Com­pa­nies pro­mot­ing use of telemedicine ser­vices, but many em­ploy­ees re­main wary

The Charlotte Observer (Sunday) - - Business - BY TOM MUR­PHY Associated Press

Wal­mart work­ers can now see a doc­tor for only $4. The catch? It has to be a vir­tual visit.

The re­tail gi­ant re­cently rolled back the $40 price on telemedicine, be­com­ing the lat­est big com­pany to nudge em­ploy­ees to­ward a high-tech way to get di­ag­nosed and treated re­motely.

But pa­tients have been slow to em­brace vir­tual care. Eighty per­cent of mid­size and large U.S. com­pa­nies of­fered telemedicine ser­vices to their work­ers last year, up from 18 per­cent in 2014, ac­cord­ing to the con­sul­tant Mercer. Only 8 per­cent of el­i­gi­ble em­ploy­ees used telemedicine at least once in 2017, most re­cent fig­ures show.

“There’s an aw­ful lot of ef­fort right now fo­cused on ed­u­cat­ing the con­sumer that there’s a bet­ter way,” said Ja­son Gore­vic, CEO of telemedicine provider Te­ladoc Health.

Wide­spread smart­phone use, looser reg­u­la­tions and em­ployer en­thu­si­asm are help­ing to ex­pand ac­cess to telemedicine, where pa­tients in­ter­act with doc­tors and nurses from afar, of­ten through a se­cure video con­nec­tion. Sup­port­ers say vir­tual vis­its make it eas­ier for pa­tients to see a ther­a­pist or quickly find help for ail­ments that aren’t emer­gen­cies. But many still fall back to go­ing to the doc­tor’s of­fice when they’re sick.

Health care ex­perts have long said that chang- ing be­hav­ior can be hard. In telemedicine’s case, pa­tients might learn about it from their em­ployer and then for­get about it by the time they need care a few months later. Plus emo­tions can com­pli­cate health care de­ci­sions, said Mercer’s Beth Um­land.

“My lit­tle kid is sick, I want them to have the best of care right away, and for some peo­ple that might not reg­is­ter as a telemedicine call,” she said.

Some pa­tients, es­pe­cially older ones, also just pre­fer an in-per­son visit.

“Go­ing to the doc­tor’s of­fice is a big event in their life and some­thing they look for­ward to,” said Ge­of­frey Boyce, CEO of In­Sight Telepsy­chi­a­try, which pro­vides vir­tual men­tal health ser­vices.

Tom Hill is among that crowd. The 66-year-old from Mooresville, In­di­ana, said he’s never used telemedicine and has no plans to.

“I be­lieve in a hand­shake and look­ing a guy in the eye,” said Hill dur­ing a re­cent shop­ping break at a down­town In­di­anapo­lis mall. “I don’t buy any­thing on­line ei­ther.”

But the prac­tice does gain fans once pa­tients try it.

Julie Guer­rero-Goetsch has opened her MDLive telemedicine app sev­eral times since first us­ing it about a year ago to get help for a si­nus in­fec­tion.

The Fal­lon, Ne­vada, res­i­dent was skep­ti­cal, but she didn’t have time to go in per­son. MDLive con­nected her to a doc­tor soon after she opened the app. She said he started ask­ing ques­tions about symp­toms “just as if I was sit­ting in a doc­tor’s of­fice” and pre­scribed an an­tibi­otic.

Caitlin Pow­ers tried telemedicine re­cently after hear­ing about it through a friend. The Columbia Univer­sity grad­u­ate stu­dent was feel­ing stuffed up and wor­ried she might be com­ing down with the flu. She said her ap­point­ment started on time, lasted 10 min­utes, and she spoke by video with a doc­tor in Florida while never leav­ing her Brook­lyn apart­ment.

“As a stu­dent, I don’t re­ally have time to spend three hours wait­ing to see a doc­tor, and this was so easy,” she said.

Doc­tors have used telemedicine for years to mon­i­tor pa­tients or reach those in re­mote lo­ca­tions. Now more em­ploy­ers are en­cour­ag­ing peo­ple cov­ered un­der their health plans to seek care vir­tu­ally for sev­eral rea­sons.

Telemedicine can re­duce time spent away from the job, and it also can cost half the price of a doc­tor’s visit, which might top $100 for some­one with a high-de­ductible plan. How­ever, those sav­ings can be negated if telemedicine’s con­ve­nience causes peo­ple to overuse it.

Wal­mart said it cut the cost for vir­tual vis­its to give an­other care op­tion to the more than one mil­lion peo­ple cov­ered by its health ben­e­fits.

Em­ploy­ers aren’t the only ones push­ing the tech­nol­ogy.

The drug­store chains CVS Health and Wal­greens are pro­mot­ing apps that let cus­tomers con­nect to doc­tors. Some in­sur­ers like Os­car Health are offering it for free to cus­tomers as a first line of treat­ment.

Ease of use is one of the rea­sons re­searchers and telemedicine providers think the prac­tice will be­come more wide­spread in sev­eral ar­eas of care. Those in­clude der­ma­tol­ogy and fol­low-up doc­tor vis­its after a surgery or med­i­cal pro­ce­dure.

Men­tal health vis­its are an­other area ripe for vir­tual care be­cause pa­tients can feel more com­fort­able talk­ing to a ther­a­pist in their own home, said Boyce of In­Sight Telepsy­chi­a­try, which de­liv­ers men­tal health care in about 30 states.

Boyce said peo­ple also like the anonymity of a vir­tual visit.

Men­tal health vis­its were the most com­mon use of telemedicine by pa­tients un­til pri­mary care over­took that spe­cialty a few years ago, Har­vard’s Dr. Ateev Mehro­tra and other re­searchers found in a re­cent study of claims data from a large in­surer.

Re­search firm IHS Markit es­ti­mates that telemedicine vis­its in the U.S. will soar from 23 mil­lion in 2017 to 105 mil­lion by 2022. But even then, they will prob­a­bly amount to only about one out of ev­ery 10 doc­tor vis­its, said se­nior an­a­lyst Roeen Roashan.

MDLive CEO Rich Berner said telemedicine is like the dig­i­tal video recorder TiVo, which took a while to catch on with view­ers.

“Peo­ple were so used to do­ing things the other way that it just took a lit­tle while to kind of re­ally go main­stream,” he said. “But when it did, it went main­stream big-time.”


Caitlin Pow­ers has a telemedicine video con­fer­ence in New York. Pa­tients us­ing vir­tual care can in­ter­act with doc­tors and nurses through a se­cure video con­nec­tion.

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