Dr. Frydman discovered that another benefit of telehealth was learning more about her patients’ home environments. One older telehealth patient proudly told her about tending the greenery she noticed behind him. Then, over several months, she saw that his house plants were wilting and dying. “It prompted me to ask about his mood, his energy,” she said, and his answers revealed a previously unsuspected problem.
In her palliative care practice at Mount Sinai, Dr. Frydman has found that of course, telehealth has limits. “You sometimes want to see patients walk into the room,” she said. “Has their gait changed? How do they get in and out of a chair?”
That’s what soured Marcia Weiser, 83, on telehealth. “It’s better than nothing, but I don’t see that it’s optimal,” said Ms. Weiser, a retired calculus teacher on Manhattan’s Lower East Side. Many of her health issues, like joint pain and cholesterol monitoring, require “something hands-on, or a blood test or a urine test or an eye test,” she said. “I can’t get that on a computer.”
While telehealth may not be for everyone, studies have shown that both patients and doctors broadly support it. After 2023, when the current Medicare extension ends, “the core question for policymakers will not be whether to allow telehealth, but how to make it efficient, effective and equitable, available to everyone,” said Dr. Jacobson.
Researchers are still investigating whether patients using the virtual services fare as well as they do with in-person care, though one review of clinical trials using video teleconferencing found largely similar results.
Analysts are also tracking whether video and phone visits replace in-person appointments or are additional, unnecessarily boosting Medicare spending. Whether telehealth is more prone to fraud than in-person care is unclear, too.
Improving equity in telehealth poses another challenge, since access to digital devices and the internet varies significantly between different groups.