December 21, 2009
Virtual Office Visit Via The Web
An article in today's New York Times describes an online doctor's visit service that will be offered by OptumHealth, a division of UnitedHealth Group next year. It is called "NowClinic" and it is described as "a service that connects patients and doctors using video chat."
OptumHealth believes that NowClinic will improve the delivery of health care by offering services in areas where there is a shortage of primary care physicians and limited access to care for many patients and also by expediting the paperwork and claims process.
The system will be first introduced in Texas and then eventuallty nationwide. According to the article, "180 counties in Texas do not have enough physicians, 70 percent of patients cannot obtain a same-day visit with their primary care doctor, and 79 percent of emergency room visits are for routine problems." NowClinic's launch will represent the 'first time that online care will be available nationwide, regardless of insurance coverage.'
For $45, anyone in Texas can use the system. "Doctors hold 10-minute appointments and can file prescriptions, except for controlled substances. Eventually they will be able to view patients’ medical histories if they are available."
This system will also be available in Hawaii and Minnesota through Blue Cross Blue Shield and to some members of the military seeking mental health care through TriWest Healthcare Alliance.
The service has encountered some resistance from physicians and state medical associations who are concerned with the lack of in-person contact. The NY Times article points out that " Texas law requires that before doctors consult with patients or prescribe medicine online or over the phone, they form a relationship through means like a physical examination."
The Texas Medical Board, which regulates doctors in the state, is evaluating its telemedicine policies in light of new technologies. But Mari Robinson, executive director of the board, said that an online or telephone exam was inadequate if doctors and patients had not met in person and was 'not allowed under our rules.'
After this service began in Hawaii last year, "lawmakers passed legislation that allowed doctors and patients to establish a relationship online, though the Hawaii Medical Association opposed the bill."
As these technologies break new ground, individual physicians, medical associations and lawmakers will need to re-think the concept of treatment and revise the guidelines and laws accordingly.
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