The Fallacy of Expensive Telemedicine

[Jeffrey Rodman (Jeff Rodman)]

A recent story on NPR's Morning Edition  mentioned that some insurance companies are not convinced that telemedicine lowers costs, because it can lead to more visits and tests. Let's look at this claim. We'll even be generous to it by ignoring the fact that telemedicine’s effectiveness isn’t measured only by cost, but by quality of care, quality of life, family stability, ability to earn, and other factors.  

Simply adding test costs to the cost of a telemed session is looking at only part of the picture. Any issue has a whole “life cycle" (pardon the pun) where the total cost/benefit includes not only those other costs (lab tests, for example), but a host of benefits including financial ones, like avoided costs. What if, in that example, a subsequent $200 test showed that a $200 prescription would avoid an eventual $20,000 surgery, which itself added a 10% risk of $200,000 in complications? Total cost with the test and medicine was $400, total average cost without the test was $40,000. Skipping the test only pushed the problem down the road, in other words, and let it grow into a much bigger problem. The tiger didn't go away because we decided to close our eyes.

Telemedicine is how patients and doctors can keep their eyes open and avoid the tigers.  If we ignored the full picture and concluded that telemed is bad because more testing and follow-up is bad, then most medical instruments, from the "say ahh" orange stick to the blood–pressure cuff (sphygmomanometer, one of my favorite words) are even greater culprits.  From personal experience, I can attest that without the bit of technology known as the stethoscope, my own direct life-cycle healthcare costs would have been much cheaper because I’d be dead.