This story was produced by the St. Louis Post-Dispatch, in partnership with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.
Missouri’s largest health insurer recently launched a new online patient-doctor interface, a move that reflects the growing importance of telehealth as the industry looks to curb costs and enhance patient access.
More patients than ever are seeing their doctors through computer screens and smartphones. It’s a trend that shows no signs of subsiding as hospitals and insurance companies continue to roll out the latest technological advances.
For patients, they can see a doctor without the inconvenience of traveling to an office and sitting in a waiting room. For doctors, it allows them to see more patients in an efficient, cost-effective way.
Anthem BlueCross BlueShield in Missouri said these factors led them to develop LiveHealth Online, a telemedicine platform that became available to all members last month. The platform visually connects customers to doctors around the country from their computer, tablet or phone.
“This responds to a concern that people have raised,” said Dr. Jay Moore, the senior clinical director at Anthem. “It’s difficult sometimes for them to get care that is timely and efficient.”
A doctor is on call 24/7 and LiveHealth Online costs no more than a regular copay for an office visit. Patients that aren’t Anthem members can also use the platform for $49 a visit.
The American Telemedicine Association defines telemedicine as the "remote delivery of health care services and clinical information using telecommunications technology." It says 200 networks and 3,500 service sites currently operate across the country.
It’s also one of the fastest growing sectors in the health care industry. The American Medical Association, which represents doctors, expects the telemedicine market to grow from $1 billion next year to $6 billion by 2020.
Lawmakers have also embraced telehealth. Missouri enacted a law in 2013 requiring insurance companies to reimburse for services rendered via telemedicine if the same service could be delivered in person. About 20 other states have similar laws.
The AMA provided a general endorsement for telehealth services last year while underscoring the continued importance of a patient-doctor relationship.
When telemedicine first took shape in the early 2000s, some patients and doctors were concerned the relationship between the two groups could suffer using the medium, to the detriment of health care.
But some say those fears haven’t panned out. Dr. Thomas Hale is the executive medical director for Mercy Health’s telehealth services. He says our culture has evolved to the point where interactions on the computer screen are considered real.
“The relationship with the caregiver is extremely important,” he said. “The virtual, visual encounter is now viewed by the patient as a relationship.”
Doctors also see telehealth as a way to reach patients in rural areas who don't have regular access to a physician. It could even help alleviate longstanding concerns about a shortage of primary care doctors. (The Association of American Medical Colleges estimates that by 2025 there will be a shortfall of between 12,500 and 31,100 primary care physicians.)
Mercy is currently constructing a "visual care center" that will house 300 physicians, nurses, technicians, researchers and support staff to coordinate the Chesterfield-based health system's telemedicine programs.
Mercy currently uses telehealth platforms to stroke-related consultations by neurologists and intensive care monitoring, among other functions. The center is expected to be completed this summer.
As technology continues to advance doctors are able to perform more tasks using the Internet.
Part of Anthem’s telemedicine program includes the installation of kiosks at workplaces. The kiosks include a computer screen to visually connect with a doctor, as well as hook-ups for thermometers, blood pressure monitors and dermal imaging cameras.
Stephanie Vojicic, Anthem’s regional vice president of sales, says the kiosks could provider care to workers while preventing them from missing time — and money — on the job going to a doctor’s office.
Hale also sees telehealth being used increasingly to monitor patient health to keep them out of the emergency room and hospital. He says monitors could be used to track a patient’s heart condition, for example.
“It’s all about getting more and more data,” said Dr. Chris Veremakis, medical director for Mercy’s telehealth programs.
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