Coming to a screen near you
John Hearne speaks with Mary O’Brien, founder of VideoDoc, an Irish company that offers companies access to an online doctor consultation service via mobile phone, plus technology for GPs to do likewise
VideoDoc, offers companies access to an online doctor consultation service via mobile phone, plus technology for GPs to do likewise.
With doctors’ waiting rooms overflow with seasonal flu victims, the dilemma for many patients centres on trying to get to see the GP without risking contracting something worse. One solution is to see the doctor without actually leaving the house.
It’s called telehealth, and it’s all about harnessing telecommunications to help improve health outcomes.
VideoDoc is an Irish firm that offers an online doctor consultation service via web and mobile, and also offers the technology directly to GPs to offer these facilities to their own patients.
Co-founder and CEO Mary O’Brien acknowledges that one of the key challenges the company faces lies in teaching people what online consultation can offer.
“The NHS in the UK has a statistic that says 60% of everything that’s treated in general practice can be treated over the telephone, and that’s before you add the benefit of a video,” she says, listing a very wide range of situations when GP care may not require a conventional consultation.
“When you’re worried about a personal health or medical issue, if you want to get a health assessment, a medical or a test, if you need a referral or second opinion, when you need a sick note, if you are considering A&E for a non-emergency situation ... when you’re not comfortable talking to your own GP about a problem or if you’re travelling and need medical care.”
She estimates that since the service was established three years ago, VideoDoc has treated upwards of 160 complaints.
Mental health issues, including anxiety, depression and stress feature frequently in the stats, as do urinary tract infections, eye infections and skin conditions.
“The patient,” she explains, “takes a high definition photo of their skin and the doctor can then prescribe a topical cream, or whatever it is that’s required. As these services become more commonplace, patients become more aware of them and the benefits of convenience, as well as price.”
She adds that 30% of patients are now on their third virtual visit.
There will always be situations, however, where remote diagnosis and treatment won’t work. O’Brien says that 25% of cases they see are referred back to general practice.
“Patients might need to go for urine screen, a blood test, they might need a physical check-up, they need the doctor to lay their hands on them to be diagnosed and effectively treated.”
But does it really make sense to dispense with a physical examination at all? Do the risks of misdiagnosis and unsafe prescribing increase with the distance between doctor and patient?
Two years ago, the Irish Medical Organisation called on government to prevent health insurers from offering customers video access to GPs on the grounds that these services posed a risk to patients.
Mary O’Brien says that the doctors that work with VideoDoc are all trained in ‘telemedicine protocols’ and in delivering remote health services.
“Doctors by profession tend to err on side of caution; that’s why 25% of patients are referred back to their own doctor, to A&E or to an out-of-hours doctor service. So in terms of misdiagnosis, or unsafe prescribing, coming to us is not any different to going to see a doctor in general practice. Those kinds of issues can happen, but it’s about the safety netting and the training we give doctors to ensure that they do not.”
Contrary to what you might think, online consultations tend to take longer than conventional ones, primarily because the remote doctor must put in the time taking notes and exploring the patient’s history.
It is, of course, possible to share medical files with the remote service along the same lines as you would do to authorise sharing medical files in the case of conventional practice.
The patient can also authorise sharing medical information from the remote consultation to their own GP. All VideoDoc treatment providers are Irish Medical Council registered GPs, based in Ireland.
Once you have an online account, you can log in at any time and view your consult history. In addition, all patients get a personalised discharge document at the end of each consultation, detailing all that was discussed together with treatment details; so instead of having to remember everything, you can refer back to this document. It also includes detailed general information on the nature of the illness or condition.
As a business, VideoDoc is focused on the corporate subscription market. The company commissioned a survey late last year which found that digital health services could play a role in attracting employees in a buoyant labour market.
Some 45% of the 1,000 employees questioned said that they did not receive any healthcare benefits from their employer. Of those that did, 43% said that it was insufficient to cover the cost of private health insurance.
The survey suggested that if provided with digital health services, this perk would influence 65% of employees in their decision to work for one company over another.
“We charge a company €15 per employee, which buys a subscription for 12 months of unlimited doctor appointments for an employee. Obviously, that doesn’t replace health insurance but it is a health benefit, and it’s not cost prohibitive.”
When questioned about time currently being spent away from work to visit a GP for everyday illness, almost two-thirds of those asked said that they had taken time off in the past year to visit a GP. Of these two thirds, 27% admitted it was only for prescription renewal services. With regards to cost, 16% of Irish employees said they spend anywhere between €200 to €600 a year on standard GP appointments.
“Online doctors services are a cost-effective and timely way of receiving GP care for treatment and diagnosis of everyday illness,” says Mary O’Brien. “In fact, many VideoDoc corporate subscriptions across the UK and Ireland have reported benefits to their overall company as a result. As well as improving employee engagement and retention rates, they are seeing a real reduction in absenteeism, as staff don’t have to take time off work during business hours to visit a GP.”
Digital health remains a relatively new concept in Ireland. Only 13% of employees said they’d used online consultation in the past and almost one quarter admitted they didn’t know the service existed. Providing digital health benefits to staff is not, however, all that new. A 2016 Mercer National Survey for employees in the US showed that almost 60% of large employers provide medical coverage for a digital health service.
Meanwhile, health insurance providers are also embracing this phenomenon. VHI’s online doctor service gives everyone — not just VHI members — online GP access between 8am and 10pm every day for €24 per consultation. Laya Healthcare also offers a discounted online GP service, as does Irish Life Health.
The patient can take a high definition photo of their skin and the doctor can then prescribe a topical cream, or whatever they need. As these services become more commonplace, patients become more aware the benefits of convenience, as well as price — Mary O’Brien, founder and CEO of VideoDoc