would be psychiatric services, where as expected, physical examination seems to be less of a requirement. Indeed, psychiatric services online have exploded since the Covid-19 pandemic demanded us all to stay at home.
With the US healthcare system ranked at the bottom of the list of wealthy countries, a notable question to ask is: What would happen if a quarter of all healthcare is delivered without physical examination.
Experts fear that our healthcare outcomes would be intolerably worse and any promise of telehealth would be undone by poor performance. We need to innovate in order to add physical exam to any serious telehealth solution now and in the near future if we are really to leap forward into the digital health revolution. Telehealth needs to take a comprehensive approach and include a time honored basic medical tool - physical examination, in order to confidently move into the future of digital health.
Gal3n Health offers a telehealth solution that is simple in its operation and allows for a physical examination to be conducted.
