Wisconsin health systems encouraging use of video visits
Virtual checkups safer for physicians, patients
Virtual, or video, visits could become commonplace as health systems take steps to prevent physicians and other staff as well as patients from becoming infected by the coronavirus.
Health systems and insurers are encouraging people with questions about their symptoms to consider the live, interactive visits done through a smartphone, tablet or laptop with a webcam. The Centers for Disease Control and Prevention also recommends that patient use telehealth services. And the technology could prove invaluable in the nation’s response to the pandemic.
For one thing, video visits and other types of telehealth or telemedicine are ideal for helping patients follow two recommendations: Stay at home and call first before going to a clinic or hospital unless it’s a medical emergency.
Froedtert Health, for example, is transferring all calls about the virus — whether to a clinic or hospital — to a triage service staffed by registered nurses around the clock. The nurses, following guidelines from Centers for Disease Control and Prevention, then advise the next step that patients should take.
“We have centralized so that we can ask deeper questions and determine if that person is eligible for testing,” said Michael Anderes, chief innovation and digital officer of Froedtert Health.
The nurses are encouraging patients to schedule a video visits with their physician or another clinician or to use an on-demand service available 24 hours a day.
“Our number one goal is to keep our physicians and staff healthy, so they can take care of people,” Anderes said.
Virtual visits also can help prevent clinics and hospital emergency departments from being overwhelmed.
“Our ER is getting a lot of calls,” Anderes said. “Every single clinic is getting a lot of calls. Our scheduling is getting calls. It’s kind of coming in everywhere.”
Further, if a physician, nurse practitioner or physician assistant does become infected with the virus, he or her could see patients virtually from home while quarantined. And if health systems cancel elective procedures, health systems conceivably also could draw on specialists to help handle the video visits.
“You basically can do it off a modern laptop,” Anderes said.
Bellin Health has expanded its video visits to enable patients to schedule a visit specifically for the respiratory disease caused by the virus, said Kathy Kerscher, vice president of primary care for the health system based in Green Bay.
When patients with specific symptoms call a clinic, the health system is suggesting that they start with a video visit or e-visit, basically a secure form of email. It also is promoting the use of virtual visits through social media.
“It’s all about protection — protection of the patients, so not exposing themselves to sick people or, if they are sick, not exposing others to them,” said Shane Degan, a physician and vice president of primary care for Bellin Health. “It’s about protecting our staff — our nurses, our doctors — and ultimately keeping the whole community safe.”
Most health systems now offer video visits. They include Aurora Health Care, Ascension Wisconsin, ProHealth Care, ThedaCare, UW Health, Marshfield Clinic and UnityPoint Health. The health systems staff the services themselves or contract with a national company, such as American Well, known as Amwell, Teladoc, and Doctor on Demand.
(Physicians and nurse practitioners must be licensed in Wisconsin to diagnose and treat a patient in the state.)
Health insurers, such as Anthem, also have their own telehealth services, such as video visits, that are available through their health plans.
The percentage of patients who have used virtual visits has been relatively small. Most people also are unaware of the service: Almost three out of four people don’t have access or are unaware of telehealth options, according to a survey done by J.D. Power.
That, though, already is beginning to change.
“It seems like it is starting to ramp up in the last two days,” Anderes of Froedtert Health said recently.
Froedtert Health also has seen an increase in the use of its chatbot, a computer program designed to take questions, provide answers and then recommend a level of care.
The chatbot, which was updated for COVID-19, the disease caused by the coronavirus, is available on its website and open to the public.
Similarly, Bellin has seen an increase in the use of e-visits, in which patients fill out a detailed questionnaire that is sent through the MyChart portal in its system for electronic health records.
The cost is $35 and typically not covered by insurance.
Few insurers cover video visits. But UnitedHealthcare’s health plans generally do. Common Ground Health Care also covers the visits. And 98% of large employers now offer telehealth services, according to the Business Group on Health.
But many health insurers have indicated that they will start covering video visits.
“We are working through that right now with certain payers, and we have had some success,” said Kerscher, of Bellin.
The law passed by Congress for emergency funding also includes a provision that will allow clinicians to bill Medicare for care delivered by telehealth during the public health crisis.
Many of the services are cash only and must be paid by credit card. But Ascension and ProHealth have lowered the cost of video visits to $20 to encourage their use during the crisis.
ProHealth also has set up a coronavirus hotline — (262) 928-4499 — that can help people with symptoms determine whether they need to seek care. People who need to make an appointment can be connected to a scheduler, and those needing care may be encouraged to use its video service.