Beam Yourself Up, McCoy

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For something like 130 years, humans have had the telephone, yet it didn’t occur to the health care industry to formalize phone-based diagnosis and treatment until some 50 years ago. In 1996, the next frontier arrived when the Institute of Medicine said, “Hey, I bet this Internet thing could make it a lot easier to see patients who live out in the middle of nowhere!”

Today, some insiders are hailing telehealth as a sharpshooter in the assault on the broken health care system. The term refers broadly to the use of communication technology to examine and monitor patients (the more specific “telemedicine” is used specifically for doctor-patient interaction). Think Skype with electronic medical records plugged in. Of the many benefits, the most obvious is telehealth’s potential to expand patient access to primary and preventive care while reducing costs.

President Obama’s Health and Human Services Department has focused on applications for rural folk, which it estimates make up 20 percent of the patient population, spread out over 80 percent of the country. Public health officials also hasten to point out that city dwellers can be every bit as isolated as their rural peers—by poverty or lack of transportation, for example. Veterans Affairs is deploying telehealth to treat patients in outlying areas, as well as those who are unable to get into centers for appointments, and the recently opened Las Vegas VA Medical Center includes a telehealth unit.

The pitfalls of the approach will also be apparent to anyone who has had a phone call or online chat with a customer-service representative lately. To save money, companies may outsource these positions to overseas operations, resulting in interactions that are sometimes confusing for the customer. If you find explaining your cellphone’s latest malfunction to a guy in India frustrating, imagine telling him about the irregularity in your digestive functions.

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