Are e-visits coming to a doctor near you?
I’m attending the mHealth summit in Maryland, which is filled with all sorts of gadgets, apps, and promises of better technologies in the future. But for the here and now, it’s hard not to be a little skeptical -- especially after passing a booth in the exhibition hall promising an app for app fatigue, that is, medical app disorder suffered by physicians who have too many software downloads on their phones and tablets that fail to deliver.
Can anyone say oxymoron?
Being an optimist, I decided to believe the eager woman at the exhibit booth who promised me that this app will work, really, to allow doctors to “customize their experience.” But no, it’s not yet available. Nor is a cool-sounding app to help smokers quit by customizing advice based on answers to survey questions. (The inventor told me he’s still looking for more funding before he can quit his day job.)
I put a little more faith in the predictions made by Aetna, one of the biggest insurance providers, and Intermountain Healthcare, a large health delivery network based in Salt Lake City, on when we can expect to see e-visits to online doctors and health care providers.
Intermountain is testing such a virtual health care visit, in which patients log on and chat with a doctor from home or any other remote location. They first go through a receptionist, sign off on paperwork, and then chat with the doctor face to face over an iPhone or on a computer screen.
The doctor can examine a wound, rash, or bruise over the phone and refer a patient to an online specialist if necessary, or advise them to head to an urgent care center for stitches.
“We want to ramp it up to 24 hours a day, seven days a week,” Marc Probst, Intermountain chief information officer, told me in an interview. “We’re trying to reduce unnecessary emergency room visits” as well as time spent sitting in a doctor’s waiting room.
Intermountain’s 4,000 employees are testing the idea, and Probst said the queueing system needs to be perfected to make sure patients aren’t waiting too long online to see a doctor.
Tech experts at Intermountain and elsewhere are also working on developing tools that patients can attach to their computers or smart phones, such as stethoscopes, otoscopes (to check ears, throats, and noses), or doppler devices to listen to a fetal heartbeat, to reduce in-office visits. Nothing, though, can replace the simple feel of a doctor’s hands on a patient’s skin to press and palpate for pain, swelling, and discomfort. Probst agreed on that.
In a keynote address at the conference, Aetna president Mark Bertolini touted convenience as the new priority for measuring quality in health care.
Prescriptions sent digitally to a pharmacy before a patient leaves the office should be the norm everywhere by now. It’s not. (I know I usually still have to take a prescription for one of my children to the pharmacy myself and wait for it to be filled despite the fact that my kids’ pediatricians have switched to an electronic medical record.)
To help patients keep track of their own health issues, Aetna plans to launch a digital platform called CarePass in March that anyone (with or without Aetna) can download onto their smart phones, tablets, or computers to sync and manage all their health care information, from fitness and nutrition apps to electronic medical records and doctors appointments. Unfortunately, it only works with the 20 apps that Aetna has so far loaded onto the platform, but it looks like it could reduce a lot of app clutter on your phone if you find those apps are better or at least as good as the ones you’re using now.
I was less impressed by a new Aetna fitness app called Passage that Betrolini was praising. It lets you pick a city such as Barcelona or Paris to “tour” while you’re working out on an elliptical trainer or treadmill. As much as I love running through foreign cities when I’m on vacation as a way to sightsee, I can’t imagine getting excited about seeing footage of these places; frankly, I’d rather watch the travel channel or, better yet, CNN.Deborah Kotz can be reached at firstname.lastname@example.org. Follow her on Twitter @debkotz2.