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What is Telemedicine?

Patients and doctors are busier than ever before. Both are leveraging technology to stay on track with deadlines, goals, organization and participating in excellent medical care.. One of the newer tools for use on both sides is telemedicine. In short, any health care that takes place between a patient and a clinician who are not in the same physical location could be considered telemedicine. With the advent of ubiquitous quality and secure video, telemedicine has evolved into a virtual, secure, video conversation platform that allows you to see your doctor from almost anywhere. Usually requiring only an internet connection, a webcam, and PC or laptop, telemedicine gives you much more convenient access to doctors with much less wasted travel and waiting times.

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What exactly is Sleep Telemedicine?

Sleep doctors have been practicing a form of telemedicine for decades by reading sleep studies remotely over internet connections. Recently, there has been an explosion in the field and video telemedicine has  made major inroads in several other medical specialties, including stroke, urgent care, dermatology, ophthalmology, and psychiatry, among others.

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Can sleep disorders be accurately diagnosed via telemedicine?

There may be room here for a healthy debate on the topic, but my answer is unequivocally “yes.” The diagnostic bible of sleep medicine is the International Classification of Sleep Disorders – Third Edition (ICSD-3). This book details the formal criteria necessary to make sleep disorder diagnoses and is consistent in delineating that the diagnosis can be made from a patient’s history in conjunction with sleep studies, although not all sleep disorders require a sleep study. This information can be readily obtained through telemedicine.

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What are the advantages of sleep telemedicine?

There are many advantages, including decreased cost of care and convenience to patients and doctors. At a minimum, patients may only need a computer or  smartphone, and an Internet connection to have a telemedicine evaluation. Patients can spend more time with their doctors and less time traveling to and waiting for them. This may prevent missing appointments, delaying medical care and may save patients from having to take time off from work and commuting to their doctor’s office. In some regions of the country that are underserved by sleep medicine, this could save a patient several hours of travel to the nearest sleep clinic. Also, there is risk involved, for the patient and from a public health standpoint, to having excessively sleepy people driving this much.

From a doctor’s standpoint, telemedicine allows us more flexibility in where and when we provide patient care. It is also a novel platform for increasing access to health care and has tremendous potential for improving population health outcomes.

What are the disadvantages of sleep telemedicine?

Physical examination is generally limited to observation. Biometric data, such as BMI and neck circumference, is provided by the patient and the clinician is not able to validate it objectively. Another drawback to telemedicine  is that, by definition, telemedicine does not allow “laying of hands” by the provider, preventing the physical connection that many doctors argue enhances the therapeutic  patient-doctor relationship. There are also theoretical privacy risks such as your protected health information (PHI) becoming  exposed over an unsecured network. It is important for your telemedicine provider to use a platform that conforms to HIPAA requirements.

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Will my insurance cover telemedicine services? Will I be able to get the prescriptions that I need from a telemedicine consultation? What about sleep study and blood work orders?

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In the majority of states, telemedicine services have been determined to be equivalent to traditional healthcare services.  There has been a rapid proliferation of “parity” laws in states requiring insurance companies to reimburse telemedicine and traditional services equally. You can learn more at americantelemed.org. Please check with your own medical insurance if these services are covered.

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Telemedicine providers can prescribe medication and electronically send  prescriptions to your pharmacy. Diagnostic testing, including sleep studies and laboratory tests, can also be ordered.

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