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Virtual Doctor Visits Considered Major Step Forward for Maine Patients

Patty Wight
Anthem's Rory Sheehan demonstrates a video doc visit.

Seeing the doctor is now only a few clicks away, thanks to new apps that allow you to do virtual visits on your computer, smartphone or tablet. Anthem Blue Cross and Blue Shield announced today that it's covering video visits for most of its Maine members when they use the Internet tool LiveHealth Online. Many see the development as a major step forward in convenience and access to health care.

Say you've got a health concern such as a sore throat or a rash and you want to see a doctor. But you can't peel away from your job. Or your illness crops up in the middle of the night. Maybe the weather's too bad for driving. If it's not an emergency, a video visit is a great option, says Dr. Jeff Holmstrom, medical director at Anthem and practicing family physician.

"They can get sound medical advice, treatment if appropriate, for routine medical conditions," he says.

It's not a replacement for a primary care doc. It's for greater access and convenience, says Anthem spokesman Rory Sheehan. He demonstrates how to use LiveHealth Online on his smartphone.

"So I downloaded the app," he says.

Then he created a profile with his name, insurance and contact information. The app appears as a white square on his phone, and he taps on it.

"So then when you get into it, you get a listing of all the providers," he says. "And it will tell you which providers are available."

There's a picture of each doctor, all U.S.-based, along with basic information about their experience and the cost of the visit: $49. If you're covered under Anthem, a visit at LiveHealth Online will cost you a typical office co-pay: about $20. Sheehan chooses a doctor in Vermont, and as he waits for his appointment to begin, someone named "Katie" appears on his phone.

"We're waiting here for a few minutes while your care provider opens your file and reviews the information you've shared," Katie says. "Just like in the office, they want to know a little more about you and your health care concerns before entering the room."

About a minute later, a cheerful doctor appears by live video on Sheehan's smartphone.

"Hi Rory — Hi! This is Dr. DeHaas," Dr. Sherri DeHaas. She says after meeting her virtual patients, she asks some questions, then moves to a physical exam. Yes — a physical exam over two-way video.

"I guess the question would be, how do you do a physical exam for a patient who's not in front of me?" DeHaas says. "But we can actually do a pretty good job."

Take a sore throat. DeHaas says she'll have patients get really close to the camera on their phone or computer and shine a flashlight in their mouth. Once she makes a diagnosis, she'll call in a prescription if necessary, then send follow up info to the patient and their primary care physician. Visits can run as long as 50 minutes, but most are only 8 or 9. DeHaas left an office setting to work solely as virtual doctor a little more than a year ago, and says she now gives better care.

"Because I can spend enough time with the patients," she says. "I know it doesn't sound like it because it's only 10 minutes. But in reality, before, in a 15-minute visit, I had to address the concern, and 3, 4, 5 chronic concerns, and I had to address preventative care, and I had to document the visit, and I also had to look at labs. So there was so much I had to squeeze into a 15-minute visit, I felt I couldn't do such a good job."

Studies by the Rand Corporation and the University of Pittsburgh about virtual visits found they don't result in any more follow-up visits than a typical office visit, which can be a sign of misdiagnosis. Researchers did find that doctors are more likely to prescribe antibiotics in a virtual visit. Dr. Wendy Wolf of the Maine Health Access Foundation says virtual visits aren't suitable for all circumstances, but they're an important step forward in patient-centered care.

"Currently, it's really arranged more to serve health providers with limited hours and usually having to go to offices for in-person visits," Wolf says. "And yet many things can be easily addressed by phone or video chat."

Other insurance companies have started covering video visits in additon to Anthem. In January, Cigna offered visits with MDLive as an option for employer-based health plans. Maine Community Health Options also offers coverage for any HIPAA-compliant telemedicine service.