Wal­greens, in­sur­ers push ex­pan­sion of vir­tual doc­tor vis­its in Amer­ica


Mil­lions of peo­ple will be able to see a doc­tor on their smartphones or lap­tops for ev­ery­day ail­ments once the na­tion’s largest drug­store chain and two ma­jor in­sur­ers ex­pand a bud­ding push into vir­tual health care.

Wal­greens said Wed­nes­day that it will of­fer a smart­phone ap­pli­ca­tion that links doc­tor and pa­tients vir­tu­ally in 25 states by the end of the year. That growth comes as Unit­edHealth Group and the Blue Cross- Blue Shield in­surer An­them pre­pare to make their own non- emer­gency telemedicine ser­vices avail­able to about 40 mil­lion more peo­ple by next year.

Doc­tors have used video feeds and other tech­nol­ogy for years to treat pa­tients in ru­ral ar­eas or re­mote lo­ca­tions. But ex­perts say grow­ing smart­phone use and cus­tomer de­mand are fu­el­ing a rapid ex­pan­sion of the prac­tice, called telemedicine, into ev­ery­day care the fam­ily doc­tor used to han­dle. Now this push is gain­ing an ad­di­tional boost from health care com­pa­nies with broad, na­tional reach.

The Amer­i­can Telemedicine As­so­ci­a­tion es­ti­mates that about 450,000 pa­tients will see a doc­tor through the In­ter­net this year for a pri­mary care con­sul­ta­tion. That’s a small slice of the roughly 15 mil­lion peo­ple who will have care de­liv­ered by telemedicine, which has mostly been used by spe­cial­ist doc­tors. But the pri­mary care por­tion has prob­a­bly dou­bled over the past cou­ple years, said Jon Link­ous, CEO of the non­profit as­so­ci­a­tion.

“I would say with­out a doubt it’s the fastest area of growth in telemedicine,” he said. “There’s this con­ve­nience fac­tor that makes it so com­pelling to con- sumers.”

Drug­stores, gro­cers and big re­tail­ers like Wal- Mart have been open­ing clin­ics in­side their stores for years now, giv­ing pa­tients sev­eral less- ex­pen­sive al­ter­na­tives to a doc­tor’s of­fice when they need help. In­ter­net doc­tor vis­its aim to of­fer even more con­ve­nience by pro­vid­ing care wher­ever the pa­tient is lo­cated.

Pro­grams of­fered by Wal­greens Boots Al­liance Inc. and the in­sur­ers give cus­tomers around- the- clock ac­cess to doc­tors who can di­ag­nose and treat con­di­tions like al­ler­gies, a si­nus in­fec­tion or pink eye that don’t re­quire a phys­i­cal exam.

‘ Only us­ing telemedicine for

cer­tain con­di­tions’

The ex­tent of the care a pa­tient re­ceives can vary by state. Some reg­u­la­tors pre­vent a doc­tor from us­ing a telemedicine visit to write pre­scrip­tions for con­trolled sub­stances or abor­tion- in­duc­ing medicines. Some states also re­quire a doc­tor to have an es­tab­lished re­la­tion­ship with a pa­tient, which might in­clude a phys­i­cal or men­tal exam, be­fore al­low­ing them to do a telemedicine visit.

Th­ese vir­tual vis­its can cost around US$ 49 for pa­tients with no cov­er­age or in­sur­ance that makes them pay a high de­ductible. That com­pares with typ­i­cal prices of US$ 70 for a clinic or more than US$ 100 for a doc­tor’s of­fice visit.

Wal­greens started testing its app last De­cem­ber on smartphones and is ex­pand­ing it to both tablets and per­sonal com­put­ers.

Unit­edHealth Group Inc., the na­tion’s largest health in­surer, just started cov­er­ing telemedicine vis­its ear­lier this year for about a mil­lion peo­ple with em- ployer- spon­sored health plans. The in­surer aims to ex­pand that to 20 mil­lion cus­tomers next year.

An­them Inc. started its LiveHealth On­line ser­vice in 2013 by of­fer­ing it to a few thou­sand peo­ple. It now pro­vides the ser­vice in 44 states and also ex­pects 20 mil­lion of its cus­tomers to have ac­cess by next year.

Doc­tors say telemedicine can help im­prove ac­cess to care for many pa­tients, as long as the care is good, a record of the pa­tient visit makes it back to that per­son’s regular doc­tor and safety isn’t com­pro­mised.

Dr. Robert Wer­gin ex­pects to do more telemedicine vis­its in the fu­ture as more in­sur­ers begin to cover it. The Mil­ford, Ne­braska, doc­tor said it can help many of his pa­tients who are older and have a hard time get­ting out of the house.

“I can see a real there,” he said.

But the pres­i­dent of the Amer­i­can Academy of Fam­ily Physi­cians also cau­tioned that telemedicine has lim­its. He noted, for in­stance, that one of his pa­tients re­cently wound up hav­ing quadru­ple by­pass surgery af­ter com­ing to see him for a burning sen­sa­tion in his chest. The physi­cian could rule out acid re­flux as a po­ten­tial cause by ex­am­in­ing the pa­tient’s ab­domen, some­thing a doc­tor couldn’t do in a vir­tual visit.

Wal­greens said the doc­tors in its pro­gram are trained to quickly de­ter­mine whether a pa­tient needs more care than they can pro­vide dur­ing a vir­tual visit.

“We’re very care­ful in only us­ing telemedicine for cer­tain con­di­tions that are amenable to this,” Wal­greens Chief Med­i­cal Of­fi­cer Dr. Harry Lei­der said. “We’re not treat­ing heart at­tacks.”


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