The New House Call- Telehealth is Bringing the Doctor Back Home

woman video chat with DrWatch any movie set in the late 19th or early twentieth century where someone has taken ill and inevitably, a doctor will arrive at the patient’s home, black bag in hand, and sit next to them in their own bed to take a look. In fact, this is the origin of the term “bedside manner”.

In the 1930’s house calls were standard practice for physicians. Approximately 40 percent of doctor patient visits happened in the patient’s home. By 1950, this had decreased to 10 percent, and by 1980, to about only 1 percent. –American Academy of Family Physicians

In a way, some of this shift to medical care at a dedicated facility outside of the home makes sense. A physician at an emergency room (ER) for example may need access to a CAT scan machine, an MRI machine, a cardiology lab, or a lab for blood work. It is hard to imagine all of this being taken to the patient’s home in that traditional little, black doctor’s bag. The propagation of the modern day insurance system also played a part in the reduction of house calls by physicians due to their policy for reimbursement on these type of visits.

The house calls, for all intents and purposes, are gone. However, the march of technology and the need to better allocate the limited resources of a physician’s time, while reducing the cost of medical care are bringing back the house call in an innovative new way.

Enter Telehealth.

Telehealth as a concept has been around for some time, but it seems that the introduction of new technology alone is not enough to tip the scales. You need an accompanying change in the attitudes and acceptance of the technology by the patients themselves. You also need acceptance of the technology by both the medical community, as well as by the medical insurance system to assure payment. For the last few years, these needed changes had been slow to materialize, however today the pendulum has begun to swing in favor of telehealth.

A recent Harris Poll showed that 66% of people surveyed are open to visiting with their doctor over video. The appeal of convenience and shorter wait times were strong drivers of this willingness. Another interesting revelation in the poll was that for “middle of the night” care, 21% of respondents indicated they would choose a video visit. This may on the surface seem low, but when you consider the fact that 17% said they would call a 24 hour nurse line, and an additional 5% indicated they would use an online symptom checker, the result is that 43% of the respondents chose methods that did not require seeing a doctor in person. That means telehealth in some form has now reached the same level of preference as a visit to the ER, (44% chose this method), when it comes to middle of the night care.

For obtaining prescriptions, an overwhelming 70% of respondents said they would prefer a video visit with the doctor. Prescription refills, birth control, antibiotics, and prescriptions for chronic illness are all situations that align well with online consultations.

Doctors Matter

Another telling finding in the Harris Poll on telehealth was that doctors still matter. Just because patients are willing to meet with a doctor over video doesn’t mean that they are willing to meet with any doctor available. In fact, 88% of those polled wanted the ability to choose their online doctor just as they would their primary care physician (PCP). 7% of respondents said they would be willing to switch PCPs to get video visits, which indicates that adding telehealth services would not dramatically attract new patients to a practice, but would create opportunities to retain more existing patients, especially younger patients who would be more likely to leave.

Doctors do indeed matter, and not just in a patient’s choice of physician, but also in the doctor’s choice to use telemedicine in their practice. As stated above, doctors do not currently face a mass exodus if they choose not to employ telehealth. However, doctors who have made the leap have found they can offer the same quality of care and positive patient outcomes when they utilize HD video for patient visits.

“The first thing I do when I treat a patient is I look at their face,” said Dr. Peter Antall, President and Medical Director of the Online Care Group, which provides telehealth services. “A person’s facial expressions and body language give me an understanding for their overall well-being that could be missed over the phone. Beyond that, video gives me an opportunity to see skin rashes or tonsils – important signs when making a diagnosis. With the HD-quality video, I can assess the patient closely and provide a diagnosis that will produce the best possible outcome.”

This aligns well with the Federation of State Medical Boards’ policy recommendations of utilizing both high quality audio and video in telehealth.

Cost of Care

The survey shows that 62% of patients expect telehealth visits to cost less than an in person visits. This is a reasonable assumption, and has proven to be true in reality. Studies have shown that “telehealth visit saves about $100 or more compared to the estimated cost for in-person care.”  Given these savings, it seems odd that insurance companies have been slow to embrace reimbursements for these visits.  Today however, 22 states now have laws requiring that telehealth visits be paid in the same way as traditional office visits, and the Affordable Care Act also has rules in place that will continue to pave the way for increased technology in healthcare.

With consumer attitudes on telehealth dramatically shifting, insurance policies rapidly changing to allow for telehealth reimbursements, telehealth’s innate cost advantages, and the growing acceptance of telehealth in the medical community based on realized positive outcomes, it is no surprise that telehealth is poised to revolutionize healthcare.  It all adds up to one thing.

The house call…is back!

 

Avidex AV is revolutionizing the way healthcare facilities and doctors are delivering care. Their 20 years of experience is being leveraged to drive down the cost of care while promoting positive healthcare outcomes.  Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

 

Resources:

#1: http://www.aafp.org/afp/2011/0415/p925.html

#2: http://www.fiercehealthit.com/story/patients-increasingly-open-video-doctor-visits/2015-01-23

#3: http://cdn2.hubspot.net/hub/214366/file-2374840622-pdf/TelehealthConsumerSurvey_eBook_NDF_Electronic_Version_(2).pdf\

#4: http://www.fiercehealthit.com/story/new-york-enacts-telehealth-parity-law/2015-01-12

 

Joel Harris

About Joel Harris

Joel Harris brings invaluable insight to the Avidex team in his role as CEO, with years of experience leading national technology, healthcare and business organizations. You can reach Joel at jharris@avidexav.com

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