Is there a Doctor in the Mouse?

July 14th, 2009 | Sources: Wall Street Journal


This post first appeared on the Practice Fusion blog.

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.

NowcoughtwiceBig 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. 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.


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