Transcript Telemedicine

Telemedicine
Presented by:
David Cloud
Director of Sales
MyidealDOCTOR
Definition
• Telemedicine is a doctor’s visit over the phone of via
video technology. It is a 24/7/365 service that allows
members to speak with a licensed physician who can
consult, diagnose, and if needed prescribe medication
for common and acute illnesses.
• Telehealth is the delivery of health-related services
and information via telecommunications technologies.
Telehealth could be as simple as two health
professionals discussing a case over the telephone or
as sophisticated as doing robotic surgery between
facilities at different ends of the globe.
History of Telemedicine
• 1964: Under a grant from the U.S. National Institute for Mental Health
(NMH), the Nebraska Psychiatric Institute began using a two-way closedcircuit TV link between the Institute itself and Norfolk State Hospital
about 112 miles away.
• 1967: A medical station was established at Boston's Logan International
Airport and linked to Massachusetts General Hospital (MGH),via twoway microwave audio/video link.
• 1971: 26 sites in Alaska chosen for telemedicine testing via satellite
communications.
• 1972: NASA begins using telemedicine trials to help people living in
remote locations with little or no medical services.
• 1972: The U.S. Department of Health, Education and Welfare (HEW)
funds seven telemedicine research and demonstration projects.
History of Telemedicine
• 1980’s: Multiple “start up” telemedicine providers market to rural individuals
and rural small businesses with little consistency and regulations
• 1994: 20 states adopt standard telemedicine regulations.
• 1997: Georgia adopts standard telemedicine regulations
• 2005: Telemedicine market grows to 2 million members nationwide
• 2012: Current market at 8 million members
• 2016: Due to physician shortages, new healthcare mandates, and access to
healthcare concerns, market expected to grow to 40-50 million members.
Physician Network
Most networks have at least 1 if not 4 of the following:
- Family Practice
- Internal Medicine
- Emergency Physician
- Pediatrician
• Most physicians on telemedicine networks hold multistate licenses.
• Member must be speaking with a physician that is
licensed in the state they are currently in regardless of
where they live.
Healthcare Access of the future
According to the
American Medical Association,
70% of doctors visits and
40% of ER visits
could be avoided through
telemedicine.
Common Conditions treated by
Telemedicine
- Asthma
- Allergies
- Bronchitis
- Cold and Flu
- Constipation
- Diarrhea
- Ear Infection
- Fever
- Gout
- Headache
- Infections
-
Muscle Strains
Insect Bites
Joint Aches
Nausea
Pink Eye
Rashes
Urinary tract infections
Prescription refills
Stomach Virus
Sore Throat
Chronic Heartburn
Telemedicine Liability
• Liability falls under each physician’s state license.
• Similar to a primary care physician, if physician is not
comfortable with a diagnosis they will refer a patient
to another physician/specialist.
• No prescriptions for Class II Narcotics or lifestyle
medication’s.
• Most providers publish zero malpractice claims.
Additional Telemedicine Benefits
Additional Benefits offered my most providers:
- Nutrition Management
- Weight Management
- Patient Advocacy
- Lab Testing
- Life Counseling
- Naturopathic Doctors
- Nutraceuticals
- Behavior Health (additional cost)
Additional Telemedicine Benefits
• Member Health Portal/EMR System
- Allows members to complete health history, schedule
appointments, research physicians.
- Stores doctor notes and recordings of all telemedicine
consultations.
- Allows members to share medical records with PCP or
other physicians.
- Allows members to store all medical records including
previous lab results, x-rays, doctors visits, etc on one
secured site.
- Allows members to email information only questions to
licensed physicians (live Web MD with physician).
Telemedicine Plan Designs
• PMPM Fee with Co-pay
- PMPM between $1.50- $4.00.
- Co-pay between $38-$50.
- Designed for large self funded/partially self funded groups.
- Integrated with health plan.
- PMPM employer paid.
- No broker commission/fees.
- Must comply with ERISA guidelines.
- Common in large employers.
- Providers include: Tel-a-doc, Consult a doc, MD live, Stat
Doctors.
Telemedicine Plan Designs
• PMPM Fee with No Co-pay
- PMPM fee between $5-$20.
- Available as employer paid, as a voluntary benefit, or on a
direct basis.
- Pays broker commissions/fees.
- Stand alone product, not attached to health plan.
- Can be used with self funded, fully insured, or uninsured
groups.
- Common in small to medium size employers (less than 5K)
- Only sold through brokers
- Providers: MyidealDOCTOR
Telemedicine Plan Designs
• Bundled Product
- Typically bundled with Legal plan, pet ins., discount
drug card, vision and dental discount card, road
side assistance, etc.
- Most are No Co-pay products
- Voluntary Only
- Typically sold by “direct” sales people
- PMPM fee between $15-$69.
- Providers: New Benefits
Member Benefits of Telemedicine
• Saves Time and Money
- 24/7/365 access to licensed physicians.
- Free consultations, no co-pays.
- Convenience of care via phone or video.
- Convenience of consultations from home, work, on
the road, or out of town.
- No more waiting in doctor’s office/ER waiting
rooms.
Employer Benefits
• Reduces doctor visits saving money on employer
healthcare cost.
• Reduces ER visits saving money on employer healthcare
cost.
• Reduces employee absence, increasing company
profitability.
• Increases employee satisfaction in benefit package.
• Direct Return on Investment (see calculator).
• Provides employees with state of the art benefits.
Changing Habits
• For Telemedicine to have the greatest impact on
healthcare, the public must change their existing
healthcare habits in regards to common and
acute illnesses:
- Become ill, take off work, wait in waiting room, see
physician, pay co-pay, pick up prescription from local
pharmacy.
- Become ill, call telemedicine provider, pick up
prescription at in network pharmacy.
Question and Answer
David Cloud
770-485-7119
[email protected]