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To Your Health: NLM update Transcript

No longer rare virtual care: 03/19/2018

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine (NLM).

Here is what's new this week in To Your Health, a consumer health oriented podcast from NLM, that helps you use MedlinePlus to follow up on weekly topics.

A recent perspective in the New England Journal of Medicine imagines a future where visits between a patient and a physician are rare and most encounters occur virtually, or by using a laptop, desktop, smart phone, or tablet to communicate with health care providers.

The perspective's authors write (and we quote): 'Face-to-face interactions will certainly always have a central role in health care, and many patients prefer to see their physician in person. But a system focused on high-quality non-visit care would work better for many others — and quite possibly for physicians as well' (end of quote).

The perspective's authors provide several current examples of health services where patients are encouraged to use information technology prior to seeking in person care. For example, the perspective's authors note Providence-St. Joseph Health Express Care system, with 33 clinics in four states, encourages patients to participate in virtual care. The authors write: (and we quote): 'Patients can schedule visits at any site for in-person evaluations or laboratory testing. If they want to be seen face-to-face but can't make it to a clinic, a clinician will come to their home or workplace. Patients can also use apps to manage their conditions and symptoms' (end of quote).

The perspective's authors also cite successful, ongoing programs at Kaiser Permanente, and Omaha Health (among others).

In the foreseeable future, the authors write (and we quote): 'patients could toggle on and off the shipping of medicines and view insights on various measures that their smartphone might pick up (e.g. data on total hours spent in high-allergen zones for a patient with asthma). A case manager or coach could schedule a quick video check-in, when needed, to ensure that the patient's condition was being well-managed, determine what barriers might be limiting treatment success, and decide whether any adjustments to the medication regimen or care plan were required' (end of quote).

Overall, the perspective's authors envision a new health care system where the emphasis is to bring needed care and social support into a patient's home and de-emphasize visits to physician's offices, hospitals, and clinics. Meanwhile, teams of physicians and caregivers would focus on persons with similar needs, such as patients with Parkinson's disease, diabetes, or heart failure.

The perspective's authors suggest a shift in the focal point of care to more virtual visits may be consistent with public expectations based on the significantly increased diffusion of smart phones in the U.S. in the current decade.

Consistent with public expectations, the perspective's authors suggest a shift to a virtual emphasis represents an authentic transition to patient-centered care for some.

The perspective's authors suggest health care organizations that adopt more virtual and less in-patient care (and we quote): 'may gain a competitive advantage, since the required investments should lead to operational efficiencies and increased patient loyalty' (end of quote).

The perspective's authors conclude (and we quote: 'Viewing in-person patient visits as a last resort sounds radical, but it just represents a deepened commitment to patient-centered care' (end of quote).

We note the perspective does not cover cost savings, insurance support, and how physicians would be paid for information technology interactions, or how patient bills might be reduced. Yet, the perspective suggests the increasing acceptance of virtual medicine represents an important transition with possible advancements in patient-centered care.

On the ground, MedlinePlus.gov's talking with your doctor health topic page presents an array of information about enhancing in-person or virtual care. For example, the American Heart Association provides information about communicating with healthcare professionals in the 'start here' section of MedlinePlus.gov's talking with your doctor health topic page.

MedlinePlus.gov's talking with your doctor health topic page additionally provides links to the latest pertinent journal research articles, which are available in the 'journal articles' section. Links to pertinent clinical trials that may be occuring in your area are available in the 'clinical trials' section.

To find MedlinePlus.gov's talking with your doctor health topic page, please type 'talking with your doctor' in the search box on MedlinePlus.gov's home page, then, click on 'talking with your doctor (National Library of Medicine).'

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A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you. Please join us here next week and here's to your health!