dr. Frydman found that another benefit of telecare was that she learned more about her patients’ home environments. An elderly telecare patient proudly told her about caring for the greenery she saw behind him. Then, for several months, she saw his houseplants wilt and die. “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 discovers that telehealth has limits, of course. “Sometimes you 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 soured Marcia Weiser, 83, about telehealth. “It’s better than nothing, but I don’t see it being optimal,” said Ms. Weiser, a retired math teacher on Manhattan’s Lower East Side. Many of her health issues, such as 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 expires, “the key question for policymakers will not be whether to allow telehealth but how to make it available to everyone efficiently, effectively and equitably,” said Dr. Jacobson.
Researchers are still investigating whether patients using the virtual services do as well as they do with in-person care, although a review of clinical trials using video conferencing showed largely similar results.
Analysts also track whether video and phone visits replace face-to-face appointments or are an additional, unnecessary increase in Medicare spending. It is also unclear whether telecare is more susceptible to fraud than personal care.
Improving equity in telecare poses another challenge, as access to digital devices and the internet differs significantly between different groups.