Advances in Virtual Care: Trends Medical Practices Need to Know

by Robin Farmanfarmaian

As of June 1, 2018, the state boundaries for VA physicians came down, allowing physicians to have a virtual visit with any VA patient, no matter what state both the physician and patient are physically located. This is a important change, as previously for the VA, and currently outside of the VA, physicians need to be licensed in the state where the patient is located. It is unrealistic for physicians to be licensed in every state, as each state charges a few hundred dollars for the license, and may require different CMEs – which limits their ability to care for patients. The VA understood this, and as one healthcare system, was able to greatly expand physician patient pools by erasing state boundaries for virtual care.

Globally, virtual care is growing from an $18.1B industry in 2015 to a $41.2B industry by 2021. This helps provide patients with access to HCPs, oftentimes not as a replacement for an in-person clinic visit, but as the only way the patient will see an HCP. To go to an in-person clinic visit, patients need to take a half day or more off school or work, find a way to transport themselves to the clinic, which could take many hours if they are in a rural area, and in some cases, could provide a financial hardship if they are paid hourly at their job. In addition, even if a patient is already located near a clinic, the obstacles of taking the time to go to the clinic may deter the patient from talking to an HCP at all.

Virtual care can be a first step on a patient journey, helping direct the patient to appropriate, personalized in-person care, whether that’s an ER or a specialist. It’s especially helpful for patients who are unsure if they should go to the ER, and might otherwise put off going to the hospital. If a physician on video says they should be seen, that can serve as huge motivation for a patient to go to the ER or Urgent Care.

It can also help patients manage conditions over a long period of time, prevent or even reverse some conditions. For example, take pre-diabetes: with proper behavior change, patients with pre-diabetes can potentially avoid having diabetes. But the problem is, behavior change is hard, especially without help – and that’s the main requirement for pre-diabetes. Companies like Fruit Street are using group video virtual visits, plus a robust platform that allows patients to upload photos of their meals, to help patients manage pre-diabetes according to the CDC and AMA created pre-diabetes program.

Companies like CVS and Walgreens have their own Virtual Care programs. CVS announced a new partnership with Teledoc that they are planning to rollout nationally by the end of the year, giving patients the option of $59 immediate physician visits through their mobile phone. American Well just raised $290M, bringing their total funding to over $440M. Samsung and Philips joined this last round, as they understand American Well’s big vision: to be that connector technology between employers, payers, providers and consumer facing technology.

One Medical offers their members free on-demand virtual care visits with a nurse or physician’s assistant, no matter where the patient is located. One Medical is a primary care medical practice that in addition to billing payers normally, they charge every patient an annual subscription fee of around $150, which gives patients access to a number of benefits, such as next day appointments, on site blood labs, and on-demand virtual care. Payers like United are frequently emailing their insured patients with questions such as “do you need to see a doctor now? Click here to see a doctor on demand virtually for your standard copay” and partnering with multiple virtual care platforms. United understands that informing and reminding patients that virtual care is an option could help them avoid giant ER bills.

Current healthcare systems were not built with the patient’s convenience or experience in mind. But technology is changing the patient experience, and providing opportunities for medicine to cater more towards patient experience and accessibility. Making healthcare available where patients are located, and on a patient’s timeline, means dramatically increased access and availability, which can improve patient outcomes – everyone’s main goal.