From the Archives: Written in September, 2009 - Online Consultations are an essential form of patient care

Online Consultations are an essential form of patient care   Doctors Provide the Service §  31 % of physicians reported using online communication with their patients in 2007, 25% in 2006, 24% in 2005, 19% in 2003 [1]   Payers Recognize the Service §  The top 5 health insurance companies ( United Health Group, WellPoint, Aetna, Humana, Cigna) cover online consultations [2] §  More than 100 commercial payers around the nation reimburse one or more telemedicine procedures  [3] §   The top 5 health insurance companies reimburse doctors for online consultations [4] Patients Like the Service §  76% prefer online consultations to interact with their doctors [5] §  62% of patients said the ability to talk to a physician electronically would affect their choice of doctors [6] §  57% of those with commercial insurance said they would use online consultations [7] §  75 % would like to be able to e-mail their doctors for consultations [8] §  1 in 2 consumers surveyed said they’d be likely to seek healthcare through online consultations [9] §  Patients ranked the virtual mode of online consultations as valuable as face-to-face consultations [10] §  35% of Medicaid respondents indicated they would likely use online consultations [11] §  37% of adult internet users are willing to pay to communicate online with their physicians, corresponding to $4 billion in 2002 [12]   Drivers to improve current state Online Consultation Technology -          50% of text based consultations yield an in-office visit o    Serialized, time-lapse communication impedes the Doctors ability to create a “differential moment” -          Doctors are motivated to maximize Online Consultations, thus freeing precious in-office visits for their most serious, and highest paying patients. They demand the most comprehensive form of Online Consultation available -          Much of the online communication with patients today is unreimbursable(email) because the structured communication necessary to meet Payer requirements is not conducive to effective patient care o    Doctors communicate without reimbursement because §  They care §  Customer Service/Competitive Advantage §  They want to keep their waiting room unclogged(but at the expense of not getting paid)   Why VR Improves Online Consultations -          Voice communication coupled with unlimited access to Charts & History, create a comprehensive, yet extremely efficient context for diagnosis o    Virtual Online Consultations can be as simple as quick Q/A, or as involved as complete EMR review with physiology simulations o    VR efficiently creates a real-time, multi-sensory, intuitive context for diagnosis o    If we agree that the best way to diagnose a patient is to consult with them in the office §  And if we can further agree that in-office visits could be improved for enabling diagnosis ·         Can we then say that an environment that simulates a doctor’s office, but vastly improves on shortcoming of the doctor’s office, would provide an environment capable of producing better diagnosis and treatment recommendations? o    Simulation(75% as good as in-office) + 50% VR Improvement(by doing things not possible in the doctor office) = %125 as good as in office §  Excluding diagnosis that require specialized equipment or visual exam -          Doctors who communicate online with patients in most cases are not reimbursed for the consultation o    Doctors are using available forms of communication, but are not getting paid for the service o    VR creates a structured environment in which a payable transaction occurs, and effective diagnosis and treatment can be administered -          Current State Online Consultations are rigid, and require the patient to do some self-diagnosis in order to begin the process: Fatigue, Sore throat, etc. o    In many cases, patients are not able to accurately self-diagnose, but are aware of a problem o    While statistically in may be true that many diagnosis can be classified into a few categories(Cold, Flu, etc.), this is the result of diagnosis, and not where the process begins.  A vast variety of symptoms may present, but after consultation can be slotted into a few categories -          Online Questionnaires are confusing to the patient o    Autonomous Virtual Nurse greets the patient, and solicits patient information using a combination of keypad entry and voice recognition §  A friendly voice, a clinical atmosphere, a person of authority/assistance o    This can be the reception when you arrive for a scheduled visit o    This can also be the new questionnaire Size of the Market §  70% of all doctor visits are for information only or for matters that can be handled over the phone [13] §  79% said that they would not like to use their mobile phones as an alternative method to contact their doctor [14] §  57% said that they would be likely to use an online forum or chat room monitored by their doctor technology for consultations[15] §  50% said they would be likely to access their healthcare via Internet or other computer technology [16] §  35% said they found getting through to someone via online methods the most Frustrating about e-Health Care Experiences [17] §  50% said they would be unlikely to access their healthcare via telephone consultations [18] §  25% said it takes more than 30 days to get an appointment with their doctors & 10% said they’ve had to wait 3 months or longer [19] §  90% of the visits patients made needed to be made in person. The remaining 10 percent fell into a category where the doctor’s diagnosis relied largely on a patient’s description of the ailment. (list included conditions such as headaches, certain urinary tract infections, dermatitis, and back pain)     Accessibility §  81% of household within the US have some sort of PC in their home, 92% of which have internet [20] §  90% of US physicians have high speed internet  [21] [1]  Manhattan Research Survey, 2007 ; EmaxHealth, 2006, TransformerMED [2]  PWC, 2009, etc. [3]  HealthCare Industry, 2008 [4]  Dallas News,2008 [5]  PWC, 2009 [6]  AM NEWs, 2007 [7]  PWC, 2009 [8]  Health Tracking, 2005; RelayHealth 2007; Business Tech, 2009; PWC, 2009; KP, 2009 [9]  PWC, 2009; 2006 Harris Interactive/Wall Street Journal survey [10]  Boston Globe, June 09; HealthCare Blog, April 2009 [11] PWC, 2009 [12]  Science Direct Text [13] PRLog, 2007 [14] PWC, 2009 [15]  PWC, 2009 [16] PWC, 2009 [17] TransformerMED [18] PWC, 2009 [19] PWC, 2009 [20]  PWC, 2009 [21] EmaxHealth, 2006