Health Care and Technology

Health system offers virtual appointments

Spectrum’s on-demand care will link patients with doctors via email and video.

November 27, 2015
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(As seen on WZZM TV 13) When you’re sick, the last thing you feel like doing is to go see your doctor, but, until recently, if you called your doctor’s office looking for an over-the-phone diagnosis or prescription, you were met with, “You’ll have to make an appointment to see the doctor.”

As Spectrum Health grapples with the changing needs of its patients, it began quietly offering virtual appointments with primary care providers and specialists for certain ailments.

Dr. Doug Apple, chief medical officer at Spectrum Health Medical Group, said over the past year, patients who called in and met certain guidelines were referred to virtual appointments, allowing them to “visit” a doctor via email or video.

“We were able to see a lot of patients through this type of care,” Apple said.

He said 2,000 patients saw clinicians virtually in the last year.

Spectrum is now ready to roll out the program on a much larger scale, offering on-demand care, specialty care and monitoring care to patients via secured video or email on a 24/7 basis. Apple said he expects between 5,000 and 10,000 patients to use the program annually as it becomes more widely promoted.

According to the website for MedNow, patients in need of care for the following symptoms who have access to Wi-Fi and a credit or debit card can utilize MedNow appointments: allergies, back pain, bites and stings, cough, cold and flu, diarrhea, earache and pain, fever, headache, heartburn, nausea/vomiting, pink eye, rash/hives, sinus problems, skin eruptions, smoking cessation, sprains and strains, urinary symptoms or vaginal discharge.

Patients will be charged $25 for an e-mail visit and $45 for a video visit, according to Spectrum. Appointments may cost less depending on a patient’s insurance.

Video appointments allow a clinician to gather the necessary medical history and visual observations needed to make a diagnosis.

“There is a lot that can be done that doesn’t require you actually touching the patient,” Apple said.

He said virtual appointments will likely end with the patient receiving a diagnosis that might include a prescription or an over-the-counter drug recommendation, a referral to another doctor, or an appointment for the patient to come in for an in-office visit.

“If it’s a rash and we know its poison ivy through the visit, we can prescribe something through a formal prescription or recommend something over the counter,” Apple said. “If it doesn’t look like poison ivy and it looks to be something more concerning that requires a visit, we can help facilitate that.”

Patients who have a diagnosis will be able to benefit from video appointments with specialists through Specialty MedNow. According to the website, virtual appointments are available for the following issues: behavioral health, cardiology, diabetes education, limb care preservation, oncology, pediatrics vascular services and wound care.

The following additional services are expected to be added to the Specialty MedNow program soon: bariatrics, palliative care, pediatric nephrology, pediatric intensive care, pulmonology, sleep medicine and vascular.

Apple expects advances in technology will increase clinicians’ ability to see patients virtually in the future, particularly those in need of monitoring appointments for chronic illnesses and disease management.

“As technology gets better, we will be able to connect to different devices that will allow us to do more virtually hands-on,” he said. “For instance, my Apple Watch calculates my heart rate and it can monitor EKG activity. We can also look at what will happen with blood pressure monitors as they become wireless and they connect to health records.

“The better technology becomes built into our health records, the better we will be able to interact with patients in real time for more acute illnesses or managing disease states.”

He added, “A patient with diabetes, for example, today we see those patients in an office every three months for about 15- to 30-minute visits. We ask the patient how have you been since your last visit, are you following your diet, what are your glucose levels, do you have any symptoms or complaints. The reality is, a lot of times patients don’t have any new complaints or challenges with their diabetes. We send them on their way and see them again three months later.

“But what are we doing to partner with patients in those days in between appointments? I think we will get to a point where we will be monitoring with patients. When they take their blood sugar, it will pop up in a health record, where somebody will know — is it in control or out of control, are you taking your medications, do you have any concerns with your medications, what has changed day-to-day to affect your health?”

Apple said there are two benefits of MedNow that stand out: increased access and flexibility for patients, and cost savings. He noted MedNow offers consultations with clinicians 24/7, so patients can pick a time that works for them. They save time by not having to travel to and from a doctor’s office and from not having to wait for the appointment.

Patients also will likely save money.

“We have been able to prove that this mode of delivering care is less expensive,” he said.

He said the hope is the trickle-down effect of this less expensive delivery model will impact insurance premiums, bringing the total cost of health care down for everyone.

Apple said since Spectrum began offering virtual appointments, the reaction has been positive.

“We’ve found, not only for patients but for the providers that are performing the service, that the satisfaction is high and our outcomes have been if not the same, better,” he said.

For anyone nervous about accessing health care virtually, Apple said Spectrum takes patients’ safety and security seriously.

“We don’t want this information to be in the wrong hands,” he said. “It has to be with the patient in mind and making sure we are protecting their information but yet we are answering their call when they are sick or even when they are trying to manage a disease.”

Spectrum said all MedNow interactions are performed through a secure system and are in compliance with HIPPA law.

Apple said, in the long term, the key to MedNow’s success will be increasing access, utilizing the technology available and making sure it remains an affordable option.

He said national brands offering this type of service are seeing exponential growth.

“It is considerably increasing,” he said. “I think that speaks to the demand from customers and patients … because of how our days are busy and we don’t have a lot of free time.

“I think this is going to become part of how we work with patients going forward.”

The program is currently only available for adults, but Apple said pediatric services will be sometime in early 2016.

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