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Virtual doctor's office visits via telemedicine to be norm

| Thursday, Oct. 31, 2013, 11:45 p.m.
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Who wants to get off the couch when they're sick if a doctor is just a mouse click away?

Virtual doctor visits could become as common as face-to-face appointments because health insurers, hospital systems and employers view it as a way to clamp down on rising medical costs. They hope that by giving patients easy access to a primary care physician, it will discourage them from visiting a costly emergency room when they get sick.

The trend is emerging as millions of Americans are expected to gain health insurance under the Affordable Care Act, commonly known as Obamacare. The influx of new patients could put a strain on some doctors' offices, possibly driving more people to the hospital for routine illnesses if they can get an appointment quickly.

In Western Pennsylvania, health giants UPMC and Highmark Inc. are rolling out new services that allow patients to video-conference with doctors through computers, tablets and smartphones. They are the first to offer such services in the region.

“We think more and more people, as they become more familiar with telemedicine ... this is something that is just going to be commonplace,” said Natasa Sokolovich, executive director of telemedicine at UPMC.

But for all the promise of technology to help patients, some doctors warn that an eVisit can't replace face-to-face consultation in an office.

Nonverbal cues can be very important in accurately diagnosing patients, said Dr. Bruce MacLeod, president of the Pennsylvania Medical Society, a Harrisburg-based advocacy group for physicians across the state. Some details could be missed in a video conference, he said.

“I believe telemedicine is going to serve a bigger and bigger role in increasing the efficiency that we can monitor our patients,” MacLeod said. “I think there's a lot of potential there, but I don't think it'll ever replace” a personal doctor visit.

MacLeod, who is also director of emergency medicine for Highmark-owned West Penn Hospital in Bloomfield, said virtual doctor visits can be a convenient way to start the interaction with a doctor.

Highmark, which has offered a telemedicine benefit to a limited number of large national companies since 2012, is making it available to all customers who buy individual coverage under Obamacare starting in 2014.

And UPMC, the largest hospital network in the region, will offer the service to anyone in the state through its website starting next week.

Convenience is the big selling point of telemedicine services to patients, industry officials said. Rather than having to wait days or weeks to schedule an appointment at a doctor's office, a video conference could be scheduled within minutes or hours, and the patient wouldn't have to leave home.

“The biggest reason we're doing this is for member convenience,” said Dara Smith, director of strategic products for Highmark. “Everyone is so busy.”

While patients wouldn't save money — they will have to pay a charge or co-pay similar to visiting a doctor's office — insurers would save by not paying out claims for more costly treatment in urgent care centers and hospitals.

“Our members report to us that when they are using a Teladoc consultation, they avoid unnecessary trips to urgent care centers, which are more expensive to the consumer and the insurer,” said Jason Gorevic, CEO of Teladoc Inc., a Dallas-based company with which Highmark contracts to provide the telemedicine service to its members.

Teladoc has more than 6 million members signed up across the country and predicts it will have more than 7 million by January.

Members whose plans include the Teladoc service pay an office visit co-pay, which can run up to $40, to video-conference with a physician, Smith said.

UPMC's service — called AnywhereCare — will be open to anyone in the state of Pennsylvania and will cost $38 for non-UPMC Health Plan members, spokeswoman Wendy Zellner said. UPMC Health Plan members pay the same as their office visit co-pay, which in many cases is less.

In both services, a patient must establish an account and enter personal information and health history before using the service.

Teladoc physicians, who are board-certified medical doctors, can diagnose, recommend treatment and prescribe medication for minor illnesses, including cold and flu, bronchitis, allergies and infections.

UPMC AnywhereCare will use physicians and nurses from its network of urgent care centers to consult with patients online.

An eVisit with a Teladoc physician is guaranteed to take place within an hour after an online request is made, and the average wait time is 16 minutes in Pennsylvania, Gorevic said.

Patients can request an Anywhere-Care eVisit 24 hours a day, but the video consultations will be scheduled from 9 a.m. to 9 p.m., seven days a week.

“We can't afford to not get into this space,” Sokolovich said. “It's where industry is moving.”

Alex Nixon is a staff writer forTrib Total Media. He can be reached at 412-320-7928 or anixon@tribweb.com.

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