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Telemedicine vs in-person doctors: Which is better?

Telemedicine vs in-person doctors: Which is better?
PHOTO: Unsplash

In this day and age, one of the biggest changes we’ve seen is the increasing adoption of technology in the healthcare industry. From electronic health records, wearable technology, to remote monitoring tools, digital solutions will continue to play a vital role in the future of healthcare.

With the pandemic in play, the utilisation of telemedicine technology has become increasingly common among healthcare providers worldwide and an essential modality for providing care.

But certain individuals still have reservations on the effectiveness of these remote video consultations between clinician and patient, despite being progressively acceptable.

In this article, we’ll take you through the different forms of telemedicine, how they vary from in-person visits, and why you should consider making the switch.

What is telemedicine?

Telemedicine or telehealth is the provision of health-related services through the use of communication technologies and digital information, like computers, mobile devices, and software.

The primary purpose of telemedicine providers is to connect patients to vital health care services virtually, making healthcare accessible to anyone and everyone regardless of the distance.

What are the different forms of telemedicine?

There are four common ways in which telemedicine can be conducted and provided: Live video conferencing, remote patient monitoring, store-and-forward telemedicine, and mobile health.

Live video conferencing

Synchronous telehealth or live video conferencing is a two-way video-based conference that allows both parties to communicate, allowing doctors to provide immediate medical advice to patients in real-time. Out of all the telemedicine formats, live video conferencing also happens to be the most commonly used in the healthcare sector.

Remote patient monitoring (RPM)

Unlike live video conferencing, RPM requires the use of technological devices to monitor and record a patient’s clinical signs and health data remotely. The information gathered will be sent to health care providers, where their vital signs will then be assessed accordingly.

This method is extensively used to manage patients with chronic conditions as well as senior patients who are unable to travel back and forth to receive outpatient care due to mobility issues.

Store-and-forward telemedicine

Also known as asynchronous virtual care, this particular form of telemedicine involves the electronic delivery of a patient’s clinical information to another site for further evaluation.

Healthcare providers on the receiving end will then collect and store the relevant data in a secure cloud-based platform, which commonly consists of demographic data, medical history, laboratory reports and diagnostic imaging scans.

Patients residing in rural areas with limited access to medical specialists benefit most from this form of telemedicine, allowing them to receive quality care despite the distance factor.

ALSO READ: 'We did not expect high number of cases': Telemedicine providers stretched thin as more people go into home recovery for Covid-19

Mobile health

Most healthcare providers recommend the use of health-based software apps to their patients for continued healthcare monitoring remotely.

Through the use of mobile devices such as smartphones, tablets, and even smartwatches, patients can now monitor a variety of health factors easily like heart rate, pulse rate, dietary tracking, sleep cycles, movement tracking, and many more.

Unlike the other telemedicine types, mobile health is targeted more towards patient use than doctors, which encourages patients to be more disciplined and conscious about their physical health.

Advantages and disadvantages of in-person visits

Advantages of in-person visits

Ability to conduct routine assessments with ease

There are no limitations to what medical providers can test or examine during an in-person visit. Certain physical examinations may require the use of special equipment or additional tests, which may not be readily available in the case of telemedicine.

What’s more, patients with multiple tests may also have the chance to complete all their assessments within the same day depending on the availability of services at the practice, ultimately reducing the need for follow-up appointments.

The next time you’ll be visiting your doctor again would be to review the test results, which can be weeks or months away.

Enhanced rapport between patient and doctor

Despite the rise of virtual consultations, some say that the patient experience provided by in-person care remains the gold standard. While a similar level of quality can be achieved, in-person visits allow for better rapport between both parties and give patients a chance to voice out their concerns without worrying about a time limit.

Apart from improving the overall patient experience, studies also suggest that personal and therapeutic interactions between patients and clinicians build trust and increase the likelihood of patients being compliant during treatment — something which may be challenging to achieve over Zoom, especially for the older generation.

Reimbursement and billing

Medication, consultation fees, medical tests, and other outpatient-related costs can be easily reimbursed at your medical institution, regardless if it’s through Medisave or private health insurance. In comparison, the cost of some telehealth services may not be claimable or covered by insurance.

With that, in-person care eliminates the need for out-of-pocket medical expenses and can lead to significant savings at the same time.

Disadvantages of in-person visits

Limitations for patients with mobility difficulties

We all know how travelling back and forth for a medical checkup can be quite the hassle. For seniors and homebound patients, making the trip for the appointment can be physically and financially taxing for them and their caretakers.

In the case of working adults, several aspects that need to be factored in for in-person visits include taking time off from work and the cost of childcare, all of which can cause great inconvenience and disrupt one’s daily routine and schedule.

Long and extended waiting times

More often than not, the waiting time may take longer than the actual consultation itself. On top of that, you also have to factor in the time it takes to travel back and forth from your original destination.

For quick routine appointments and common procedures, it would be a hassle to book an appointment and visit the doctor, especially for those recovering who need rest.

ALSO READ: Guide to telemedicine providers in Singapore: Here's how much it costs to see a doctor (virtually)

Increased risk of infection

The whole purpose of adopting telemedicine solutions, especially during this time, is to limit the number of unique visitors coming in and out of hospitals, which helps limit the spread of Covid-19.

While the situation is at a better rate, medical institutions remain as one of the highest risk places for catching the virus, given the nature of medical institutions.

Yes, hospitals and other healthcare facilities may currently have stringent practices against infection control. But if you have loved ones at home with underlying medical conditions, even the slightest form of exposure could be fatal.

Care professionals that you trust

Homage Care Professionals are carefully selected with your safety and well-being in mind. Our online doctors as well as caregivers and nurses go through a rigorous screening process, and are selected to care for you and your loved ones based on your needs.

Want to find out more about our online doctors and care professionals? Simply reach out to us by filling out this form!

Advantages and disadvantages of telemedicine

Advantages of telemedicine

Limited risk and exposure to infection

Now more than ever, the use of telemedicine across the globe has become increasingly vital in the fight against Covid-19. Especially during high-risk periods, going to the hospital or clinic means being exposed to people who may be sick, increasing one’s risk of contracting the virus

Receiving care through telemedicine services eliminates that risk entirely, which is especially important for patients with immunodeficiencies and underlying health conditions or elderly persons.

For those with elderly loved ones at home who are at greater risk of contracting the virus, you may want to consider shifting to telemedicine if you haven’t already done so.

Improves clinical workflows and waiting times

No waiting time for patients, easy follow-up for post-surgery or illness, reduced cancellations, and immediate feedback from doctors. These are just some of the factors that contribute to enhanced workflow efficiency as a result of telemedicine services.

Virtual appointments allow patients to simply log in to their online meeting links from the comfort of their homes, with no waiting time involved.

Queries and questions can also be asked directly during these consultations. In turn, patients can receive immediate and quicker responses without having to relay messages back and forth between doctors and nurses.

No transportation time or costs

With virtual care, you can say goodbye to lost travel time and additional transportation costs for good.

During in-person checkups, the waiting time can take longer than the actual consultation itself, which explains why more and more Singaporeans prefer the convenience that comes along with telemedicine services.

Convenience for patients with mobility limitations

Showing up to facility-based health care appointments can be incredibly challenging for people with disabilities and mobility issues.

On top of that, travelling to these appointments require the assistance of their caregivers or family members, who may need to take a leave from work as well. This may deter patients from showing up and skipping treatment due to the burden of excessive travel to their respective facilities.

Telehealth makes it more accessible for these individuals to receive the same level of care as they would at hospitals. They need not worry about transportation time and additional costs and can focus on receiving the treatment that they need.

Disadvantage of telemedicine

Technological limitations

Telehealth services may not be as easily accessible among technologically challenged individuals, especially senior patients who are not as exposed to mobile devices.

Since older adults don’t use online tools as often as younger digital natives, some may struggle with common issues such as accessing various devices and apps and connecting to the internet.

Electronic glitches or internet issues may also occur, which may affect the overall quality of the session

Physical examination is limited

Video-conferencing technology may allow for high image quality, but it may not be able to capture vital patient information the same way a physical examination would.

Unlike routine tests that are best conducted in-person, most telemedicine services would not be able to measure important vital signs on the spot such as temperature, heart rate, and blood pressure. At most, clinicians can only assess what they see through the screen and what the patient tells them.

On top of that, more-in depth procedures that require blood work and imaging tests call for a more hands-on approach, all of which cannot be fulfilled virtually.

Healthcare data breaches

Cyber security concerns are often associated with telemedicine due to the nature of personal data being transmitted electronically. While medical institutions have stringent data protection policies in place by law to protect the patient’s private information, the risk of security breaches still exists.

Lack of physical interaction

Despite the rise of virtual consultations amidst the pandemic, some patients still prefer visiting and interacting with their doctor in person.

With telemedicine, you may not get the chance to meet or bond with your doctor personally and only interact with them through a screen.

Most older adults find that building rapport and interpersonal communication physically is still necessary and valuable during the treatment process, which ultimately comes down to a preference issue.

But despite the lack of interaction, the national telemedicine guidelines set in place for healthcare professionals in Singapore state that the quality of care provided shall remain the same regardless of the medium and platforms.

ALSO READ: 7 telemedicine apps to use when you're unwell during circuit breaker

Cost comparison of telemedicine vs. in-person doctors

To give you a glimpse into what your charges would look like, here’s a brief overview of how telemedicine consultation fees compare to in-person consultations on average:

Telemedicine & in-person clinics Price
Homage Online Doctors From $20 per session (subsidies and insurances are available)
Polyclinics $6.90 to $​53.50 (excluding medication and other tests)
GP Clinics From $70 to $120
Public Hospitals From $50 to $200 (cost varies for subsidised and non-subsidised patients)
Private Hospitals (Specialist Clinics) From $120 to $200 for initial consultation
Accident & Emergency Departments (A&E) From $70 to $120 per consult

From polyclinics to public hospitals, most healthcare providers in Singapore only allow patients to make Medisave claims for inpatient services or chronic conditions including:

  • Asthma
  • Dementia
  • Hypertension
  • Lipid disorders
  • Major depression
  • Stroke

Otherwise, patients would have to cover the overall costs using out-of-pocket expenses or make an insurance claim. Unfortunately, A&E fees and non-medical treatments like ambulance transport cannot be claimed with MediSave as well.

Who should use telemedicine?

It may have become an integrated part of mainstream healthcare in this day and age, but telemedicine solutions may still not be for everyone and every situation. For serious injuries, severe pain, or other urgent medical matters, it is still best to make a physical appointment with your doctor.

Healthcare professionals highly recommend the use of telemedicine to geriatric patients, who either struggle with technology or are homebound. Individuals who live in inaccessible locations or are unable to take time off from work should also consider getting access to care virtually.

If you have a pre-existing illness or acute medical conditions that don’t require a physical examination, telemedicine would also be suitable for you.

Get the most out of virtual home care with us

Singapore’s technologically advanced healthcare system has made it possible for locals to gain access to telemedicine solutions easily. With Homage telemedicine services , you can receive quality care from the comfort of your home, any day and time of the week.

We ensure that all our care professionals are highly skilled at their practice and registered with the Singapore Medical Council (SMC), to provide you with the same quality of care as you would in an in-person visit.

For older adults who are more dependent and mobile, medical escort and transport services are also provided for doctors and hospital appointments, medication collection, visit daycare centres, and everything else in between.

This article was first published in Homage.

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