Medical & Clinical Reviews

Description

Telemedicine is a disruptive innovation in the health care marketplace that holds the potential for transforming medicine by improving access to medical care and providing a more affordable way of delivering care. On the basis of consumer demand, ongoing technologic advances, desire for greater practice efficiency, and behavioral and demographic trends, it is likely that more frequent use of telemedicine will be maintained post-pandemic and into the future. Looming areas for growth include the following: chronic disease management, care for patients in remote (eg, rural) areas, and expansion beyond direct-to-consumer models. On the basis of the multiple influences that will drive ongoing use of telemedicine, the future of allergy and immunology practice will likely entail traditional medicine in addition to telemedicine. In the spring of 2019, the American College of Allergy, Asthma and Immunology and the American Academy of Allergy, Asthma, and Immunology collaborated to form a Joint Task Force on Telemedicine and Technologic Innovation, chaired by Tania Elliott, MD, and Jay Portnoy, MD. The decision to create such a task force at that time reflected the recognition on the part of the leadership of our specialty societies that promoting awareness and encouraging competency with telemedicine and other emerging technologic innovations would be increasingly important for the practice of allergy and immunology. The resources planned for annual meetings are yet to be realized but are intended for future meetings.

Dramatic Surge of Telemedicine Use in the Health Care Marketplace

When this Joint Task Force was created, we were unaware of the foehn wind in the form of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic that would intrude 1 year after. The pandemic not only led to dramatic changes in our lives but also catalyzed a dramatic surge of telemedicine use in the health care marketplace, based on the need to reduce in-person visits in the ambulatory setting. To fully understand telemedicine and the prominent role this technology will play in the future, there are several key influences that must be appreciated. The first influence is a concept that can be regarded as being at the border between economics and psychology. Disruptive innovation is a term coined in 1997 by Clayton Christiansen, a Harvard economist,¹ who unfortunately passed away in January 2020. Such an innovation explains a phenomenon in which a simple, convenient, and more affordable solution, in an industry previously dominated by a more expensive and more complicated service, can become the norm

Introduction of Unproven and Expensive Tests and Therapies to Alter Immune Mechanisms

Immunology and reproduction are intimately combined in human physiology; however, the mechanisms whereby the uterus accepts the fetus and allows it to flourish remain unclear, at least in the human. The introduction of unproven and expensive tests and therapies to alter immune mechanisms around conception has spread throughout reproductive medicine. Specialists in this discipline need to understand more of the immune physiology of reproduction and be more conservative in the use of therapeutics until evidence-based data become available. For guidance on how to implement telemedicine at an academic center or in a community practice setting, its integration with electronic medical records, regulatory issues, and reimbursement, the reader is referred to several recent reviews. Telemedicine, in addition to serving other needs, allows patients to receive care without leaving home, while spending less time in a waiting room, on demand, and in less time. As is the case with many aspects of our lives how we shop, how we interact, and how we maintain relationships—the world has changed. The health care marketplace is also changing. Telemedicine has the disruptive potential to continue to move forward as a purpose-built business model, to encourage a successful transition.