Telehealth, the remote distribution of health services via electronic technologies, has increased significantly in recent years. Although 76% of hospital systems in the United States utilized some form of telehealth by 2018, restrictions enacted during the COVID-19 pandemic resulted in a 766% increase in telehealth encounters during the first three months of the pandemic (1). As the country loosened COVID-19 precautions, telehealth utilization stabilized at levels 38 times higher than before the pandemic (2). Telehealth allows healthcare providers to provide prescriptions to patients without physical examination or other face-to-face interactions, which has both pros and cons.
The pros of telehealth prescriptions include increased accessibility and convenience of medical care for patients and flexibility for providers. Primarily, telehealth prescriptions render medical treatments more accessible to a variety of populations, from patients in rural or underserved areas, to patients unable to travel or access transportation, to patients with limited mobility or chronic illness (3). Additionally, telehealth visits are typically billed at lower rates than in-person appointments (4). Thus, the lack of travel and the lower costs associated with telehealth result in more cost-effective care and convenience for patients (5). From the healthcare providers’ perspective, telehealth provides additional flexibility while helping to increase patient adherence (6).
Conversely, there are also several cons associated with telehealth prescriptions in addition to the pros: patient safety issues, technology dependence, and the potential for prescription abuse. Physical examinations typically comprise an important part of the diagnostic process. Without physically examining the patient, the healthcare provider may construct an incomplete understanding of the patient’s chief complaint, leading them to potentially risk the patient’s safety by misdiagnosing conditions or misprescribing treatments (5). Second, telehealth prescriptions depend on technology, especially stable Internet and electronic health records (EHR) systems. Technical problems like connectivity issues or EHR glitches can disrupt telehealth appointments and can result in errors in the prescription process (3, 5). The dependence of telehealth on technology also presents a challenge for patients who do not have access to adequate resources. Finally, patients could potentially abuse the telehealth prescription system to gain access to medications (3, 7). Therefore, healthcare providers should evaluate patient needs and potential risk factors with caution in order to avoid prescription mistakes or misuse (5).
In conclusion, although telehealth prescriptions have several pros in their favor, including increased accessibility and convenience for patients, they also have cons, including patient safety issues, technology dependence, and potential for prescription abuse. Therefore, as telehealth appointments are projected to remain a popular option in medical care delivery even post-pandemic, healthcare providers should assess if telehealth prescriptions are appropriate for their patients and exercise caution when prescribing medications without physically examining patients (5). Despite the drawbacks, telehealth prescriptions enable a wide range of patients to access medications despite mobility or transportation issues, resulting in higher quality of life for previously underserved patients.
References
1) Shaver, J. 2022. The state of telehealth before and after the COVID-19 pandemic. Primary Care 49(4):517-530. DOI: doi: 10.1016/j.pop.2022.04.002.
2) Bestsennyy, O., Gilbert, G., Harris, A., and Rost, J. 2021. Telehealth: a quarter-trillion-dollar post-COVID-19 reality? McKinsey & Company Healthcare. URL: https://www.mckinsey.com/industries/healthcare/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality.
3) Gajarawala, S. and Pelkowski, J. 2021. Telehealth benefits and barriers. Journal of Nurse Practitioners 17(2):218-221. DOI: 10.1016/j.nurpra.2020.09.013.
4) Kubes, J., Graetz, I., Wiley, Z., Franks, N., and Kulshreshtha, A. 2021. Associations of telemedicine vs. in-person ambulatory visits and cancellation rates and 30-day follow-up hospitalizations and emergency department visits. Preventative Medicine Reports 24:101629. DOI: 10.1016/j.pmedr.2021.101629.
5) Saljoughian, M. 2021. The benefits and limitations of telehealth. US Pharmacist 46(8):5-8. URL: https://www.uspharmacist.com/article/the-benefits-and-limitations-of-telehealth.
6) Harvard Business Review. 2022. 8 reasons why health care providers should offer telehealth visits. Harvard Business Review. URL: https://hbr.org/sponsored/2022/04/8-reasons-why-health-care-providers-should-offer-telehealth-visits.
7) Seitz, A. and Whitehurts, L. Feds seek to limit telehealth prescriptions for some drugs. AP News. URL: https://apnews.com/article/prescription-drugs-medication-opioids-health-1f23131435341fd192f41f9db027255f.