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Doctor on Demand Stats Offer Insight Into Telmedicine Trends

Posted on January 5, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Recently, direct-to-consumer telemedicine provider Doctor on Demand released some statistics on its performance in 2017. While some of the report was self-congratulatory, I still think the data points are worth looking at, especially for clinicians.

For starters, it’s worth noting that the company now considers itself a fully integrated medical practice. For example, it’s begun offering lab testing services through Quest Diagnostics and Lab Corp. as part of a program to control chronic conditions such as diabetes, high blood pressure and high cholesterol levels.

Another factoid the stats offer is that its physicians are generally in their mid-career; apparently, Doctor on Demand’s average physician has 15 years of experience. The company doesn’t offer any perspective on why that might be, but it suggests to me that clinicians who participate are both confident that they can manage care remotely and comfortable with technology.

Why is that the case? My guess is that this work may not be attractive to younger doctors, who might feel uneasy managing patients online given their lack of experience. It also suggests older physicians, some of whom still consider telemedicine to be a poor substitute for face-to-face care, probably aren’t engaging with telemedicine either.

Other data provided by Doctor on Demand includes the top reasons for visits included treatment of cold and flu, prescription refills and infections, which isn’t surprising. It also notes that mental health visits climbed 240% over 2016, with anxiety, depression and stress being the most common symptoms treated. This is more interesting, as it suggests that among other problems, consumers feel they aren’t getting their mental health needs met in real life.

Meanwhile, when it comes to the company’s self-reported benefit statistics, I’m taking them with a large grain of salt, but I found them to be worth a look nonetheless. The company says it saved its patients nearly $1 billion in healthcare costs and saved over 1.6 million hours that would otherwise have been spent in doctor’s waiting rooms. These results were allegedly generated by a base of 1 million patients, according to the San Francisco Business Times.

I’m not writing this to suggest that Doctor on Demand is better or worse than other telemedicine companies and video services offered by privately-employed physicians or hospital telemedicine services. Still, I got a kick out of learning what trends a well-positioned telemedicine service was seeing in the marketplace. While Doctor on Demand’s results may not reflect the market as a whole, they certainly offer food for thought.

One Example Of An Enterprise Telehealth System

Posted on August 30, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

While there’s a lot of talk about how telehealth visits need to be integrated with EMRs, I’m not aware of any well thought-out model for doing so. In the absence of such standardized models, I thought it worth looking at the approach taken by American Well, one of a growing list of telehealth firms which are not owned by a pre-existing provider organization. (Other examples of such telemedicine companies include MD Live, Teladoc and Doctor on Demand.)

American Well is now working with more than 170 health plans and health systems to streamline and integrate the telehealth process with provider workflows. To support these partners, it has created an enterprise telehealth platform designed to connect with providers’ clinical information systems, according to Craig Bagley, director of sales engineering for the firm.

Bagley, who recently hosted a webinar on EMR/telehealth integration for AW, said its system was designed to let providers offer telehealth consults labeled with their own brand name. Using its system, patients move through as follows, he said:

  • First, new patients sign up and enter their insurance information and demographics, which are entered into AW’s system.
  • Next, they are automatically connected to the provider’s EMR system. At that point, they can review their clinical history, schedule visits and get notifications. They can also contact their doctor(s).
  • At this point, they enter the telehealth system’s virtual “waiting room.” Behind the scenes, doctors can view the patients who are in the waiting room, and if they click on a patient name, they can review patient information collected from the EMR, as well as the reason for the visit.

Now, I’m not presenting this model as perfect. Ultimately, providers will need their EMR vendors to support virtual visits directly, and find ways to characterize and store the video content generated by such visits as well. This is becoming steadily more important as telemedicine deployments hit their stride in provider organizations.

True, it looks like AW’s approach helps providers move in this direction, but only somewhat. While it may do a good job of connecting patients and physicians to existing clinical information, it doesn’t sound as though it actually does “integrate” notes from the telehealth consult in any meaningful way.

Not only that, there are definitely security questions that might arise when considering a rollout of this technology. To be fair, I’m not privy to the details of how AW’s platform is deployed, but there’s always HIPAA concerns that come up when an outside vendor like AW interacts with your EMR. Of course, you may be handing off clinical information to far less healthcare-focused vendors under some business associate contracts, but still, it’s a consideration.

And no matter how elegant AW’s workaround is – if “workaround” is a fair word – it’s still not enough yet. It’s going to be a while before players in this category serve as any kind of a substitute for EMR-based conferencing technology which can document such visits dynamically.

Nonetheless, I was interested to see where AW is headed. It looks like we’re just at the start of the enterprise-level telemedicine system, but it’s still a much-needed step.