Survey: Telehealth Increases Access to Care, Continuity

Michael Laff Minneapolis – November 11, 2015 04:12 pm

Your patients depend on you for the best medical care, and thanks to technology, they don’t necessarily need to visit your office to receive it.

As more family physicians begin using telehealth systems, speakers at the AAFP State Legislative Conference, held here Nov. 6-7, discussed how the technology can enhance patient care and sharedfindings from a survey(www.graham-center.org)(22 page PDF) of family physicians’ thoughts about and use of telehealth.

Researchers at the Robert Graham Center for Policy Studies in Family Medicine and Primary Care said 15 percent of the 1,557 physicians who responded to the survey reported using telehealth in the past year. The survey contains some bias because respondents were more likely to use telemedicine, explained Megan Coffman, M.S., a health policy administrator for the Robert Graham Center who presented the research.

Respondents said the technology’s strongest points are improving access to care and providing continuity of care. Obstacles they cited included the cost of equipment, lack of training and potential liability.

A profile of the typical telehealth user emerged as one who:

  • is more likely to be practicing in a rural area (76 percent),
  • works with six or more family physicians (40 percent) and
  • uses electronic health records (98 percent).

When physicians were asked how they used telehealth, the leading responses were diagnosis or treatment (55 percent), chronic disease management (26 percent) and patient followup (21 percent). Physicians, whether they use telehealth or not, agreed that the technology improves access to and continuity of care. The question of whether it reduces cost has not been answered.

“There is not enough data on whether telemedicine saves money,” said Coffman. “That is yet to be seen. From a patient perspective, it saves time and money, but there is not enough information.”

Telehealth systems are good for increasing efficiency, said William Thornbury, M.D., R.Ph., the founder of an online appointment site called meVisit.(www.mevisit.com)

“We take 60 patents per day at the clinic,” said Thornbury, who also serves as medical director at the Medical Associate Clinic in Glasgow, Ky. “I can’t take any new patients. The real problem is 30 percent of my patients don’t need to be in the clinic, but the only way to get paid is to see them there. ”

meVisit’s telehealth application, available on mobile phones and computers, is designed to allow physicians to address minor health problems that do not require an office visit. Patients can select a reason for a consult from a menu or type it in themselves, and they can upload photos.

Thornbury said family physicians should consider telemedicine because retail health clinics are doing so. Walgreens plans to launch a telehealth mobile application in 25 states starting in January 2016.

“How is our health system going to compete in this arena?” Thornbury asked.

Thornbury said most patients pay a $37 copay for telemedicine visits. One of the concerns among insurers is that ease of access could lead to frequent, unnecessary consults, but Thornbury suggested that copays could be raised to solve that problem, should it arise.

States are beginning to recognize the value of telemedicine and are requiring insurers to do the same. Montana, for instance, passed a law requiring insurers to pay for telemedicine on terms equal to those for office visits.

As the medical profession moves to greater efficiency with an emphasis on reducing costs, Thornbury said family physicians should press hard for fair payment.

“Radiologists are benefiting from new technology that allows them to work faster, and they are not being asked to take less money,” he said. “Why are we being penalized for it? If we are more efficient and take on more liability, care is care is care.”

Related AAFP News Coverage
Gauging the Promise and Perils of Telemedicine
AAFP Calls for Adequate Payment, Fewer Restrictions

(6/24/2014)

Robert Graham Center Forum
Telemedicine Can Build Bridge to Expanded Health Care, Say Panelists

(2/5/2014)

More From AAFP
Member Interest Group: Telehealth

Family Practice Management: Should You Treat Your Patients Virtually?

Link to original article on AAFP

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Walgreens’ Telehealth Grows As We Warm To Digital Doctors

By: , November 12, 2015, 2:48 PM

It has also updated and improved the app, which provides round-the-clock access to MDLive’s network of U.S. board-certified doctors.

“Walgreens app-based approach is different than CVS’ in-store telehealth offering, and we’re still waiting to see what Walmart will do when it begins to roll out its option, but it’s clear telemedicine is gaining rapid acceptance,” says Jonathan Linkous, CEO of American Telemedicine Association, based in Washington, D.C. “We’ve seen more growth in the last two years than we have in the previous 20.”

Two years ago, he says, consumers had 800,000 tele-consultations with doctors, and that’s increased to 1.2 million this year. The biggest use is for urgent-care consultations with primary-care doctors, followed by mental health. And he expects a growth rate of at least 20% to 25% next year. “That’s pretty rapid, but it’s still only a drop in the bucket compared to its potential.”

“We have seen that telehealth solutions play an important role in helping to improve patient outcomes,” says Adam Pellegrini, Walgreens VP of digital health, in its release, “and we will continue to work to evolve our offerings to ensure our patients can choose what’s most convenient for them, whether that’s live doctor consultations, digitally chatting with a pharmacist or visiting a Healthcare Clinic.”

At its Minute Clinics, CVS uses telehealth to help handle patient overflow during busy times, giving customers the option of stepping into a private room for a tele-consult rather than waiting. In a recent study, it found that 95% of patients said they were highly satisfied with the quality of care and ease of use. One-third even said they preferred a telehealth visit to having a clinician in the same room.

For consumers, telehealth offers convenience and often a much lower cost than an in-office or even in-clinic visit. But Linkous says telehealth is also gaining traction because so many doctors and providers, who have been required to build elaborate patient portals, would like to offer it on their own platforms.

In a sign that Americans are cozying up to the idea of seeing a doctor via smartphone, Walgreens says it is expanding its partnership with MDLive to an additional 20 states. The retailer, which began testing the service back in December in California and Michigan, expanded to five states in June.

Link to original article in Media Post

US Behind the World in Telemedicine

September 17, 2015 •

“The recommendations balance the potential benefits and expanded use of telemedicine with the importance of maintaining the patient-physician relationship and patient safety,” Hilary Daniel from American College of Physicians, Washington, DC, said by email.

Read the entire article HERE

Telemedicine in Chronic Kidney Disease

MedicalResearch.com Interview

MedicalResearch.com recently posted an interview with Dr. Judy Tan from Mount Sinai Hospital in New York. The topic of the interview was to discuss preliminary results of her groups’ study of a tele-nephrology service.

Dr. Tan comments that chronic kidney disease affects 26 million people in the United States. As in other specialties of medicine, many patients have difficulty with access to care. In order to meet the demand of the patients at the Hudson Valley Veterans Affairs Medical Center, her group developed an outpatient tele-nephrology service. The technology uses medical video conferencing equipment and customized medical instruments such as stethoscopes. Their hypothesis is that clinical outcomes would be comparable when care was delivered via the tele-nephrology service compared to in-person visits.

As an initial step, Dr. Tan’s group has enrolled patients in the tele-nephrology program. The preliminary data shows that in the patients followed for 1 year, estimated GFR was well preserved, systolic blood pressure was reduced, urine protein-creatinine ratio decreased, and the majority of patients were on ACE Inhibitors. As a next step, the Dr. Tan hopes to prove non-inferiority to a group of patients treated with conventional in-person care. If her hypothesis proves correct, she hopes to expand services further and address other types of kidney disease.