Direct to Consumer Telemedicine

Elliott, Tania; Shih, Jennifer

doi:10.1007/s11882-019-0837-7

Cited by 39 publications

(19 citation statements)

References 13 publications

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“…Broadly, there are 2 models of eVisit (virtual visit) currently available in Canada and the United States—a pay per use model and an insured model. In a pay per use model, also referred to as Direct to Consumer, the consumer (patient and/or family) pays a fee to access a physician for a health care consultation through a virtual visit [33]. In the insured model, virtual visits are covered by private or public health insurance.…”

Section: Discussionmentioning

confidence: 99%

Home Virtual Visits for Outpatient Follow-Up Stroke Care: Cross-Sectional Study

Appireddy¹,

Khan²,

Leaver³

et al. 2019

J Med Internet Res

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BackgroundTimely, in-person access to health care is a challenge for people living with conditions such as stroke that result in frailty, loss of independence, restrictions in driving and mobility, and physical and cognitive decline. In Southeastern Ontario, access is further complicated by rurality and the long travel distances to visit physician clinics. There is a need to make health care more accessible and convenient. Home virtual visits (electronic visits, eVisits) can conveniently connect physicians to patients. Physicians use a secure personal videoconferencing tool to connect to patients in their homes. Patients use their device of choice (smartphone, tablet, laptop, or desktop) for the visit.ObjectiveThis study aimed to assess the feasibility and logistics of implementing eVisits in a stroke prevention clinic for seniors.MethodsA 6-month eVisit pilot study was initiated in the Kingston Health Sciences Centre stroke prevention clinic in August 2018. eVisits were used only for follow-up patient encounters. An integrated evaluation was used to test the impact of the program on clinic workflow and patient satisfaction. Patient satisfaction was evaluated by telephone interviews, using a brief questionnaire. Access and patient satisfaction metrics were compared with concurrent standard of care (patients’ prior personal experience with in-person visits). Values are presented as median (interquartile range).ResultsThere were 75 subjects in the pilot. The patients were aged 65 (56-73.5) years, and 39% (29/75) resided in rural areas. There was a shorter wait for an appointment by eVisit versus in-person (mean 59.98 [SD 48.36] days vs mean 78.36 [SD 50.54] days; P<.001). The eVisit was also shorter, taking on an average of only 10 min to deliver follow-up care with a high degree of patient satisfaction versus 90 (60-112) min for in-person care. The total time saved by patients per eVisit was 80 (50-102) min, 44 (21-69) min of which was travel time. Travel distance avoided by the patients was 30.1 km (11.2-82.2). The estimated total out-of-pocket cost savings for patients per eVisit was Can $52.83 (31.26-94.53). The estimated savings (opportunity cost for in-person outpatient care) for our eVisit pilot project was Can $23,832-$28,584. The patient satisfaction with eVisits was very good compared with their prior personal experience with in-person outpatient care.ConclusionsThe eVisit program was well received by patients, deemed to be safe by physicians, and avoided unnecessary patient travel and expense. It also has the potential to reduce health care costs. We plan to scale the project within the department and the institution.

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Section: Discussionmentioning

confidence: 99%

Home Virtual Visits for Outpatient Follow-Up Stroke Care: Cross-Sectional Study

Appireddy¹,

Khan²,

Leaver³

et al. 2019

J Med Internet Res

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“…With a home-based video interaction, the patient can have an interaction with a provider, who, in addition to obtaining a thorough history of symptoms and exposure risk, can perform an observational assessment. 11 This assessment should include the following:…”

Section: Home-based Video Encounters For Triagementioning

confidence: 99%

Telemedicine in the Era of COVID-19

Portnoy

Waller

Elliott

2020

The Journal of Allergy and Clinical Immunology: In Practice

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538

465

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“…As allergy care (allergic rhinoconjunctivitis, sinusitis, asthma/bronchitis, rash) has been a particular focus of DtC telemedicine companies, there is significant potential for patients with allergies and asthma to seek care outside of the medical home. A concern about this trend is that most of the virtual allergy care through DtC telehealth platforms has been provided by nonallergists, which may have implications for adherence to evidence-based best practices [21].…”

Section: Direct-to-consumer (Dtc)mentioning

confidence: 99%

Telemedicine Pays: Billing and Coding Update

Bajowala¹,

Milosch²,

Bansal

2020

Curr Allergy Asthma Rep

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Purpose of Review Telemedicine is a rapidly growing healthcare sector that can improve access to care for underserved populations and offer flexibility and convenience to patients and clinicians alike. However, uncertainty about insurance coverage and reimbursement policies for telemedicine has historically been a major barrier to adoption, especially among physicians in private practice (the majority of practicing allergists). Recent Findings The COVID-19 public health emergency has highlighted the importance of telehealth as a safe and effective healthcare delivery model, with governments and payers rapidly expanding coverage and payment in an effort to ensure public access to healthcare in the midst of an infectious pandemic. This comprehensive review of updated telemedicine coverage and payment policies will include a tabular guide on how to appropriately bill and optimize reimbursement for telemedicine services. Summary This review of current trends in telemedicine coverage, billing, and reimbursement will outline the historical and current state of telemedicine payment policies in the USA, with special focus on recent policy changes implemented in light of COVID-19. The authors will also explore the potential future landscape of telehealth coverage and reimbursement beyond the resolution of the public health emergency.

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Direct to Consumer Telemedicine

Cited by 39 publications

References 13 publications

Home Virtual Visits for Outpatient Follow-Up Stroke Care: Cross-Sectional Study

Home Virtual Visits for Outpatient Follow-Up Stroke Care: Cross-Sectional Study

Telemedicine in the Era of COVID-19

Telemedicine Pays: Billing and Coding Update

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