When you’re coming down with a cold, there are a few items you typically reach for to start feeling better: cough drops, herbal tea, maybe an over-the-counter medication. For most of us, though, having the ability to talk to a doctor online wouldn’t top that list. But that may change as health care companies increasingly steer customers toward streaming video apps that help patients talk to doctors more frequently.
The push towards talking with a doctor online comes as many primary physicians are over-booked and patients struggle with their own busy schedules. At the same time, insurers and employers see an opportunity to save money by reducing pricier visits to doctors’ offices and urgent care clinics.
Outsourcing care is not new. In rural areas, doctors have long relied on telephone and video connections to consult with specialist doctors far away.
But this year an estimated 450,000 patients will talk with doctors online to ask a basic medical question or receive medical advice for ailments like colds, infections or aches and pains, according to the American Telemedicine Association industry group. Here are some key questions and answers about these virtual visits
.Q: How do online doctor visits work?
A number of companies allow consumers chat with a doctor through a smartphone, tablet or computer. Typically patients are routed to local doctors, over a secure highly encrypted network, to a doctor who is licensed to practice and prescribe medicine in their home state.
In the last year, several leading health care companies announced they would begin incorporating telemedicine into their offerings. Walgreens is currently rolling out a similar version that offers the ability to talk to doctors online in 25 states. Meanwhile, UnitedHealth Group and the Blue Cross-Blue Shield insurer Anthem prepare to make telemedicine services available to more than 40 million people by 2016.
This increased adoption is partially a response to recent law changes in 29 states requiring health insurance companies to cover telemedicine delivered via online video or over the phone. Additionally, the programs appeal to consumers and their employers by reducing time lost to traditional doctor appointments.
“The ability to talk to a real doctor within minutes from your phone is something that people really value,” says Dr. Jonah Feldman, a health care delivery specialist at Winthrop University Hospital.
It depends. If you’re in one of the states that require insurance coverage of telemedicine, you may not owe anything — or you may only owe your standard co-pay, which can range from $15 to $25. But even without insurance, you may still save money. Most online doctor consultation charge about $40 to $50 per session, which is half the typical charge to see a primary care doctor at a physical location.
The savings could be even greater compared with an emergency room visit, which typically costs hundreds of dollars. Many people who don’t have insurance go to the emergency room as a last resort when other health providers won’t see them.
Those savings have attracted interest in the technology from large insurers and employers.
“If I’m managing a health plan, I clearly don’t want someone to go to the emergency room for coughs, colds, sneezes or urinary infections,” said Dr. Ford Brewer, an executive with MDLive, which provides online consultations for Humana, Cigna and other companies.
Most online services specialize in treating easy-to-diagnose conditions, including colds, ear infections, rashes and allergy problems. Doctors in telemedicine companies can usually prescribe from a small list of common medications. The prescription is typically sent electronically to a pharmacy near the patient.
Virtual visits can also be effective in addressing mental health issues like anxiety and depression.
Brewer says the demand for online therapists is driven by the same issues affecting primary care doctors.
“There’s just not enough access out there in the country,” Brewer says. “So you have that ability for mental health providers, as well as primary care docs, to be able to see more patients, provide more access online.”
It’s important to note that the level of care available to patients can vary by state. For instance, some states require a doctor to have an established relationship with a patient, which might include a physical or mental exam, before allowing them to do a telemedicine visit.
Telemedicine companies are generally not designed to handle medical emergencies and will instead direct patients to call 911. Likewise, they will not attempt to treat complex, chronic diseases like cancer, Parkinson’s disease or Alzheimer’s.
Finally, experts say most companies will not write prescriptions for addictive painkillers or non-essential medications like Viagra.
“Patients should not expect to get controlled substances, lifestyle drugs or anything that’s going to raise eyebrows,” says Nathaniel Lacktman, an attorney who specializes in telemedicine.
Going to the doctor can be frustrating: It costs money and time, and often very little of that time is spent with the doctor you’re there to see. Many people in the tech industry want to change that with telehealth services. Telehealth will allow you to talk with doctors online and complete an entire doctor’s visit from anywhere you are located.
The concept has been around since the 1990s, but now the movement is gaining steam. About 52 percent of hospitals used telehealth technology as of 2013, and 74 percent of consumers say they would use telehealth if offered, according to the American Hospital Association.
The rise in telehealth is partly due to its potential to increase access to care for patients in rural areas and for the disabled or elderly, but it also modernizes health care.
“People do everything online or on their cellphones— banking, learning, buying. This is the way health care has to go, too,” says Dr. Kevin Biese, vice chair of emergency medicine at the University of North Carolina’s medical school. Biese online doctor service to follow up with and advise patients he sees in the emergency room.
While some telehealth services are best for certain populations, almost anyone can find benefit. The next time you think you need to squeeze in a doctor’s appointment, you may be able to save yourself the hassle with an online visit. The trick is knowing when and how to use telehealth to get the care you need quickly and at a low cost.
Telehealth refers to any health service delivered over technology such as a follow-up visit by phone or video conference. Telemedicine, another term you may have heard, is the type of telehealth that involves medical testing using devices or apps that can measure vital signs and transmit them to your doctor in real time.
Telemedicine is more useful for monitoring disease, complicated pregnancies, and postoperative care. For example, you may have had multiple doctor visit or spent days in the hospital just for safety monitoring after surgery in the past. Now, portable medical equipment and mobile apps can deliver your doctors the same information from the comfort of your home.
Telehealth visits are usually simpler. Especially for elderly or vulnerable population groups, Biese says, it’s better to talk with doctors online for follow-up visits and minor questions. That way, it’s easy for those patients to avoid leaving home in poor health.
Doctors can also do initial consultations over video chat. For example, if a child injures his ankle, his parent can use their mobile device with a video call to show the swelling, and the doctor can then advise whether an emergency room visit or x-ray is even necessary.
“Quite often, they would’ve gone to the ER for just a sprain, and urgent care would provide the same benefit at a much lower cost,” Biese says.
Specialists often use telehealth to keep up with their regular patients. People with mental illnesses can have a brief chat with their therapists while on vacation or away at college— or those who use daily medications can discuss side effects, switching, or refilling their prescriptions over video chat with their physicians.
If you have a chronic condition, consider searching for mobile apps for disease management; some provide access to doctors and other disease experts. If your condition requires frequent doctor office visits, talk with doctors online to reduce unnecessary trips and save yourself time and money.
Insurance and state governments are seeing the value in telehealth solutions. Currently, 31 states have adopted a bill to require insurance companies to reimburse patients for telemedicine, especially for online doctor visits. Insurance companies recognize online doctor visits as a way to increase health coverage efficiency to drive the cost of health care down.
Medicaid programs in every state offer some sort of coverage for telemedicine, however, some details may differ. Such as Medicare which requests that patients make themselves available at a medical facility while seeing a doctor, while other programs will allow doctor visits from work or home. The Center for Concerned Health Policy has a map of the 50 states and District of Columbia that can assist you with understanding how the Medicaid program handles telehealth in your state.
If you’re uninsured or don’t have a telehealth benefit, you can still use services like Chat Live MD. While telehealth services enables you to s p e a k with your own doctor, others let you interact with a doctor you don’t know for simple questions — great for the uninsured and those without a primary physician. Most are available as apps, and usually cost under $100 per visit.
If you are insured your health insurance may include a telehealth benefit; most major insurers do. Commonly, telehealth visits for minor ailments and questions are covered except for a copay or low flat rate, usually under $50. Your health plan’s website will have the full details, so check to see what’s available.
“Doctors are catching on that patients want more mobile access to care, so those who aren’t jumping on board now will start,” Biese says.
Simply asking about it may be enough to give your doctor that nudge to use it.
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