Virtual Doc Kiosks – A Giant Leap for Telehealth

Just a couple of weeks ago, I wrote about doctors who FaceTime or video Skype with their patients. I’ll freely admit that while I’m as addicted to my Smartphone as the next person, I generally feel as if these healthcare innovations will result in overworked doctors and demanding patients.

And now, here’s something else to think about. According to a recent article in Computerworld, pharmacy chain Rite Aid, in conjunction with healthcare provider OptumHealth, is rolling out online physician chat rooms. Patients can virtually chat face-to-face for 10 minutes with a physician for $45. Virtual chats with OptumHealth nurses are free.

Pros of this system:
Shorter Wait Times: No more Waiting Area blues, and no more wondering if the paper robes cover you adequately enough.
Doctor-Pharmacy Cross Referencing: If Rite Aid already has a patient’s pharmacy history, the provider/nurse can access it any time. No need to rely on a patient’s memory any more.
Electronic Capture of Medical Records: These can be communicated to the patient’s PCP in needed.
No more scheduling tag: Walk in for a chat when YOU are ready.

Cons:
Steep price: $45 for a 10 minute chat is a tad high in my book. But when you look at it in terms of what the uninsured have to do to get any medical attention at all (either pay the high consultation rates, or negotiate with a kind-hearted doc for lower fees, or wait till their conditions become full-blown emergencies), it doesn’t look as pricey. I would also be really interested in seeing how insurance companies will react to telehealth initiatives like these. Will they, for example, reduce co-pays for such visits?
Revolving cast of physicians: The advantage of this system is you get to see a medical professional; you’ll probably not be able to ask to be connected to that incredibly insightful Dr. Smith you saw last time. Also if this takes off in a big way, maybe it’ll be a Dr. Reddy located in Hyderabad, India (though I should go on record at this point – I have absolutely no problem in being seen virtually by a Dr. Reddy or Dr. Khan in Pakistan, or anywhere else in the world)
Unclear logistics: Say, you have an abcess that you have to get checked on your er… backside. Are the kiosks private enough for truly comfortable patient-doctor interaction? Is there anyone else just offscreen at the doctor’s office, watching the video chat?

Definitely things to think about. I want to leave you with anecdotes from a different field – education. A few years ago, tutoring companies in the US figured out that American kids could really benefit from one-on-one tutoring from teachers. VOIP technology became cheap, even international video calls via Skype were free or for pennies a minute. I heard about this phenomenon when I enquired about a teacher at my high school in India. Many teachers at my school had quit to join such companies, and the school was making do with either substandard teachers or filling teaching gaps with part-timers on an ad-hoc basis.

It’s too soon to know what route these TeleHealth initiatives will take, but the scenario I described is not impossible with medicine too. While I’m excited about the convenience of these kiosks, I also think it would be a sad day if all/majority of our interaction with our providers is done online.

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Priya Ramachandran

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

4 Comments

  • One word – malpractice.

    One thought – expensive?

    $45/10 minutes maxes out to $270/hr. With lawyers up to $1000/hr and accountants in the $300-$500/hr range, how is $270/hr for a physician expensive? Unless, of course, your bank account is more valuable than your health, or you believe that your health is worthless and health care should therefore be free. Have you ever called a plumber on Christmas day?

    No provider can perform a physical exam over a video link, and making a diagnosis without a physical exam is prima facie negligence. I’m curious to know how the retailers are dealing with that.

    The only option that comes to mind immediately is that the physicians are simply prohibited from providing a diagnosis (the smart ones will prohibit themselves), or are at least limited to recommending over the counter medicines (which would be fine with the pharmacy, I’m sure.) But if all you can get is a general discussion, or an advisory to buy ibuprofen, then $45 does start to look pretty expensive.

  • Al Davis, thanks for your comment.

    I get all the logical reasons why medical attention is priced the way it is (malpractice, cost of a medical education, business expenses), but they don’t resonate with me on a more elemental level. Teachers, who are tasked with nurturing young minds, aren’t paid anywhere near that much per hour. And for people without the safety net of an employer-paid insurance, medical attention can cause quite a dent in monthly budgets.

  • I’m not a physician, but don’t they have to be licensed to practice medicine by a state licensing board? How could I get medical advice in Detroit from a physician in Pakistan? I also agree with Al that without a physical exam, you can’t really be handing out a diagnosis. Not sure I would want to know how a physician would perform a cervical or prostate exam. I like the idea, but I just don’t see how you get past the physical exam.

  • Kevin Finn,
    The licensing issue is an interesting one and I’m not sure about the legal details of it.

    Certainly not all things can be done using Telehealth, but one of the secrets of medicine is that the physical exam is often not needed in the treatment that the doctor provides. I’ve often heard doctors say they just do it so that the patient feels like they were examined, not because it influences their diagnosis or treatment in any way. In these situations, Telehealth is a great alternative. For those situations where a physical exam is necessary, going to an actual doctor is still an option.

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