Telemedicine on Capitol Hill
Hospitalist Ateev Mehrotra, MD, MPH, garnered an audience in Congress last month with his speech on telemedicine that called on lawmakers to take a deliberate approach to the healthcare strategy.
Dr. Mehrotra, a staff physician at Beth Israel Deaconess Medical Center in Boston and a policy analyst for RAND Corporation in Santa Monica, Calif., testified before a health subcommittee of the Energy & Commerce Committee[PDF]. He urged politicians to understand that telemedicine has immense potential but needs to be implemented deliberately to ensure that it provides quality care, improves access to those who need it most, and is used in the most cost-efficient manner.
He spoke with The Hospitalist after testifying:
Question: What do you hope the committee took away from your speech?
Answer: Go in with [your] eyes wide open. Experience tells us this is going to work in some ways and is not going to work in some ways. I think some people are naive and think telemedicine is perfect.
Q: Overutilization is a fear of yours. Tell me why.
A: For every great and remarkable intervention we have introduced in medicine, there has been this potential concern. I gave the example of cardiac catheterization, [which] has saved tens of thousands of lives probably. I can cite many other examples from MRIs to CTs [computed tomography] to robot-assisted surgery, etc., where that overuse issue is very significant. Economists believe [new technologies] are one of the greatest drivers of increased healthcare spending in the United States. With that as background, one shouldn’t be surprised that telemedicine would face the same issues.
Q: With a national push for telemedicine, is that overall a good thing?
A: Maybe I’m just too much of a doctor, but I think about this very much like I think about a drug. You have positive benefits, and you’ve got side effects. You need to be aware of the side effects … it doesn’t mean in many cases you don’t prescribe the drug because the drug is helping overall. If you take that same framework to telemedicine, I would say I’m overall very enthusiastic about the multitude of benefits … but not all telemedicine is the same. TH
