Telemedicine has come thundering into professional and public lives after plodding growth and acceptance over the past 20 years. As consumers and professionals have rapidly turned to telemedicine for routine care over the past two months, a question remains: should physicians adopt telemedicine for the long-term once the pandemic has slowed? 

Telemedicine from a provider’s perspective

While it’s still unclear whether patients will insist on electronic access to their doctors (and whether clinicians will support consumer demand), it’s likely that convenience, comfort with technology, and fast appointment-booking capabilities will be key factors for consumers. 

From a clinical perspective, providers and practices considering telemedicine should consider a few questions:

  • Have I adopted a telemedicine system that’s easy to use and allows for clear, uninterrupted communication with patients?
  • Have I established workflows that allow for efficient management of multiple patients?
  • Does mixing in-person and telemedicine visits in a clinic day work, or is block scheduling more workable?
  • Am I being paid equivalent fees for telemedicine and in-person care?
  • Is my overhead greater, lower, or the same?
  • Are my patients asking me to see them in person or via telemedicine?
  • Before a visit is scheduled, how can I be reasonably certain that I can conduct an exam that’s not missing important medical information that would have been readily available from a physical examination?

Indications of telemedicine’s future are abundant. The AMA has published a guide for telehealth implementation that can assist clinicians in gearing up for telemedicine or anticipating a return to more stringent guidelines once the pandemic eases.

Telemedicine and the Elderly

For practices with a focus on elder care, questions often arise beyond what we’d consider for younger populations. Will seniors be comfortable with technology? Also, will assessments and coordination of care be equivalent to services provided in the office? As with the bulk of the literature on telemedicine effectiveness, we’re seeing promising trends for senior care, including those with memory impairment. 

Results of a three-state care coordination initiative are promising. This study comprised care coordination intervention largely provided in-home, targeting caregivers as well as patients. Results showed the telehealth intervention demonstrated improved quality of life scores and fewer emergency department visits. Reductions were also seen in caregiver burden and depression compared to care-as-usual. 

Assessing Cognitive Impairment via Telemedicine

As routine care for cognitively impaired individuals transitions into technology-assisted delivery, confidence in the delivery increases.  Additionally, real-world programs indicate that care may not only be equivalent, but sometimes exceeds that of legacy care models. 

BrainCheck has actively adapted its existing platform for easy at-home and remote cognitive assessment. Early indications are that remote cognitive assessment via BrainCheck is readily adopted by patients with modest assistance from a family member or caregiver. 

Clinicians can assess and re-assess cognitive status as their patients self-isolate. Given the almost universal stance that seniors are at a heightened risk of complications from COVID-19, it’s likely that routine office visits will be among the last to return to prior patterns. 

Additional Telemedicine Resources from BrainCheck

We’re always improving our platform based on practice and patient feedback — and that’s especially true during this public health emergency. BrainCheck will continue to share emerging best practices with you as we fine-tune our systems based on the experience of our clinical customers and their patients.

Find BrainCheck telemedicine resources here »

Reference: Possin KL, Merrilees JJ, Dulaney S, et al. Effect of Collaborative Dementia Care via Telephone and Internet on Quality of Life, Caregiver Well-being, and Health Care Use: The Care Ecosystem Randomized Clinical TrialJAMA Intern Med. 2019;179(12):1658–1667. doi:10.1001/jamainternmed.2019.4101


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About the author

Robert Cuyler, PhD


Robert Cuyler is a clinical psychologist with decades of clinical, management and consulting experience. He is a Clinical Advisor at BrainCheck and the chief clinical officer of Palo Alto Health Sciences. Previously, Dr. Cuyler served as the CEO of JSA Health Telepsychiatry and clinical advisor to MDLive/Breakthrough Behavioral. Dr. Cuyler received his PhD in psychology from Louisiana State University and his postdoctoral fellowship from the Menninger Foundation.

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