5 Predictions For Telemedicine Physician Jobs in 2021

Eagle now provides coverage for 13 medical specialties — and the list of hospitals requesting these specialists grows daily. Here’s a snapshot of the potential ahead.

NICU & PEDIATRICS

Newborns and children require specialized care that may not be available in small community hospitals, especially on a 24/7 basis. Newborn Intensive Care Unit (NICU) support is necessary at a moment’s notice to evaluate and stabilize newborns, then determine the next steps in their care.

Pediatrics has been especially hard-hit by the physician shortage. In a nationwide survey by the Children’s Hospital Association, children’s hospitals were asked to name areas where pediatric specialist vacancies persisted for over a year.

Pediatric Neurology, Pain Management, Cardiovascular, and Otolaryngology were among the pediatric specialties with the highest wait times. The average wait time to see an Otolaryngologist is 2.3 weeks – one of the highest average wait times of surgical specialties.

Also, the demand for Pediatricians is expected to rise by 15 percent by 2026. These specialists will likely expect to earn an average salary of $212,000 a year, with a 5% increase per year.

A community hospital may have a pediatric hospitalist, a family medicine specialist, or a medical pediatric hospitalist who can provide daytime care for pediatric patients. However, if there are any coverage gaps (nights, weekends, holidays), the hospital must rely on locum tenens physicians at a high cost.

If a nurse assistant is trained in pediatric care, they need a pediatric specialist who will work with them. Without this on-the-spot care, there is a high likelihood the infant or child must be transferred, resulting in great family stress as well as transportation costs.

Telemedicine, increasingly, is coming to the rescue. For example, a Chicago health system is expanding its telemedicine platform to provide on-demand access to emergency pediatric services. Pediatricians at two suburban hospitals can access NICU specialists from a tertiary hospital via virtual care consults. The hospitals’ Emergency physicians will use the platform to connect with pediatric emergency medicine specialists.

This connection with Specialists provides the two hospitals with instant access to care — and reduces the need for costly and stressful transports to a tertiary hospital in downtown Chicago.

At Children’s Hospital Los Angeles, the efficacy of pediatric telemedicine care has been studied, with researchers determining that rounding conducted by offsite doctors ― with the assistance of remote-controlled robots ― was just as effective for NICU patients, compared to the regular on-site specialists.

MATERNAL-FETAL MEDICINE (MFM)

Severe maternal illness is on the rise in the United States, and women are dying in childbirth and from pregnancy-related causes at rates far greater than in any other economically advanced nation. States hit especially hard are Alabama, Arkansas, Kentucky, New Mexico and Texas.

For example, Alabama women die from pregnancy and childbirth complications at more than double the rate of women nationally, according to the National Center for Health Statistics at the Centers for Disease Control and Prevention. Alabama now ranks third highest in the nation in maternal death rates, behind Arkansas and Kentucky.

According to a CDC report, the severe maternal illness rate during delivery increased almost 200 percent from 1993 to 2014 across the US. This increase is due to increased rates of acute renal failure, cardiac disease, blood transfusion, and respiratory distress syndrome. A study of New Mexico found that women of color are more likely to be at risk for preterm birth, maternal and infant mortality — and that three out of five maternal deaths are preventable.

Researchers expect the rate of severe maternal illness to continue to increase. As women continue to become pregnant later in life, the chances for pre-pregnancy obesity, pre-existing chronic medical conditions, and cesarean deliveries increase, thereby increasing the rate of severe maternal illnesses.

Identifying at-risk women early in their pregnancy will potentially help provide timely medical care — and telehealth technology is at the heart of that program. This is expected to help prevent illness and death, shorten hospital stays, and reduce health care costs, researchers state.

The UAMS research team will recruit 50 pregnant women to test if maternal patient care can be improved using telemedicine video calls with UAMS maternal-fetal specialists and remote patient monitoring of blood pressure rates.

CHRONIC DISEASE MONITORING: In tandem with the growing obesity rate in this country, Eagle has seen a rise in requests for Endocrinology and Nephrology. While Eagle already provides Nephrology services on a limited basis, as well as Gastroenterology, there is discussion of adding Endocrinology and Dermatology.

Research shows that telehealth can be effective in treating diabetes patients. A year-long study conducted by the University of Nebraska and Wake Forest University found that a telehealth platform can help reduce the risk of diabetes in high-risk populations — by focusing on preventive measures to improve health and wellness.

In the first half of this year, the pandemic forced the medical community to adapt fast, using telemedicine as a stopgap measure to handle the emergency. As the months wore on, telehealth proved to build loyalty among patients and their doctors.

Doctor.com surveyed more than 1,800 patients about telehealth and the technology involved. The response was clear: Telemedicine is the future of healthcare. In early 2020, patient adoption was up 33% over the previous year.

Patients have increasingly shown their comfort levels with technology in setting appointments online. This trend continues, “mirroring today’s consumer experience: easy, immediate access to physicians, right from their smartphones — call it the “Uberization of healthcare,” according to a Medical Economics report.

Telemedicine saves patients over 100 minutes compared to an in-person visit, with each appointment in the comfort of their own home. In the Doctor.com survey, telehealth adoption is largely driven by convenience factors:

• Easy-to-use technology
• Online scheduling capabilities
• Immediate appointment availability

Instead of wasting half a day traveling to an appointment, a patient just hops on a 10-minute call before deciding on next steps or if a more extensive in-person appointment is warranted.

For physicians, the most promising implication relates to patient adherence. Telehealth removes barriers to care — while strengthening the patient/physician connection. Patients seem to recognize how telemedicine improves their healthcare: 93% report that they would use telemedicine to manage prescriptions, and 91% say that telemedicine would help them stick to appointments, manage prescriptions and refills, and follow wellness regimens as dictated by their doctor, reports Medical Economics.

Brick-and-mortar healthcare facilities are also evolving, with telemedicine being used in growing numbers of urgent care settings, micro-hospitals, and ambulatory care centers, as well as inpatient and outpatient surgery centers.

For example, Nutex Health, a Texas-based consortium of licensed, 24/7 micro-hospitals and freestanding Emergency Rooms, offers the convenience of a primary care provider’s office with the accessibility of a traditional ER. With over 25 locations across 8 states, including Oklahoma and Texas, the company is demonstrating how healthcare is evolving to meet consumer demand for convenience and proximity. Their team of board-certified emergency physicians provide superior patient care, along with quick treatment and drastically reduced wait times. (18)

In 2020, Eagle received requests for follow-up care ― inside of hospital-affiliated outpatient clinics ― for TeleNeurology, TeleStroke and TelePulmonology.

The trend toward telemedicine has been recognized by the American Medical Association’s vice president of digital innovation, who reported that even prior to the pandemic’s onset, telehealth visits and remote patient monitoring had doubled since a 2016 survey, increasing from 14% to 28% of physician respondents. (19)

The “AMA Digital Health Study” surveyed 1,300 physicians in 2016 and again in February 2019. Since the beginning of the COVID-19 pandemic, the use of telehealth rose dramatically. An estimated 60% to 90% of physicians were using some sort of telehealth services. About one-half were using telehealth for the first time.

“More physicians than ever have recognized digital health tools as an advantage for driving efficiency and safety in health care,” said Meg Barron, the AMA’s vice president of digital innovation.

The University of Virginia Center for Telehealth is developing a program to increase access to primary care and urgent care — as well as improve care in long-term care facilities, dialysis centers, clinics and other provider locations. A special program will improve access to 24/7 care in long-term care facilities via telemedicine consulting.

The UVA center has been a longstanding leader in the field, focusing on remote patient monitoring and intensive care. Most of the applications have been facility-based, until the arrival of COVID-19. Now, the center is using telehealth services to increase access to primary care and urgent care and to improve the efficiency of care with long-term care facilities, dialysis centers, clinics and other provider locations.

New telehealth goals have been set for inpatient and outpatient use, to improve access, triage and patient care management, reduce patient and provider COVID-19 exposure, conserve personal protective equipment, provide better access for primary care and specialty visits, and improve internal and external training.

The center is also using telehealth service to expand access to long-term care patients and facilities and has adapted remote patient monitoring developed for in-patient use to out-patient management of individuals with chronic conditions.

Amid this expansion of telemedicine, some barriers still exist that have slowed the progress. The physician’s ability to practice across state lines has been hampered.

During the pandemic, most states relaxed in-state licensing requirements for physicians. This allowed physicians to provide telehealth services in other states, to reach underserved rural and community hospitals. It also expanded access to many medical specialties that were critical to treating coronavirus patients — many that aren’t typically available outside metropolitan areas. However, the need for such access still exists.

Physicians, particularly specialists, must be able to work across state lines – and expansion of the Interstate Medical Licensing Compact (IMLC) is one possible solution.

By simplifying the physician licensing process, we can improve patient access to providers via telemedicine. One avenue is the IMLC, an agreement to streamline the licensing process for doctors outside their State of Principle License (SPL). Although just 29 states are participating in the IMLC, the potential is clear. It’s time to expand the IMLC and erase state licensing boundaries.

Eagle supports ILMC expansion to license physicians in multiple states. This is one more step towards solving the physician shortage and enabling a wider, easier adoption of inpatient telemedicine programs.

Since 2008, Eagle has proven (via experience) that virtual medicine is indeed a viable delivery model in hospital facilities. The Eagle model has also proven to be the most effective, compared to other platforms that utilize hard-wired beds connected to a “bunker” of computer screens that show alerts to doctors and nurses when a patient’s blood pressure drops, for example, or another significant change in condition is detected.

Eagle’s model is a team effort with on-site nurses and physicians who are “on the ground” monitoring ICU patients. This local team alerts Eagle’s team of intensivists (working from their home offices) via videoconferencing technology — and within just a few minutes, they are visible “on the cart” to diagnose the patient and recommend treatment options.

This has proven to be a more cost-effective approach and more proactive, compared to hiring locum tenens support. Tele-intensivists aren’t only available for emergencies, but they also can perform pre-emptive rounding. That is, rounding to spot potential problems before they occur.

The Eagle specialists are flexible; if a hospital only wants Tele-ICU coverage on weekends, we can provide it. Eagle provides the core team to share patient care management with onsite intensivists and/or hospitalists — via a cart with a video conferencing monitor.

All Eagle Specialists receive training, so they feel comfortable (and effective) in engaging with physicians via a remote monitor. And the technology has been fine-tuned since 2008 to ensure the highest-level audio/visual interaction, with the patient (and all bedside monitors) easily available.

Tele-ICU Coverage: The Eagle team covers the night and weekend gaps in ICU staffing, performing proactive Eagle Eye Rounding™ with ICU nurses to assess, triage and institute early treatment in patients with an acute decline in their clinical status. Our telemedicine intensivists can perform nursing unit rounds, as needed.

Or they can run an ICU, handling everything from floor call to attending rapid responses. Code Blue can even be managed virtually, with an Eagle Specialist calling the orders to the on-site team. Eagle has worked out the entire drill, so everyone on the ground (and virtual) knows exactly what to expect, how to proceed. We can report 100% positive outcomes with every Code Blue.

In fact, access to Specialists can help reduce 30-Day readmission rates and penalties. Simply by getting a second opinion, emergency staff can successfully discharge patients — greatly reducing readmission rates.