[NEW YORK] Telemedicine services, which allow doctors to treat patients via video, are gaining acceptance among consumers and insurance companies as it becomes clearer when a virtual visit is appropriate, industry executives say.
Telemedicine has been more widely offered over the last five years, promoted by health plans such as Cigna Inc and New York-based insurance startup Oscar Health.
As many as 15 million people used the services this year, up 50 per cent from 2013, according to the American Telemedicine Association.
"The insurers have been adopting this at a really rapid rate because they see benefits from better access to care," said Jason Gorevic, chief executive of Teladoc, the largest US telemedicine provider. "It eliminates unnecessary visits to more expensive sites."
Teladoc is working with over 20 health plans, including Oscar and Aetna Inc. It has gained momentum as insurers better understand how to use the services.
Aetna plans to add virtual behavioral health consultations for issues such as depression and anxiety. Next year UnitedHealth Group will roll out services to employer-sponsored and individual plans through partnerships with Doctor on Demand, American Well and NowClinic.
On average, video-based visits cost less than US$50 compared with about US$80 for a traditional doctor's visit. "The notion of supporting people's behavioural health needs through other channels is critical," said Rich Feifer, Aetna's chief medical officer of national accounts.
Oscar Health offers telehealth services for free for its 100,000 members. CEO Mario Schlosser says the move has paid off, with 91 per cent of care cases resolved after the first virtual appointment.
Patients can call or use Oscar's website or mobile app, typing in symptoms such as: "I can't stop wheezing."
The services are geared for conditions that do not require testing for confirmation, and the on-call doctor can determine if an in-person appointment is needed.
Patients can add photos before speaking with a doctor, who normally calls within 9 minutes.
Some hospitals are using telemedicine as an early form of triage for more serious conditions. "If it's an acute problem, even though telemedicine doesn't have the completeness of being in person, the value is exponentially higher," said Randall Moore, president of Mercy Virtual in Missouri, which describes itself as a virtual care facility, in which doctors monitor patients remotely via electronic hook-ups to medical devices; patients may be at home or in a Mercy hospital.
At Mercy Virtual, which is part of a health system operating in seven states, doctors keep tabs on intensive care patients and make calls on what to do if a patient's condition worsens, alerting on-site staff.
Mr Moore says the provider's telemedicine programme saves around 1,000 lives annually, has cut the length of stay at Mercy hospitals by up to 40 per cent, and saves US$35 million each year.
Penske Truck Leasing is working with Aetna and Teladoc to offer virtual services to its 18,000 employees, 20 per cent of whom have taken advantage, according to the company's vice-president of benefits and compensation, Joe O'Neill.
Penske offers it for free, calling it a "cost neutral"decision that helps employees who are often on the road get care.
The University of Pittsburgh Medical Centre saves about US$300,000 each year through its telemedicine program according to executive director of telemedicine Natasa Sokolovich.
The new services still face hurdles. The Texas Medical Board has tried to stop Teladoc from operating in the state, arguing that physicians should only diagnose illnesses or prescribe medication after seeing patients in person. State courts have sided with Teladoc.
Other states have also fought against expansion by increasing regulations or not recognising the practice.
"Widespread adoption has been limited based on state requirements on how it can be used," said Clare Krusing, a representative with trade group America's Health Insurance Plans. "Each state is approaching it somewhat differently."