Transformative Medicine: Patient Visits Move Online

Video Visits With Patients Are Taking Off

Neil Chesanow


September 24, 2014

In This Article

New Products and New Players

Major vendors now offer Apple and Android apps to enable patients to seamlessly meet with doctors on their mobile devices without complicated fussing. Dr. Schoenberg maintains that American Well's app is among the most popular in both app stores, with 3000-4000 downloads a day.

To extend the reach of its virtual physician network, which is staffed by the Online Care Group, American Well has launched a line of telehealth kiosks, installable on-site at employers, retail outlets, and strategic locations within health systems. The kiosks don't use computer keyboards or mice, just touch-sensitive screens, so even patients who aren't computer-literate can use them.

In addition to offering high-definition video, "the kiosks actually have biometric devices built into them," Dr. Schoenberg explains. "They measure blood pressure, weight, and other standard measures, and such devices as stethoscopes and derma-cams feed live data to physicians as well."

Providers of virtual visits aren't the only ones who see the market for remote consultations poised for explosive growth. For doctors who are in ACOs and PCMHs that take risk, the prospect of increasing patient access virtually without having to schedule additional office visits in busy practices is appealing, Dr. Schoenberg says. American Well counts ACOs and PCMHs among its clients.

A key to making risk-sharing profitable is to tightly monitor patients with chronic conditions for compliance with prescribed regimens. But what if you're not part of an advanced integrated delivery system staffed with case managers, social workers, dietitians, diabetes educators, and other dedicated support personnel?

The next best thing is to offer patients with uncontrolled chronic conditions 24/7 virtual access to a doctor. An on-call physician can field virtual requests during non-office hours, or a practice can use a cross-coverage virtual network, such as MDLIVE offers in partnership with Sentara Healthcare.

Sentara, based in Norfolk, Virginia, includes over 100 sites -- from acute care hospitals to assisted living facilities -- in Virginia and North Carolina.[21] MDLIVE doctors cover for Sentara doctors in affiliated practices after hours, notifying them of virtual interactions with patients. Patients in Sentara's coverage area who don't have a primary care physician, as many don't, are referred to one by their MDLIVE counterparts, Parker says.

Sentara is far from the only health system that sees the benefits of virtual visits. "Right now, we have 276 hospitals nationwide connected to the MDLIVE Health Cloud," Parker says. "We're going to have over 400 by the end of the year."

Telecommunications giant Verizon introduced a videoconferencing platform, Verizon Virtual Visits, in June.[22] Doctors, health networks, and hospital systems can use Verizon's platform to remotely see patients. Employers that don't have provider panels can use a virtual physician network that Verizon is building. A downloadable app makes virtual visits user-friendly for both doctors and patients.

Venture capitalists have taken notice too. A new San Francisco, California, startup, Doctor on Demand, is building a virtual network of over 1400 physicians, the Silicon Valley Business Journal reports.[23] The company has raised $24 million in funding since its founding last year, with backers that include Google Ventures and Athena Health CEO Jonathan Bush. The firm already has a major corporate client: Comcast, which will offer the service to its US employees.

"In the past 12 months, we have been turning the corner, and this is now running like crazy," Dr. Schoenberg says. "We are no longer in the incubation or the novelty physician stage. We're now moving at a pace in which people are talking about how we can scale this. What are all of the areas of medicine that this can be applied to? How do we use this to keep elderly patients at home longer? How do we democratize healthcare and make it equally accessible all around the country? How can we lower costs? How can we help physicians practice in a way that gives them a better lifestyle, because we're burning physicians out of the profession? All these things are all happening at once."


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