Dr. Frydman discovered that another benefit of telehealth was learning more about the home environment of her patients. An older telehealth patient proudly told her about tending to the greenery she noticed behind him. Then, for several months, she saw her houseplants wither and die. “It prompted me to ask questions about his mood, his energy,” she said, and her responses revealed a previously unsuspected problem.
In her hospice palliative care practice at Mount Sinai, Dr. Frydman has found that, of course, telehealth has limits. “Sometimes you want to see patients walk into the room,” she said. “Has their approach changed? How do they get in and out of a chair? “
This is what embittered Marcia Weiser, 83, about telehealth. “It’s better than nothing, but I don’t think it’s optimal,” said Ms. Weiser, a retired professor of calculus on the Lower East Side of Manhattan. Many of her health issues, like joint pain and cholesterol monitoring, require “something practical, or a blood test or a urine test or an eye test,” she said. “I can’t get this on a computer. “
Although telehealth is not for everyone, studies have shown that it is widely supported by patients and physicians. After 2023, when the current Medicare extension ends, “the central question for policymakers will not be whether to allow telehealth, but how to make it efficient, effective and equitable, accessible to all,” said Dr. Jacobson.
Researchers are still investigating whether patients using virtual services fare as well as with in-person care, although a review of clinical trials using video teleconferencing found broadly similar results.
Analysts are also checking whether video and phone visits replace in-person appointments or are additional, unnecessarily increasing Medicare spending. It is also unclear whether telehealth is more prone to fraud than in-person care.
Another challenge is improving equity in telehealth, as access to digital devices and the Internet varies considerably from group to group.