Technologies That Let Patients Consult with Physicians via the Web ... Spreading Rapidly

[CC-Conrad Clyburn-MedForeSight]

Colleagues,

As reported in US News and World Report ... (See quote from MedTech-IQ member, Jay Sanders at the end of the article!) ...

Donita Gano woke up one Sunday morning with a problem. The 59-year-old public-health nurse had fallen and gashed her elbow about 10 days before. Now it was warm and inflamed, signs of probable infection. She logged on to an online clinic launched early this year by her health plan, Hawaii Medical Service Association, and chose an available physician. She clicked on "Connect now," and soon she and the doctor were engaged in an online chat about her symptoms. If she'd had a webcam and if the doctor had been amenable, she could have displayed her elbow for his inspection. He ordered an antibiotic, which she picked up right after logging off. "Pretty painless," says Gano...

... A 10-minute "visit" costs $10 for members and $45 for nonmembers, paid with a credit card. HMSA says thousands of patients have registered ...

... The technology behind the HMSA program, created by American Well, a Boston company, is being picked up by other health insurance plans. Blue Cross & Blue Shield of Minnesota launched a pilot version this fall and plans to offer it to all members by mid-2010. A recent partnership between American Well and OptumHealth, a division of UnitedHealth Group, will take Online Care nationwide to all consumers, regardless of insurance provider. Then there is MDLiveCare, a national service with more than 100,000 members who may or may not be covered by a healthcare plan and who pay a flat $35 per online visit to consult with primary-care providers, specialists, and therapists in the network...

... Many Americans are would-be prospects for online care. Half say they would be interested in using the Internet not only as an information source but to receive healthcare directly, according to a recent survey by an arm of PricewaterhouseCoopers...

... About 10,000 individuals, most of them residents of the New York metropolitan area, can already get an online (or phone) emergency consultation with one of 34 ER physicians who have signed on with a company called SwiftMD...

... Paients in Brooklyn, N.Y. ... have the option of joining Hello Health. After an initial face-to-face visit, patients pay $100 to $200 an hour for each encounter, whether it's in person or online ... the $35 monthly membership fee covers unlimited E-mail exchanges with Hello Health doctors. Online, patients can see their doctor's schedule and make their own appointments ... Hello Health is in the process of rolling out nationally...

"Given the economic crisis that we're in," says Jay Sanders, president emeritus of the American Telemedicine Association, "we're dramatically reducing costs." These technologies are unlikely to replace office or hospital visits entirely, says Sanders. But they are tools physicians can add to an evolving "electronic black bag,"...

Read on at: http://health.usnews.com/articles/health/living-well-usn/2009/10/27...

[Joseph Kvedar]

its great to see access to this mode of care growing. As citizens become more accustomed to these offerings, they will get out of the habit of assuming one needs to visit the provider to 'make care happen'. However, access does not equal utilization. i have not seen any of the firms offering this kind of service publish statistics on utilization. So one must continue to be a bit skeptical that the adoption challenge has been fully met.

[CC-Conrad Clyburn-MedForeSight]

Joe,

Thank you for your cogent and thoughtful comment. Though these developments appear encouraging, we will have to monitor closely to assess whether they ultimately bear lasting fruit.

By the way, congratulations on what I have heard was another exceptional "Connect Health" conference. We all appreciate your continued leadership as we transform the way healthcare is conceived and delivered.

CC

[Brice Drogosch]

Hello CC;

Mirial delivers a Video ACD solution that is currently providing access to ASL agents to support the deaf community with access to many "hearing" related services. For example, a deaf person enters an emergency room and needs to have medical attention, a nurse or medical staff can simply call into the Video ACD and have immediate access to a ASL signer to help deliver the needed communication.

According to recent researches, 78% of healthcare consumers are willing to interact with physicians online, over 85% of physicians would rely on web services to simplify their operations and 90% of them see the Internet as a source of competitive advantage.

Other studies show that in the area of psychiatric care or counseling (schools) that use of video can deliver a greater access to health care and counseling support. There are also some studies that show a that a young student is more responsive to a video counsultation thaand less inhibited by the physical presence.
Mirial has published a white-paper on a Video ACD that can be utilized to deliver these type of capabilities very cost effectively.

Here is the link if interested: http://www.mirial.com/solutions/Telehealth.html

[CC-Conrad Clyburn-MedForeSight]

Brice,

Thank you for the useful information on the ASL application for the deaf community. I was unaware of this development, and appreciate you sharing it with the community. When you get a chance, you may want to post some information on Mirial. It sounds like an interesting approach you are pursuing.

CC

[Sean Khozin, MD, MPH]

As the physician using the Hello Health platform featured in the US News and World Report, I have found that "virtual" consultations--ie, video, IM, and email--are reducing the number of in person follow up visits in my practice and have enabled me to create continuity of care between office visits. By being remotely connected to my patients, I'm able to better manage complex issues, especially those of patients with chronic diseases and multiple comorbidities. Furthermore, virtual connections between care providers can enable more effective care coordination and health information exchange.

[CC-Conrad Clyburn-MedForeSight]

Sean,

Thank you for the illuminating comment. It is good to see that what many advocates have contended, that connected health would better streamline and integrate care delivery, is your experience in real world practice. I think that the advent of readily available Web 2.0 tools will accelerate this transformation of care delivery more rapidly than many have anticipated. What are your thoughts from the frontline?

CC

[Didier Chabanol]

Hello,

Very interesting blog. I post this comment to present our activity which are related to telehealth. IVèS is providing hosted video-assistance services based on total conversation platform (live video, audio and text). Those services meet the uses of everyday life for deaf, blind or medically monitoring people. More precisely today it is to provide :
- phone for the deaf (video relay service)
- remote visual help for reading or moving in an urban environnement for the blind
- caring for someone remotely (social ties and tracking medical data)

We advocate the need for interoperability, ie to implement industry standards in order to connect to our platform devices from other suppliers (medical sensors, video phone, ...) and so that users can choose the most appropriate devices. We have, in particular, incorporate Web 2.0 technologies.