Companies embrace videoconferencing with doctors
May 24 2015
CT Post/Stamford Advocate/Danbury News Times
By Amanda Cuda
Dr. Mia Finkelston sees the same kinds of cases as most family doctors — people with seasonal allergies, parents who worry whether their children’s sniffles should keep them out of school the next day and the usual assortment of rashes, viruses and other ailments.
The difference between Finkelston and most other family physicians is that a large portion of her patients never set foot in her office.
Instead, the Maryland-based doctor examines these patients, some of whom live in Connecticut, via videoconferencing.
She’s one of several doctors available through Anthem Blue Cross/Blue Shield’s new LiveHealth Online app, which allows customers to seek non-emergency medical care via their computer, tablet or smartphone. Instead of heading to an office, patients simply log on and can arrange a consultation with one of several doctors throughout the country. LiveHealth Online is one of many services allowing patients to receive treatment without leaving their homes.
Others include MDLive, a telehealth service that has partnered with the insurance company Cigna to provide services to members. A number of local doctors, including some from Stratford-based Northeast Medical Group, provide medical care through MDLive, as well.
Many of these services have doctors available 24 hours a day, seven days a week, allowing, for example, a busy professional to get a nagging cough checked out after he or she gets home from the office at night.
Finkelston, who has been practicing telemedicine for several years, said although she doubts these kinds of programs will totally replace office visits, they do play a valuable role for many families.
“I really think the biggest advantage of these services is convenience,” she said. “You save a heck of a lot of time on non-emergency care.”
Dr. Amit Rastogi, interim CEO of Northeast Medical Group, echoed those sentiments, and said services such as MDLive increase the odds that patients will see a doctor when they need one.
“It’s very challenging for patients to have access to primary care physicians,” Rastogi said. “This is a great way for us to keep patients out of the ER who don’t need to be there.”
However, some in the medical community take issue with some telemedicine services, including Dr. Robert Russo, president of the Connecticut State Medical Society. Russo said though there is a place in medicine for these kinds of programs, patients often can’t get the kind of care they would receive from a physician who knows them personally.
“It breaks the patient-physician bond because no medical information travels with the patient (to the telemedicine doctor),” said Russo, a radiologist based in Bridgeport.
Filling a niche
Anthem introduced LiveHealth Online to Connecticut group members in September, and to individual and Medicare members at the beginning of this year.
The purpose of the program was to offer customers fast, around-the-clock medical help while also allowing them to avoid the hassle and expense of traveling to an urgent care center or hospital emergency room, said Dr. Peter Bowers, medical director for Anthem Connecticut.
“Doctors’ offices can’t be open 24/7,” he said. “For the right clinical scenario, we think it fills a niche in the marketplace.”
The “right clinical scenario” is a non-emergency medical problem that can be easily addressed via a video consultation — anything from a mild sore throat to diet and nutritional advice. Years ago, these are the types of complaints a patient would take directly to a primary care physician or other family doctor. But, with an ongoing shortage of these kinds of professionals, getting a fast appointment is sometimes easier said than done.
There’s also the matter of those medical issues that happen outside of regular office hours, such as a child who develops a cough or low fever on a Sunday evening.
Finkelston said much of her business comes from precisely those kinds of Sunday night calls from parents wondering how serious their child’s ailment is.
“They’ll say ‘Can I send him or her to day care? Can I go to work?’ ”
The service offers a variety of doctors, many of whom, including Finkelston, are licensed to practice in Connecticut, even if they aren’t based there.
The company is looking to connect with physician groups in Connecticut about participating in LiveHealth Online, and is already establishing a relationship with Farmington-based Pro-Health Physicians.
Anthem is one of several insurance companies to try to tap into the growing interest in online doctors’ visits.
Others include UnitedHealthcare, which announced in April that it was expanding coverage options for virtual physician visits. Cigna, meanwhile, began offering MDLive services to certain customers in 2013.
Northeast Medical Group, which houses the outpatient practices affiliated with Yale-New Haven Health Services, began its partnership with MDLive about a year ago, hoping to provide patients with better access to physicians and to keep people with non-life-threatening problems out of the emergency room.
Rastogi said the group didn’t have the capability to establish its own telehealth platform, and decided to work with an existing service. About a dozen Northeast Medical Group doctors are credentialed to use the service, and Rastogi said so far the partnership seems to be working well.
Pros and cons
Indeed, convenience seems to be the advantage most mentioned when it comes to telemedicine.
Joanna Leach, 45, of Meriden, said LiveHealth Online saved her significant time earlier this year when she had a cold that wouldn’t go away. Leach knew she should see a physician but “my personal doctor is three towns away.” Instead, she decided to try LiveHealth Online.
She flipped open her laptop, opened the Anthem app, and set up a profile. Based on that, she was presented with a list of doctors licensed in Connecticut that she could “visit.” Ultimately, she picked a female internist and “within five minutes, I was face to face with her.”
The doctor had Leach take a deep breath, which inspired a coughing fit. She was eventually diagnosed with bronchitis and prescribed medication.
“It was a very cool, very convenient experience,” Leach said. “I felt it was almost more personal than an in-person visit. You’re face to face with them on the monitor. They have to pay attention to you and not breeze through the visit asking questions off a clipboard.”
Telemedicine services are not only convenient, but potentially money-saving.
Anthem members are charged a regular doctor’s office co-pay for using Live-Health Online. The program is available to non-members for a fee of $49, paid online. That’s significantly cheaper than an emergency room visit, which, depending on the patient’s illness, could cost several hundred dollars, or even a visit to an urgent care center, which could cost into the $100 range.
But some, including Russo, see disadvantages to these kinds of services.
Russo said he isn’t wholly opposed to telemedicine — particularly services that allow patients to connect with their regular physician or practice after hours. The problem he sees with services such as LiveHealth Online is they connect patients with doctors who don’t know them or their medical history.
LiveHealth Online only keeps records of visits made through the service — meaning its doctors typically don’t have access to a patient’s history prior to his or her first LiveHealth Online visit.
John Jesser, vice president of provider engagement strategies for Anthem, said quick or urgent care clinics often lack access to a patient’s medical records. “This (service) really is just a backstop for when a doctor is not available.”
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