In relatively few years, videoconferencing has advanced tremendously, from something that required expensive and complicated hardware setups to something most smartphone, tablet, and PC owners have easy access to. Using video for virtual visits in healthcare is a little more complicated -- the connection has to be reliable and the service HIPAA compliant to protect patient medical information -- but nonetheless virtual visits are gaining popularity as a new way to deliver healthcare.
Becky Wai, a spokesperson for online video service VSee, told MobiHealthNews on the sidelines of the American Telemedicine Association (ATA) meeting in Austin this week, that of the 900 million doctor visits that took place in the US in the last year, about 50 percent of them could have been done remotely.
Of course, virtual visits can't do everything that a doctor can do in-person. But in the average primary care checkup, a patient sees a doctor for about 7 minutes. In that context, it's not hard to see the advantage of cutting out the extra time and making the most of a short visit. Many speakers at ATA said that virtual visits aren't just a "good-enough" replacement for when a "real" visit isn't possible. In many ways, virtual visits are actually superior.
1) Convenient for both patient and doctor
Vidyo, which offers device-agnostic HIPAA compliant videoconferencing software, announced a deal at ATA to provide video conferencing services to the Alaska Native Tribal Health Consortium, that will connect 2,500 providers at 200 different sites to patients. Connecting people to care in rural areas is a classic use case where a video visit is much more convenient than an in-person one, but it's far from the only such case.
Barb Johnston, CEO and cofounder of online clinic HealthLinkNow, said her company's services come in handy for patients who don't want to leave their home because of PTSD; patients with a new baby who are being treated for post-partum depression; and patients who are in jail, including patients who could present a risk of harm to their psychiatrist. Her practice also offers up telepsychiatry care in primary care settings.
"We've been linking in all over and that has been phenomenal," Johnston said. "Patients prefer to see a mental health provider in their regular doctor's office. No stigma. We beam in when needed, and get out of the way when we're not needed."
Services like VSee and Vidyo work on a growing number of consumer devices and strive to be quick and easy for a patient to download.
"Patients have said to me, before I had to take a half day off work -- now I just leave work early," said Dr. Ray Dorsey, director of neurology telemedicine at Johns Hopkins Medicine. "We can get to the point where people make decisions about where they live or where they retire without having to think about their care. They can live where they want and the care will come to them."
2) A virtual waiting room is better than the physical one
Nobody really likes waiting in a doctor's waiting room. Aside from the general annoyance of waiting, it's problematic for sick people to surround themselves with other sick people, especially for the elderly or those with weakened immune systems.
"It seems like an assembly line," said VSee's Wai. "You can wait in your own home, be comfortable."
Johnston at HealthLinkNow has implemented a virtual waiting room that replaces old magazines with health-relevant animations. While patients are waiting for their doctor to be ready for a virtual visit, they have access to that specially created online material, designed to both entertain and educate the patient about health risks.
3) Increased patient engagement thanks to screensharing
Video conferencing doesn't just let doctors and patients see each others' faces. VSee showed off a platform at ATA that enables doctors to bring up a patient's chart or past radiology record and annotate it with a virtual pen during the conversation. This helps the doctor show patients very specific visuals. One partner, the University of California at San Francisco (UCSF) cancer risk program, uses the service to show patients their cancer pedigree and discuss it.
HealthSpot, a company that has developed health kiosks which include virtual doctor visit capabilities, takes advantage of Vidyo's API for connecting devices. During a virtual visit, a doctor can listen to a patient's heartbeat, take their blood pressure, and look in their ear with a connected otoscope, to name just a few devices.
This is yet an area where the virtual visit outshines the in-person one, because, for example, the e-otoscope's readout shows up on the patient's screen as well as the doctor's, allowing the patient to see inside their own ear in near realtime. This makes it easier for doctor's to explain procedures or conditions and for patients to be even more of a partner in their own care.
4) More convenient, automatic record-keeping
In addition, because doctors are already using camera's in remote care it's very easy for them to securely and privately take and save a relevant medical photo, via a connected otoscope or dermoscope. That means when the patient is in for a follow-up visit, the doctor is more likely to be able to compare anything unusual to how it looked in the last visit. On the doctor's end, the patient's EHR can be pulled up right alongside the real-time videofeed, making it more convenient for the doctor to update information. If information is being gathered through data input on the patient's side, as with HealthSpot, that information can even (potentially) populate directly into the EHR.
5) Patients feel like doctors pay better attention to them during virtual visits
Anecdotally, patient response to virtual visits appears to be positive, and fears that patients will always miss the personal touch seem unfounded. In fact, something about the camera interaction actually makes some patients feel more connected.
"The content of the visits are quite similar. Once you've done this for a while, it can be a lot simpler," said Dorsey. "Patients will say to me 'I've never had someone listen to me like he did.'"
Johnston echoed that sentiment. "I'm still shocked by how patients tell us they feel the doctors are more focused on them," she said.
Vidyo's Senior Vice President of Vertical Markets, Amnon Gavish, said that the key to that kind of interaction is a high quality video feed with as little delay as possible.
"You get very low latency, which is lower than you would get with the phone line, and that actually contributes to a very natural flow of the call. It's proved to be critical to creating the trust," he said. "Patients and doctors say they forgot they were talking to the camera."