Virtual Medicine Provides Faster, Easier Access to Care
Jul 29, 2019 11:17AM
● By Vanessa Orr
There’s nothing worse than coming down with a massive case of poison ivy during the summer—except for having to take time to make a doctor’s appointment, leave work, sit in a waiting room, undergo an exam and wait in line to get your prescription.
The good news is that through virtual visits, you don’t have to do any of these things—and you can get the medicine you need to start healing more quickly.
Virtual doctor visits, a form of telemedicine, have made it much easier for patients with noncritical issues to receive a diagnosis from medical professionals without ever having to leave home. Other programs under the telemedicine umbrella, like telestroke, telepsych and remote monitoring programs, also provide patients with access to physicians like they’ve never had before.
“Virtual urgent care visits, such as those provided by UPMC AnywhereCare, provide a fantastic way for patients to have their exams done remotely via a video visit,” explained Dr. Andrew Watson, medical director for telemedicine at UPMC and past president of the American Telemedicine Association. “In most cases, it is equally effective as an office visit, and in some cases, it’s even better than face-to-face care.
“There are real benefits to the patient, such as the speed with which they can get an get exam and an opinion from a licensed clinician,” he added. “It’s faster to do it from home, especially for people who live far away from medical facilities. There’s no chance of getting get stuck in traffic, and people are saving the expense of travel, gas, tolls, time off from work, and the cost of childcare. This all adds up, especially in rural communities.”
As technology is changing, so is the way that healthcare systems are using it to reach patients.
“Today’s disruptive technology has so many uses; just look at everything that our phones can do,” said Angela Pantelas, director of strategy and operations, Telehealth for Allegheny Health Network. “We wanted to utilize these capabilities for serving patients. Seeing the backlog of patients in physicians’ offices, we began to brainstorm about the best way to leverage technology to mitigate issues in a way that was secure and compliant with HIPAA and HITECH security and privacy rules to provide more patient access.”
How it Works
For patients who are familiar with FaceTime and Skype—and even those who have never video-chatted before—the technology is easy and user-friendly. Using a mobile phone, tablet or desktop device with a camera and Internet connection, patients just log on to their healthcare accounts through their provider’s website. A debit or credit card can be used to pay for the visit.
“AnywhereCare Virtual Urgent Care is cheaper than an in-person primary care or urgent care visit,” said Dr. Watson, adding that all UPMC Health Plan members also benefit from favorable cost sharing for virtual visits that in many cases reduces the copy to $5 or even free. The AnywhereCare app collects the correct copay for a member’s benefit via credit or debit card at the time of service.
“AHN patients simply go to their MyChart account and choose a time slot to schedule an appointment,” said Pantelas. “Whether they do this through their phone or online, they can connect to a video feed that allows them to talk to a provider in real time.”
Primary Care video visits with an AHN provider are considered a covered benefit by most Highmark insurance plans so patients only pay their usual copays. For all others, it’s a $49 fee.
AHN also offers primary care e-visits, which is a logic-embedded electronic questionnaire that a patient can fill out to provide information about his or her condition. Based on how the patient responds to the questions, he or she may be asked for additional information, which the provider will use to diagnose the problem and issue a prescription if needed.
“It’s incredibly convenient; I personally experienced the value of this platform when I woke up with an advanced case of bronchitis on a Sunday morning. I did a video visit and had a prescription that afternoon,” said Pantelas. “The last thing you want to do when you feel lousy is get dressed and go to the doctor; and if your pharmacy delivers, you never have to leave your home.”
“What I like is that you don’t take the chance of getting any sicker than you already are by sitting in a doctor’s waiting room,” added Matt Milligan, senior project manager, Telehealth for Allegheny Health Network. “With a video visit, there’s no prospect of walking out with what someone else has.”
Another advantage is that when these visits are scheduled within a patient’s electronic medical record, all of the records are kept in one place and can be accessed by any of their physicians.
“This is true continuity of care, as opposed to using a third-party platform,” said Milligan. “Your doctors have access to your personal health records though Epic, so they know your medical history.
“With a third-party platform, there is a lot of upfront information required, which is a lot to digest for the provider, and that information doesn’t always flow back into the patient chart,” he added. “With an AHN video visit, the next time you see your doctor, all of that information will be in your permanent record.”
Virtual medicine can be used for most noncritical issues, including sinus infections, upper respiratory infections, bronchitis, flu, conjunctivitis, cough and sore throat, rashes, eye irritation, urinary problems and more.
“If a person is experiencing an emergency, this is not the right platform to use,” said Pantelas about symptoms including shortness of breath, chest pain, or pain radiating down the arm. “We have had a number of scheduled video visits triaged before the appointment when the nurse practitioner looked at the description of what the patient was experiencing and reached out proactively to get them to the ER.”
The Evolution of Telemedicine
UPMC has been providing UPMC AnywhereCare for several years and has also expanded video visits into other areas through its remote monitoring program.
“We are a national leader in remote patient monitoring, which we use for patients with congestive heart failure and postpartum hypertension, among other conditions,” said Dr. Watson. “Patients can use their home phone, or we send a tablet home with them so that we can keep track of their blood pressure and other factors, and increase or decrease medication as necessary. In the case of postpartum hypertension, for example, we measure the mother’s condition for six weeks after birth.”
Dr. Watson has used this technology to take part in more than 500 pre- and post-op consults, and there are approximately 600 patients live every day in the remote monitoring program across a diverse number of service areas. UPMC also provides other teleprograms on the system side, including consult centers.
“It’s just natural and so easy,” he said. “In many ways, it’s like laparoscopic surgery—it’s different than what we were used to, but in many ways, it’s much better. The era of minimally invasive surgery changed the whole medical landscape, and telemedicine has the same potential.”
Allegheny Health Network began using telemedicine in 2011 starting with its flagship telestroke program, and its use has continued to grow.
“We started with a very small telestroke program, doing about 25 consults a month with a couple of small hospitals,” said Pantelas. “Since that time, we’ve expanded to having nine hospitals in our telestroke network, and in the last five years, we’ve introduced 26 other virtual medicine programs across 14 specialties.”
Since these programs were started, more than 19,000 patients have taken advantage of telemedicine options, some of which are direct to consumers and others that are embedded within various specialties. Programs include teleneurology, telederm and telepsych, as well as an oncology genetic counseling program and a pre-op program for bariatric surgery.
“Telemedicine is extremely critical for a number of patients,” said Pantelas. “A patient with ALS, for example, may be physically compromised and can’t travel. They miss visits, which compounds the complexity of the disease state.
“Through our telemedicine program, these patients can stay home and virtually connect with their physicians,” she continued. “The progression of the disease can be monitored, and they can receive treatment instead of staying home with their health continuing to deteriorate.”