MEDICAL INNOVATIONS
Medical Innovations:
The Rise of Telemedicine By Johnathon Harris and Matthew Cryer
T
he growth of telemedicine has greatly expanded during the COVID-19 pandemic, in part due to its unmatched ability to continue care with patients while ensuring patients could socially distance; dramatically reducing risk of transferring the COVID19 virus.1 From 2019 to 2020, telemedicine visits for patients using Medicare increased by a factor of 63, from 840,000 to 52,700,000.2 Though the number of telemedicine visits has declined since the start of the pandemic, as of February 2021, there was a stable 38-fold increase in telemedicine usage in the U.S., which represents 13-17% of all medical visits.3 In a national survey conducted by the Harris Poll published April 2020, 35% of respondents would consider replacing their primary care provider with on-demand telemedicine visits.4 As a result of both advancement in information technology and the unique demands imposed on providers in a post-pandemic world, telemedicine as a medium for delivering quality health care is here to stay. Telemedicine is considered a subset of telehealth and is defined as, “the exchange of medical information from two separate sites via electronic means to improve patient health.”1 It began over 70 years ago when hospitals started to share information via telephone.5 This audioonly form of telemedicine was improved upon by the 1960s when the University of Nebraska used a two-way interactive television, allowing its medical students to accomplish neurological examinations of standardized patients.6 With the invention of the internet and increased availability of transmitting devices, telemedicine has continued to evolve into an important tool for both clinicians and patients. It is currently used to provide high-quality health care to patients, regardless of their location or ability to travel. Today, telemedicine is being incorporated in medical school programs, graduate medical education and in physicians’ practices. At the University of the Incarnate Word School of Osteopathic Medi24
SAN ANTONIO MEDICINE • May 2022
cine (UIWSOM), telemedicine was successfully used to allow osteopathic students the ability to interact with standardized patients during times of quarantine. UIWSOM students were taught how to accomplish a medical interview and physical examinations to include musculoskeletal and skin exams through a program that allowed for video/audio exchange, all from the safety of their homes. In 2020, the Accreditation Council for Graduate Medical Education (ACGME) approved the use of telemedicine for residents in certain programs through the academic year of 2021.1 Resources have even been made to help assist physicians with telemedicine, to include a guide on how to accomplish a virtual physical examination, how to accomplish a musculoskeletal exam and even more guides for more specific examinations, such as a virtual dysphagia examination.1 Along with benefits of reduced exposure to infections and an increased reach of health care to anywhere in the world, physicians are able to learn more about their patient and their current living conditions in ways that were not possible before telemedicine, such as the ability to get a visual tour of the patient’s home.1 Moving into the near future, telemedicine will likely have increased usage as a tool to help patients determine if and when they need to physically come into the hospital. It has already made its way into some emergency departments as a first triage before their visit to the emergency department.7 This has helped patients get screened from the safety of their home, protecting both physicians and the patient during the pandemic. Expanding this in the near future, the authors of this article believe that telemedicine could serve as a way to cut down wait time at hospitals and emergency rooms, while also allowing for the receiving hospital to better prepare for their incoming patients. Instead of a patient walking into an emergency department unannounced and then having to wait for hours based on their triage
