Explosive growth of Virtual visits

Crédit photo : eurodentaire.com
Crédit photo : eurodentaire.com

An eVisit, for those unfamiliar, is a medical consultation between a licensed healthcare provider and an eligible patient, which can occur over several communication mediums, for common, non-emergency ailments or for long-term management of health conditions. Especially in the U.S and Canada, eVisits’ popularity has increased explosively during the last 2 years.


 

 

According to a recent report of Deloitte, the number of e-Visits will reach around 100 million globally at the end of this year (1). Furthermore the rising popularity of e-Visits could potentially benefit the healthcare system around 5 billion a year (1). Another research by Parks Associates forecast that patient visits via videoconferencing alone,are about to triple , from 5.7 million in 2014 to over 16 million in 2015, and will skyrocket to over 130 million in 2018(2).

 

How does it work?

 In an eVisit, a patient logs into her secure personal health record Internet portal and answers a series of questions about her condition. This written information is sent to the physician, who makes a diagnosis, sents an e-prescription if necessary, puts a note in the patient’s electronic medical record (EMR) and replies to the patient via the secure portal (6). eVisits typically focus on nonurgent conditions, such as allergies, asthma, cold and flu, rashes, ear infections, sore throats, and urinary tract infections. If the condition is urgent, the patient is directed to a local emergency department. If the condition requires an office visit, the patient is told to contact his or her doctor. If the patient doesn’t have a physician, a local doctor is suggested.

 

How can we explain its rising popularity?

Besides the obvious convenience, efficiency and lower cost for the patient, eVisits can be provided by the patient’s own primary care physician instead of a physician at an emergency department. In addition telehealth in general can improve the communication between patients and their physicians, for example to transmit a CT or X-rays for a second opinion. Last November (2013), The University of Pittsburgh Medical Center (UPMC) renewed its patient portal and rolled out AnywhereCare, offering patients throughout Pennsylvania eVisits with doctors 24 /7 either over the phone or through video conferencing (3).

UPMC said its AnywhereCare service has an 80% satisfaction rating. According to Natasa Sokolovich, executive director of telemedicine at UPMC, patients loved the convenience and speed of eVisits.

eVisits rising success and adaption can also be explained by the potential ways an eVisit can be beneficial for a physician. Given the fact that a virtual visit lasts around 10 minutes, the physician can add a nice supplement to his/here’s regular income if they want to (4). A timely virtual visit with a doctor, on major networks like American Well where the wait time is about 10 minutes, can identify who needs hands-on care right away and who can benefit from remote treatment. This can prevent a borderline condition to become more serious during the days/weeks a patient has to wait to get a face-to-face appointment with the doctor. Furthermore eVisits have the potential to reduce the workload of a doctor by ‘off-loading’ the work/stress to their portable device and work from home. It can also increase the flexibility of a physician by offering consultations at a time convenient for them.

The Affordable Care Act is also a key factor in the evolution of eVisits (5). This act accentuates on decreasing healthcare costs while increasing quality through standardized methods of care. eVisits have already shown to reduce the overall cost of healthcare : UPMC saved an average of $86.80 per member visit compared with the cost of an office visit (3), while the report of Deloitte projects a 5 billion annual reduction on the cost of healthcare (1).

Although very promising the main concerns about eVisits center on quality issues: whether physicians can make accurate diagnoses without a face-to-face interview or physical exam, whether the use of tests and follow-up visits is appropriate, and whether antibiotics might be overprescribed (6). Further studies on the clinical impact of eVisits are a necessity considering its rising popularity.

 

To conclude eVisits can become an important player in the healthcare system keeping in mind that today the global healthcare practices focuses on decreasing costs, reducing exposure to the spread of diseases, and preventative early detection and intervention to decrease the burden of diseases. This market, in developed countries, is projected to be around 50-60 billion with an annual growth of 50% (1,2) .

 

 

Sources:

  1. Health care current: August 19, 2014; weekly insights to keep you informed and ahead. Deloitte. August 19, 2014. http://www.deloitte.com/view/en_US/us/Insights/Browse-by-Content-Type/Newsletters/health-care-current/d6afb1d319de7410VgnVCM2000003356f70aRCRD.htm#Imp5 Accessed September 4, 2014.
  2. Parks Associates: doctor-patient video consultations will nearly triple from 5.7 million in 2014 to over 16 million in 2015. Parks Associates. August 25, 2014. http://www.parksassociates.com/blog/article/chs-2014-pr10
  3. How UPMC got patients, physicians and payers on board, Healthcare informatics, 27 November 2012 ; http://www.healthcare-informatics.com/article/making-evisit-work
  4. Frequently asked questions. American Well, Accessed November 08, 2014 http://www.americanwell.com/FAQs-online-doctor-visits.html Accessed August 28, 2014
  5. The Affordable Care Act ( ACA), Accessed November 08, 2014 http://obamacarefacts.com/health-care-reform-timeline/
  6. Ateev Mehrotra, MD, Suzanne Paone, DHA, et al; A Comparison of Care at eVisits and Physician Office Visits for Sinusitis and Urinary Tract Infections, JAMA Intern Med. Jan 14, 2013; 173(1): 72–74.

 

 

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