The Virtual Doctor's Visit

Aging studies don't tell much about its inevitability

Wait, wait, don't tell us. If we are patient, media reports will enable us to fully catch up with attitudes about technology in 2006. No, despite many typos in this blog, that's not one. Virtual doctor's visits were recently discussed in a New York Times article that I posted, "Are Doctors Ready for Virtual Visits?" The answer was a definitive "no" based on a study published in the Journal of the American Medical Association (JAMA).

But as one observant reader checked, that JAMA telehealth study, published in late December 2009, was based on attitudes of doctors surveyed between 2004 and 2006! The iPhone launched in 2007. Skype was bought by eBay in 2005, and by 2006, there were more than 100 million users—apparently there are now more than 300 million users. Google launched video chat for Gmail in 2008. Hmm. Do you think between 2004 and 2006 doctors and nurses (outside of work) had much so-called virtual exposure?

How intriguing. Other surveys after 2006 contradict the JAMA study. Massachusetts General Hospital published a study in May 2009 that separated patients into groups (in person and video conference) and found that patients and doctors thought the experience was satisfactory. That study was conducted by Dr. Ronald Dixon, who runs the Virtual Practice Project at MGH. Here's another online survey that showed split enthusiasm of 970 prospective patients about the “concept” (not the experience).

Since 2006, some insurance companies and states endorse virtual visits. Several insurance companies already reimburse for online (email) visits with doctors, as Aetna and Cigna began doing in 2008. In Texas and Hawaii, online interaction with the doctor is now part of some family practices. And Blue Cross of Minnesota announced the opening of a virtual clinic using American Well software and webcam.

Forget the JAMA study—here come virtual visits. Medical practices, hospitals, and clinics are well aware of a much-changed world and consumer health care costs that can be breathtaking. American Well's virtual visit platform use is growing, as are other virtual platforms discussed in our 2009 Calibrated Care report. They have read about transformation of self-care and virtual visits in Denmark.

Given the geographic distribution of people, the distance required to reach doctors in some states and rural areas, and the availability of technology that was barely known or completely unknown in 2006, virtual doctor’s visits are going to happen. Reimbursement has begun, criteria for their use has emerged, and the JAMA study (and its much-syndicated press coverage) is already irrelevant.


By Laurie Orlov
Aging in Place Technology Watch Blog

[Originally posted January 13, 2010, at Laurie's Aging in Place Technology Watch Web site.]