Skype with Doctors

[Brandon]

https://www.yahoo.com/tech/google-testing-service-to-connect-patients-with-doctors-99906328684.html

 

Buddy just sent me this and it's exciting. The start up I work with does exactly this, but we do preventative and after/post care with it. I won't get into the ppm, but it's virtual medicine and aside from just doctors we also have all other aspects of healthcare.....therapists, psychiatry, nutritionists, etc.

 

Pretty exciting times plus Obamacare is pushing healthcare this way as companies and employers look for alternatives to reduce their rising healthcare costs.

 

There are a couple of companies that do what Google is trying....it's really just an advancement of the old EAP model. However, the AMA are pushing this model and recently released a pretty big supporting article and new telemedicine laws were updated to allow easier access for doctors to practice across state lines for this model.

 

Excited to not have to wait in a doctors office and pay less for doctors visits?

[Tank]

speaking of rising healthcare costs . . . we just got the bill for my last ER visit for a kidney stone. the CT scan cost a whopping $13k. my 6 hour visit cost a total of $19k.

[Brandon]

Yeah, it's absurd. Part of the reason companies like our are really being pushed.....offset costs.

 

It's going to be the next big thing as Google seemingly gets, but a benefit is lower costs for non-emergent visits/care.

 

Every time someone goes to the doctors their insurance gets dinged $250 with then comes back to bite them in the butt come renewal time.

 

What if someone could visit a doctor for $40, the same as a co-pay, and without it hitting their insurance their renewal rates go down?

[Vegas Halo Fan]

I went to a correctional health care conference a couple of weeks ago and I saw a live demonstration of a telemedicine system that the Maryland Department of Corrections is using. We do some telemedicine, but not on the scale that these guys do. Theirs uses a freestanding system on a rolling stand with a rotating camera head that can be turned left or right, raised, lowered, zoomed in or out and focused from either end. One of their doctors in our lecture room conducted a physical assessment of an inmate patient in a prison facility back in Maryland. They have one of their physicians stand by with the inmate in case the remote doctor has questions or wants to hear breath sounds or heart rhythms (obtained through an electronic stethoscope that transmits wirelessly to the main unit). Impressive stuff. In our setting in particular, it eliminates the time and expense of transporting inmates to outside offices, the difficulty of coordinating appointments with transportation availability, and if an appointment is canceled on short notice (which happens more often than we would like, for a variety of reasons) the doctor is still in his own office and he can resume seeing patients. He doesn't have to clear a large block of time to see inmates. It also allows a physician to schedule inmates to be seen before or after his office visits. Patients also don't have to see inmates being escorted through the clinic in restraints, which bothers some people.

Edited November 7, 2014 by Vegas Halo Fan

[Brandon]

Yeah, when I first got involved with my company one of the first things I started working with were companies and software/hardware designers for these same type of kiosks. There is so much room for change or efficiency in this window of healthcare.

 

In the long run what you will see is people using telemedicine from home instead of doctor visits, but also large companies will have a dedicated space or office in their company that hosts the same kiosk and attendant for what essentially is an on-site doctors office. They are under construction now, but not really being implemented just yet. The attendants don't need to be doctors (lower costs), just know how to operate and asset consumers with the machines....heck, some of the kiosks I've talked with don't even have the attendants, but instead have attached or unlockable items like stethoscopes, heart rate monitors, etc. that if the doctor needs the patient to use can unlock the little box and let the patient get and use whatever items the doctor needs.

 

Another thing that is going to happen is something you alluded to. Doctors are going to be CEO's or the equivalent of real estate brokers and oversee a staff of PA's. They will still have their normal practice, but will hire PA's and simply have them run the virtual medicine portals to see patients...no different than a doctor visit. Let's say a company like ours pays their doctors $150 an hour, but they can put a PA in the portal and they pay the PA $70 an hour.......they are making $80 an hour doing nothing but overseeing them the same way they do now, but with better records as everything is HIPAA compliant and has an integrated EMR system. At the same time doctor visits on average take 7 1/2 minutes (excluding the time they have to look for and go over your chart/records which are now unnecessary with an electronic EMR system) to see a patient and diagnose them. Thus, more people are being seen per hour.

 

It's an exciting time. Google jumping in makes everyone else open their eyes. The AMA just released an article about China approving methods and procedures for doctors to start engaging in virtual medicine (looks like I may be going to China sooner than I thought). Wal-mart is also beat testing similar kiosks in conjunction with the CVS minute clinic in store model to start providing healthcare in store like pharmacies have started to do.

 

A lot of innovation happening in healthcare as people are tired of rising costs and shit like Obamacare.

[Blarg]

So do they provide the patient with their own rubber glove and lube when the doctor tells them to bend over and cough?

[red321]

So do they provide the patient with their own rubber glove and lube when the doctor tells them to bend over and cough?

 

No, they have a probe that comes out of the wall.

 

On an unrelated note these kiosks are also being marketed to adult bookstores and toyshops.

[Brandon]

Probably, the ones I looked at were b2b companies.

 

The toyshops make a lot of sense.

[Tank]

"Wal-mart is also beta testing similar kiosks in conjunction with the CVS minute clinic in store model to start providing healthcare in store like pharmacies have started to do."

 

while at disney world last year, my daughter had something fly into her eye and scratch it. it was recommended to us to visit an in-store nurse at either the local wal-greens or CVS just outside the confines of disney world's property. we chose wal-greens, and were concerned because this was something we'd never heard of. fortunately, it was a minor injury and easily treated, and it didn't take very long. we felt like we received professional care and were satisfied with the results.

[Brandon]

That's the goal, and it was a lot cheaper.

 

There are always going to be cancers and serious ailments that affect a work force and their insurance or needs where someone is in a serious car accident. The main goal is those costs are always going to be there (and are around ~88% of the overall costs, but only about ~8-14% of insurance claims and issues when it comes renewal time), so cut costs everywhere else and non-emergent visits to an online portal to see a doctor or simply going to a kiosk save companies and consumers  millions.

 

That Tank type of scenario is a perfect example of what it's intended to do and implementation.

[NJHalo]

One of the Lyme Disease specialists I work with does this for patients that come from longer distances.

 

They fly to NYC for their initial visit, then he Skype/Phone consults them the next two months. He sees them every 3rd month in person.

 

It helps keep their costs down, and is easier on a semi -disabled person.

 

He has patients from Australia, Bermuda, UK, Canada, West coast of US, Brazil, etc.. 

[Brandon]

A lawyer I work with grabbed this from LinkedIn today.

 

Telemedicine Could Be Cost Saver

Lee GerberDirector at Benefits-USATop Contributor

The American Medical Association claims 30 percent to 40 percent of people in emergency rooms and 60 percent in doctors' offices do not need to be there. These statistics will get worse as we add many more insured people.

One solution is telemedicine, which represents 5 percent of the health industry now, but which some project to expand to 30 percent in three years.

What began as a way for patients far from specialized care to connect with a doctor, is evolving into an increasingly popular way for workers to avoid taking time off for minor illnesses. While tech giants provide on-site clinics and doctors for their workers, telemedicine allows even smaller employers to provide a similar, if not identical, service for their workers.

Some of the largest employers who have their own health centers are adding or will soon offer telemedicine services. A Towers Watson survey of onsite health centers this year said 28 percent of employers will offer telemedicine benefits by the end of next year, up from 8 percent now. Notes the report: In addition to on-site centers, organizations are looking to telemedicine as another way to reduce time spent in doctors’ offices and delays in securing appointments. The decrease in travel and wait times associated with visits to primary care physicians can have a direct impact on employee productivity. It reduces time away from the work site as well as time lost at the work site due to worries about a health condition or making appointments. Telemedicine is being used both on a stand-alone basis and as a complement to on-site services.”

Some employers are opting to offer a supplemental type of telehealth service. Often an adjunct to an employer health plan, these programs enable workers who opt in to have access to a doctor 24/7. Most of these supplemental programs offer direct physician consults, including diagnosis and prescriptions, but only for a limited number of conditions. Outside these, patients are directed either to their local doctor or, in serious cases, to an emergency room.

[www.benefits-usa.com/express]www.benefits-usa.com/express

[mp170.6]

One of my doctors says the major impediment to telemedicine is the red tape put up by the insurance companies. 

 

He said they use an "office visit" as a unit of measure, and that a Skype, e-mail, text message doesn't fit into that template.  Doesn't matter that the same positive result is achieved (meds prescribed, etc) they don't want to offer comparable compensation for the service the doctor provides. 

[NJHalo]

^^^^^^

Bingo

 

The doctor I was referring to is out of network only, so he doesn't have to deal with the BS, but his patients do. They know this ahead of time.

Edited November 10, 2014 by NJHalo

[Brandon]

One of my doctors says the major impediment to telemedicine is the red tape put up by the insurance companies. 

 

He said they use an "office visit" as a unit of measure, and that a Skype, e-mail, text message doesn't fit into that template.  Doesn't matter that the same positive result is achieved (meds prescribed, etc) they don't want to offer comparable compensation for the service the doctor provides. 

 

From a doctor perspective, I can see the concern. Doctors like to max out their billing to insurance companies. However, telemedicine companies are often independent and don't use or go through insurance companies....that's part of the appeal of the industry, people can go to a third party company for petty stuff like sinus infections, etc. instead of going to a doctor and dinging the main health insurance which affects renewal rates.

 

Ironically, we have had no issues with doctors signing up or wanting to be part of what we are doing. Some of it is what I posted above with the PA scenario and some of it is simply working from home in an environment where they don't have to mess with insurance.

 

Another thing we do, and I don't know why more people do this, but we have insurance codes for people so they can get reimbursed through their insurance and allow people to use their healthcare savings account (HSA) and flex spending accounts (FSA) which are huge as they allow people to write off the healthcare money spent.

 

It seems like there are articles coming out at least once per week where states or medical associations are approving telemedicine use or starting the process of altering or creating laws for doctors to work across state lines.

[mp170.6]

From a doctor perspective, I can see the concern. Doctors like to max out their billing to insurance companies. However, telemedicine companies are often independent and don't use or go through insurance companies....that's part of the appeal of the industry, people can go to a third party company for petty stuff like sinus infections, etc. instead of going to a doctor and dinging the main health insurance which affects renewal rates.

 

Ironically, we have had no issues with doctors signing up or wanting to be part of what we are doing. Some of it is what I posted above with the PA scenario and some of it is simply working from home in an environment where they don't have to mess with insurance.

 

My doc said he's willing to earn less doing telemedicine during normal business hours.  He doesn't need as many nurses or receptionists when he sees a patient online.

 

He said the lunacy is with the insurance companies expecting him to offer telemedicine on weekends, evenings, holidays, vacation days, for the same reduced rate -- even if it prevents costly Emergency Room visits.  In other words, he could save them x dollars (let's say $3000) at the ER and still get paid the normal rate (say $75 or 100) even though he sacrificed his personal time and maybe sleep to make that happen.