Happy New Year!
Now that the holidays are over, and a new year has begun, I wanted to take some time off from writing until I could find a topic worth writing about. I think I have done that with an article that was published on December 21, 2012 in the Wall Street Journal by Anna Wilde Mathews. Her article entitled, Doctors Move To Webcams, profiled a recent trend in healthcare that, while involved with primary care, could have significant impact on how medical tourism and medical tourism for workers’ compensation will be conducted in the future.
The article discusses virtual doctor visit services, which allow patients to connect with physicians from their homes. Ms. Mathews points out that WellPoint and other insurers such as Aetna and United Health plan to offer or are already offering such services to its employer and individual plans, or to certain employers as in the case of Aetna and United Health. WellPoint’s plan will allow people to consult with physicians on-demand using laptops, tablets and smartphones. A growing number of employers such as Home Depot, Booz & Co. and Westinghouse Electric are moving to include remote consultations to their benefits.
However, such services, Mathews points out, are generating tension with state regulators and doctor groups. They argue, Mathews says, that remote visits make sense when a patient is communicating with their regular doctor, but that care may suffer when patients are connecting with physicians in other cities or states, or countries (emphasis mine). A survey by Mercer, a unit of Marsh & McLennan mentioned in the article, indicates that 15% of very large employers use some form of telemedicine, and another 39% are considering doing so.
In an earlier post, Medical Tourism and Workers’ Compensation: What are the Barriers?, I discussed some of the legal barriers to implementing medical tourism into workers’ compensation, with long-distance communication and the issue of prior face-to-face contact between patient and physician as some of the minor barriers that need to be overcome. A more complete discussion of the barriers to implementing medical tourism into workers’ compensation can be found in my White Paper, Legal Barriers to Implementing International Medical Providers into Medical Provider Networks for Workers’ Compensation.
Mathews quoted Ginny Proestakes, director of health benefits at General Electric, which is testing a virtual-consult service from United Health Group’s Optum for employees in Ohio, and plans to roll it out more broadly this year. “The ability to communicate with a doctor 24/7 via the Internet, without an appointment, at an attractive price point, is very appealing.” Employers and insurers say such services could possibly ease the shortage of primary-care doctors. Ann Boynton, deputy executive officer for health coverage for California’s Public Employees’ Retirement System, said that if it does not drive down the costs, then it isn’t worth it. They started testing a service for phone and online video from Teledoc last year. Teledoc has clashed with regulators in Texas over its service, but Teledoc said that its doctors have performed more than 100,000 consults with no malpractice claims. Teledoc has clients such as Aetna, Blue Shield of CA, and Highmark.
Currently, Mathews indicates, only 13 states allow doctors to establish a relationship with a patient, without an initial in-person visit, according to the Robert J. Waters Center for Telehealth and e-Health Law. What this means for medical tourism in general, and for medical tourism in workers’ compensation, specifically, is until more states allow such visits for primary care, and more insurers offer it under individual and group plans, the barriers I mentioned in my earlier post and my White Paper are still formidable, although minor and must be overcome. Medical tourism facilitators must take this into consideration when they market, plan and sell medical tourism packages to potential patient clients. The doctors themselves, and the hospitals they work at, must also take this into consideration.
For implementing medical tourism into workers’ compensation in the US, one must be aware of state regulations and whether or not virtual doctor visit services will be included in the treatment plan for injured workers. The day when the nurse will say to a patient in the US, that the doctor will see you now, when the doctor is thousands of miles away is still not here, but that day will come.