How Telehealth Is Turning the Doctor-Patient Relationship on Its Head

by | 15 September 2015

Have you been to the doctor recently?

If you are not already one of the nearly 1 million people the American Telemedicine Association estimates will see a physician via webcam in 2015, chances are you will be in the not-too-distant future.  Increase in patient demand for healthcare is due to the aging population, increasing incidences of chronic disease as well as the expansion of insurance coverage through the Affordable Care Act. The well-established collision of technology and consumerism that has already disrupted industries such as retail, media and taxicabs is poised to turn the doctor-patient relationship on its head.

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Referred to as “telehealth” or “telemedicine,” companies such as American Well, Doctor on Demand and Teladoc offer on-demand access to a doctor, relying on the patient’s smartphone or computer to act as a virtual office. While these companies have been around for more than a decade, online doctor visits will skyrocket in the coming year as more employers and insurance companies are offering the service in order to cut costs. According to a study by the National Business Group on Health (NBGH), 48 percent of large employers surveyed made telehealth options available last year, and in 2016 that number will jump to 74 percent.

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The explosive growth in telemedicine is driven by consumers’ being more “connected” and convenience-driven, and desiring physician availability whenever and wherever, as well as by the lower costs of telemedicine technology itself.

According to a recent NIH-funded study, a visit to the ER now costs an average of $1,200.  Considering that visits to physician offices, hospital outpatient departments and hospital emergency departments numbered over 1.2 billion in 2010, if even a fraction of these visits do not require an in-person visit, the savings to be recognized by employing teleheath services are staggering. In fact, consultant Towers Watson estimates the industry can be expected to save U.S. companies more than $6 billion a year.

Recent announcements by the Cleveland Clinic of its partnership with American Well to offer MyCare Online — immediate access to virtual doctor visits for a flat fee of $49 — and by Mass General that it will allow patients to seek second opinions using telehealth technology will serve only to further the adoption of virtual visits and remote healthcare.

While not a replacement for traditional doctor appointments, the size of the market is clearly expanding as both providers and patients become more comfortable in adopting this approach for ailments and symptoms that are not life-threatening, and as the reach expands to include behavioral health and second opinions.

Retailers such as CVS, Walgreens and Target have long embraced the concept of walk-in clinics, and telehealth represents a next step in providing consumers with on-demand access to healthcare providers. In June, Walgreens announced a collaboration with MDLIVE to provide 24/7 access to MDLIVE’s network, which is planned to be available to users in 25 states by the end of 2015. CVS recently announced it will work with three companies — American Well, Doctor on Demand and Teladoc — to expand patients’ access to doctors to include online consultation and, in some cases for the telehealth companies, to refer patients to a CVS MinuteClinic.

Based on its survey of a pilot program in 12 of its MinuteClinics in Texas and California, CVS reported that 95 percent of patients were highly satisfied with the quality of care they received, the ease of using the technology and the timeliness and convenience of the care.  In addition, one-third of patients indicated they preferred a telehealth visit to a visit with a clinician in the same room.

The comparison of telehealth to Uber is understandable. But even Uber did not revolutionize cab service the way telehealth is likely to change the doctor-patient interaction. How is this likely to affect the demand for medical office space? Kristin Blount, Senior Vice President of at Colliers International in Boston, does not believe the impact on brick-and-mortar medical office space will be significant: “Doctors will still need to see patients in person and will do so in space similar to what they have right now. The medical office space is relatively small and has already been downsized to reflect that storage of medical records is no longer a space consideration.” In fact, one might argue that there could be an incremental demand for more traditional office space as health care practitioners will look for space to better accommodate this new healthcare delivery system and these doctors and nurses are not yet working from home.