Telehealth Growing as a New Way to Practice Medicine

By Brian T. Horowitz  |  Posted 2011-02-02

Telehealth Growing as a New Way to Practice Medicine

When a president touts face-to-face video chats between doctors and patients in a State of the Union address, as President Obama did Jan. 25, it's clear that telehealth has made strides as a real option for doctors, pharmacists and patients, particularly for military veterans in rural areas.

Telehealth allows health care professionals and patients to connect in real time through a Web or phone connection.

While addressing the need to increase coverage of high-speed wireless networks to 98 percent of all Americans within the next five years, President Obama dropped a mention of telehealth: "This isn't about faster Internet or fewer dropped calls. ... It's about a firefighter who can download the design of a burning building onto a handheld device; a student who can take classes with a digital textbook; or a patient who can have face-to-face video chats with her doctor."

Through insurance companies such as OptumHealth, WellPoint and Blue Cross Blue Shield, doctors and patients are using the Online Care telehealth platform from American Well to connect through Internet video chats or simply voice in real time.

Other companies in the telehealth space include Epic Systems, RelayHealth and Kaiser Permanente with its KP OnCall product.

From their homes, patients can hold video chats with pharmacists through pharmacy chain RiteAid. In the stores, they can use a computer and Webcam in a "semiprivate space" to consult with physicians, according to Dr. Roy Schoenberg, president and CEO of American Well, which launched Online Care in January 2009.

"We can completely revolutionize the expectation of the pharmacy," Schoenberg explained to eWEEK. "When a patient is going into pharmacies, they can actually get care there-see a physician, then walk over and fill [the prescription].

In addition to availability to all residents in Hawaii as well as areas of New York and Texas, all residents of Minnesota can access the service. Blue Cross Blue Shield of Minnesota was one of the first companies to offer telehealth technology to its employees and later rolled out the service to all residents in the state. Telehealth sessions cost $45.

Janel Woods, a manager in learning development at Blue Cross in Egan, Minn., participated in a pilot session for Online Care. When her 8-year-old son was getting migraines during soccer season, she turned to Blue Cross Minnesota's Online Care Anywhere portal for help. She was concerned about missing work and her son missing school. So both she and her son held a video chat with a doctor through a Webcam.

"The physician ended up sending me some research," Woods told eWEEK. "I happened to use it more as like a consultation. I wanted to find out if there were less costly solutions," she said.

Telehealth Growing as a New Way to Practice Medicine

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In another instance, Woods sought help through Online Care for pink eye. "I had my eye up to the camera," Woods said. And a doctor responded with an eye-drop prescription. For a more serious condition or in-depth exam, Woods heads to the doctor's office, however.

Still, patients can consult with doctors remotely for urgent ailments such as strep throat and urinary-tract infections. Users also can log on to Online Care to seek help for conditions such as sinusitis and bronchitis.

The service could be ideal for chronic or acute conditions in which an exam isn't necessary and also provide immediate access to a specialist who patients would otherwise have to wait weeks to see, such as waiting 60 days to get an appointment with a rheumatologist, Schoenberg said.

Telehealth could also be helpful for patients who may have difficulty leaving their homes, he said. Rather than getting out to see their doctors every one or two months, they can consult with a physician each week, Schoenberg said.

During an Online Care session, physicians access the patient's clinical data and activate a video chat or phone call to diagnose conditions and prescribe medication. The Online Care physician then sends a record of the visit to the patient's primary doctor. Patients can consult with doctors in areas such as pediatrics, ob-gyn, internal medicine and urgent care.

Schoenberg noted that the technology allows doctors to work as much or as little as they want and let the system know when they're available-especially those who might otherwise consider retirement.

"It's something that's disappeared over the last 20 years, their ability to practice as much as they like from wherever they like and continue to have a life, instead of being confined to having to show up at a practice, leaving at 6 in the evening," Schoenberg said.

"We see more and more physicians making themselves available who would otherwise be off the grid," Schoenberg noted. "We are replenishing the grid of primary-care physicians."

Telehealth visits borrow security measures from the banking industry, according to Schoenberg. "From a security standpoint, we've literally assumed into the system the same approach that the banking industry has-identification encryption," he said. "The same standards that have to do with assuring consumers that their interaction will be with a trusted provider and cannot be abused by anyone else," he added.

"It's a completely secure, confidential and intimate encounter between patient and physician," he said.

"A video is not an easy stream to tap into network-wise," Dr. David Ellis, director of telehealth for the department of emergency medicine at the University of Buffalo, told eWEEK. "You can do it, but if it's encrypted and secure, you have the confidence that you're dealing with a secure environment."

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