Prompted by increasingly permissive reimbursement policies, digital office visits--in which patients and physicians use computers to manage clinical issues that traditionally necessitate an office visit--are growing faster than biceps on steroids.
Big Insurers from Aetna to WellPoint are experimenting with such programs, which are a time-savers for everyone and less expensive than a schlep to the doctor’s.
“If…there is payment for it, we will see many more primary-care physicians doing it,” Ted Epperly told the Wall Street Journal. The president of the American Academy of Family Physicians said that at the moment, about 3% of his organization’s members offer digital office visits.
Physicians agree that the new format is best reserved for simple stuff; colds and flu, urinary infections, back pain and sleep disturbances for example.
Even in such instances, some offer the option only to patients they know, mostly as a hedge against malpractice.
And no physician in her right mind would go this route for symptoms that could spell trouble, like chest pain--any kind of pain really--or abdominal symptoms, which are notoriously difficult to diagnose without a physical exam.
The field is still in shake-out mode, with many formats for the interaction being tried in many venues across the country. The simplest approach is using secure, HIPAA-compliant email . Practice Fusion will support this activity as part of its Patient Health Record scheduled for release in Q1, 2010.
In another format, patients must complete symptom-specific algorithms in advance of the actual interaction. The snazziest approach involves live, online visits using Web video, chat or a phone conversation routed for privacy purposes through a secure computer system.
In a joint experiment of the latter approach, American Well and the Hawaii Medical Service Association combined to offer such services to enrollees, who pay a $10 co-pay for the privilege.
For non-insured online visits, the going rate around the country seems to be about $20-35 a steal when compared to the cost of the old-fashioned schlep.
Glenn Laffel, MD, PhD, Sr. VP Clinical Affairs
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