Profile: Is Telemedicine Here to Stay?

Dr. Tom Brazelton ’82 talks about the benefits of healthcare from a distance.

Dr. Tom Brazelton ’82 is running the critical care transport program in the pediatric ICU and spearheading the University of Wisconsin Health and American Family Children’s Hospital (UW Health Kids) telehealth program. He spoke with Lucia Davis ’04 about the rise of remote medicine in a time when in-person visits could put patients and doctors at risk. 

What’s the difference between telehealth and telemedicine?
From a grander perspective, I like to say that if you’ve seen one telehealth program, you’ve seen one telehealth program, because they all have their origins in very different ways. Telehealth is, broadly, distance healthcare. It covers everything from mobile apps that remind you to take your medication to FaceTime [between patients and doctors] to advanced artificial [forecasting] intelligence...that says, ‘Hey, you know what? If your weight keeps going up at this rate, you’re going to be in the ER in three days, so call your provider.’ Telemedicine is actually treating patients.

How has the COVID-19 crisis necessitated the rise of telemedicine? Is it here to stay?
The rise of telemedicine was due to the immediate need to satisfy three things, the first of which is surge protection. This involved enhancing existing inpatient (ER, ICU, acute care) capabilities and physician staffing with remote functionality. The second was social distancing between providers and patients; the ability to triage and treat patients using video, thus obviating the need to expose them (or us) unnecessarily. Finally, there’s health maintenance and restoring routine operations. Those with chronic conditions as well as patients with new conditions still need medical attention. Many of them can be seen and cared for using video and still meet the standard of care. Telehealth is here to stay, it’s just going to be a question of what gets reimbursed by Medicare, Medicaid, and the insurance companies once the COVID-19 dust has settled.

How will telemedicine work for people without reliable access to technology? 
Yeah, that is a problem. The whole premise [of telehealth] is [based on a] certain level of technology and savviness around it. With very rural providers, what we’re looking at is that patients would go to somewhere – some public libraries have a big enough of a pipeline coming in [to make it work]. One of the advantages under Obama’s administration was that a lot of money went to FCC to lay down cable and get rural areas better equipped technologically, so they could take advantage of cloud-based technologies, internet access, and so on. Those are things that we’re working out as we move forward.