Transformative Medicine: Patient Visits Move Online

Virtual Visits Benefit Physicians as Well as Patients

Neil Chesanow

Disclosures

September 25, 2014

In This Article

A New Source of Revenue for Physicians

Virtual patient visits -- via videoconferencing on a personal computer, laptop, tablet, or smartphone -- as well as remote visits via old-fashioned telephone, secure email, and even texting, are controversial to many physicians, who may regard a hands-on office visit as being the sine qua non of good patient care.

That's changing fast. In August, a Deloitte report predicted that the number of telehealth visits in the United States and Canada could soar to 75 million in 2014, representing 25% of the addressable market.[1] The study noted that of the 600 million annual visits to primary care practices in North America, approximately half were for problems that could be solved by remote rather than in-office visits.

To meet exploding patient demand, especially for videoconferencing, virtual physician networks are springing up across the country. They are being sponsored by insurers, health plans, employers, hospitals, and physician groups, often funded by millions of dollars in venture capital, and there appears to be no shortage of physicians who seek to join them. Here's why:

Reimbursement. You can earn in a virtual visit about what you earn in an office visit for diagnosing and treating the same condition -- or maybe a little less, depending on the state, the health plan, and the network. However, you can see up to six patients an hour (a virtual visit typically lasts about 10 minutes).[2,3] If you're productive, you can add a tidy supplement to your regular office income.

Flexibility. A 2013 Medscape survey, Physician Lifestyles -- Linking to Burnout, found that physician burnout is a significant problem in virtually every specialty.[4] Instead of working late nights in the office trying to pay the bills, you can offload some (or all) of that work -- and the stress that goes with it -- onto your mobile device, seeing patients remotely at home (or wherever) at your own pace.

Better care. For serious conditions, patients need an office or ER visit. But most conditions aren't serious. Even in borderline cases, it can take weeks to get an office appointment. Meanwhile, a nonurgent condition can become urgent. A timely virtual visit with a doctor -- on major networks, wait time is about 10 minutes -- can identify who needs hands-on care right away and who can benefit from remote treatment without having to leave home.[2,3] If medication is needed, an e-script can be sent to the patient's pharmacy during the session in most states.[5]

Ease of use. On the major networks, back-office transactions are fully automated. All you do is see the patient online. Network software identifies the patient's health plan eligibility, copay, or deductible. It processes the patient's credit card information. It identifies the value of the Current Procedural Terminology (CPT) code for the work you perform. It submits the claim on your behalf. Your reimbursement is deposited into your bank account immediately. You even receive malpractice coverage for each virtual visit.

Marketing. On some networks, you can establish an independent, branded storefront for your practice. This lets your patients interact with you or other providers in your practice virtually, sparing them from having to schedule an office visit for every complaint, however minor. In crowded metro area markets, this can set your practice apart from the rest, attracting new patients by offering them a convenience that they overwhelmingly tell surveyors they desire.

Taking risk. Seek to join an accountable care organization or start a patient-centered medical home? You may need to enter into risk-sharing arrangements with health plans to land contracts. Success will hinge on how tightly you're able to monitor patients with uncontrolled chronic conditions. Virtual visits make your practice far more accessible without having to add extra staff. On some networks, you can even arrange for cross-coverage by network physicians.

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