Now that private medical information is more valuable than ever, hopsitals and healthcare professionals need to balance virtual healthcare practices with security measures. Illustration by Jordon Cheung.

Not long ago, the idea of “seeing a doctor” without actually going anywhere would have seemed far-fetched. But at a time when we can deposit checks, buy and sell antiques, and take classes in astrophysics from our mobile devices, virtual healthcare that goes beyond fitness apps and WebMD is becoming part of our new reality.

More patients are making virtual contact with medical professionals every day, thanks to the advanced information and communications technologies that support telemedicine. Beyond connected devices (such as glucose and cardiac monitors) that stream data directly to hospitals and doctors’ offices, telemedicine involves videoconferencing and electronic exchange of ultra-high-resolution photos, CT scans, and X-rays among doctors and patients who may be in different states or even on different continents. That makes accurate diagnosis and expert advice on a wide variety of conditions and treatments theoretically possible from anywhere to anywhere else, around the clock.

Bringing the digital IT revolution to medicine comes at an opportune moment. “We've got an aging population and a rise in chronic diseases that require more frequent care,” says Chris Taylor, Head of Healthcare and Financial Institutions, Commercial Markets, at Zurich North America. “Replacing a portion of face-to-face visits through telemedicine could be more efficient.”

According to a 2015 Harvard Medical School study, patients spend 121 minutes on an average doctor’s visit, with more than 100 of those minutes spent commuting and sitting in a waiting room. Just how many doctors’ visits could be replaced by telemedicine? Studies show the shift could be significant. University of Rochester Medical Center researchers found that nearly 28 percent of the cases that came into the pediatric emergency department could have been handled remotely. Another study of elderly patients residing in senior living communities found that of 1,535 unique doctor visits to treat acute illnesses, 38 percent of them—and 27 percent of trips to the emergency room—were “potentially appropriate” for telemedicine.

Telemedicine aims at more than efficiencies in time and money, though: It promises to make healthcare significantly better, in part by increasing access to better medical care. Until now, healthcare has been heavily influenced by geography, with access to top specialists varying greatly by region and community. Telemedicine makes it possible to conference in the experts, whether it’s a burn specialist needed at a rural emergency room or a cancer specialist at the Mayo Clinic advising a hospital in northern Maine. A real-life example is the story of a young firefighter living in a small city in North Carolina. When he suffered stroke-like symptoms, the doctors at his local hospital were able to care for him after videoconferencing with stroke experts at a big-city hospital some three hours away.

For all its potential benefits, telemedicine also opens up new risks for both hospitals and patients. As healthcare data grows exponentially, the systems, equipment and records that are used to manage it offline are coming online more every day, making that information increasingly available to hackers as well as to doctors. Healthcare companies are being victimized by cybercrime with increasing regularity. “Retailers and financial institutions have long been frequent targets for cybercriminals,” says Taylor. “Unfortunately, healthcare facilities are now part of the epidemic.”

The expanded access to healthcare that telemedicine potentially brings is both an opportunity and a problem for hospitals. The black-market value of medical records is now ten times higher than that of credit card information. It follows that cyber attacks against healthcare providers have multiplied, doubling from 2010 to 2015, with the average data breach costing a hospital $2.1 million, according to an IBM-sponsored study by the Ponemon Institute.

“Patient information is the ultimate security and privacy issue, for all kinds of reasons,” says Taylor. In the U.S., the infrastructure for telemedicine is largely the work of third-party companies, with some 200 telemedicine networks and 3,500 service sites around the country. But just as hospitals and doctors have been held responsible for malpractice in the operating room, they may now potentially be held liable for a hack to a patient’s insulin pump or pacemaker.

Security concerns are not the only reason telemedicine is not more widespread than it is. In a 2014 national survey, only 15% of family physicians reported using telemedicine in the previous year, with 41% citing potential liability issues and more than half naming lack of insurance reimbursement as obstacles. As the U.S. Department of Health and Human Services notes, there is no standard for reimbursement throughout the insurance industry or among the states, which means that coverage for telemedicine costs is variable. Some state medical boards, such as Georgia’s, are requiring face-to-face encounters to accompany telemedicine, for example.  Similarly, some states do not reimburse Medicare patients for any telemedicine consultation done from home.

While technology is blind to borders, state medical boards are decidedly not, and licensing presents another major hurdle. “It becomes an issue any time doctors licensed in one state as a provider go across state lines,” says Taylor. Some states, such as Wisconsin, are looking into laws to speed up the licensing process to facilitate telemedicine, but many are not.

Still, telemedicine appears to be the manifest destiny of medical practice in the U.S. and around the world—not only for remote consultation and diagnosis but potentially, when the speed and reliability of digital communications allow, for expert surgery performed at a distance. As remaining security and regulatory issues are resolved, Taylor and other experts in the field say that telemedicine will transform healthcare practices and, in time, save many lives, especially in those cases when speed is critical. As Taylor puts it, “Telemedicine allows the state of the art in medicine to be delivered anywhere at any time, and ‘at any time’ really matters."

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The information in this publication was compiled from sources believed to be reliable for informational purposes only. Any and all information contained herein is not intended to constitute advice (particularly not legal advice). Accordingly, persons requiring advice should consult independent advisors when developing programs and policies. Zurich North America assumes no liability in connection with this publication, including any information, methods or safety suggestions contained herein. Zurich North America undertakes no obligation to publicly update or revise any of this information, whether to reflect new information, future developments, events or circumstances or otherwise.  The subject matter of this publication is not tied to any specific insurance product nor will adopting these policies and procedures ensure coverage under any insurance policy.
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