Following the launch of the telehealth program in these two states during the first quarter, WellPoint plans to expand the initiative to the entire country, John Jesser, vice president of patient engagement strategy for the company, told InformationWeek Healthcare. American Well, a Boston-based telehealth firm, is providing the technology for WellPoint.
Anthem Blue Cross, WellPoint's California affiliate, and Anthem Blue Cross Blue Shield of Ohio will initially offer the new online care service, LiveHealth Online, to small- and large-group fully insured customers and self-funded national employers. Ultimately, all WellPoint health plans will include LiveHealth Online, Jesser said, unless a particular customer wants it excluded.
This means a lot of people will have access to telehealth. Nationwide, WellPoint plans cover nearly 33 million people. UnitedHealth Group, WellPoint's biggest competitor, already offers telehealth consultations in 22 states.
Anthem Blue Cross members will be able to initiate online encounters from their home or workplace via live audio/video and secure chat. Doctors will be available for consultations from 7 a.m. to 11 p.m. daily, including holidays. At the start, patients will use desktop or laptop computers with webcams; later, they'll have the option to use computer tablets and smartphones, according to Jesser.
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When consumers log on to the LiveHealth Online site, the system will ask them to choose one of the physicians that Anthem has hired to do online consultations. They'll see photos of the doctors, information on their background, and ratings of the doctors by other patients. After they've selected a provider and filled out a form describing their health problem, the doctor will review the information, along with notes from past online visits, Jesser explained. Following the visit, the system will ask patients to rate the doctor and for permission to forward a record of the consultation to their regular primary care doctors.
The rollout of the program to states other than California and Ohio will depend on the regulations in each state, Jesser said. WellPoint is now analyzing these regulations to make sure it complies with all of them.
State laws differ on two issues: whether or not a doctor and a patient can establish a legally recognized relationship through a telehealth hookup, and whether doctors can gather enough information through the remote interaction to write a prescription if a patient needs one. "Some states say a doctor has to physically examine a patient before writing a prescription," Jesser pointed out. "Others say a doctor should use his or her judgment about whether or not it's appropriate to write a prescription."
WellPoint is jumping into telehealth for three reasons, Jesser said: convenience, access, and affordability. "The current healthcare system isn't always easy for consumers to deal with," he noted. If a patient wants to be seen outside of his regular doctor's office hours, he may well go to the ER; but that isn't appropriate for minor acute illnesses, and urgent care clinics and retail clinics aren't available everywhere. "This is adding a new level of care," Jesser said.
With the arrival of healthcare reform, he continued, more insured people will try to access a shrinking supply of primary care doctors. So access to care is a challenge, and telehealth provides another avenue for patients.
In addition, Jesser noted, online visits to primary care doctors will cost only $50, which is less than consumers (or their insurers) pay for a retail clinic visit, and much less than for an ER or urgent care visit. WellPoint expects LiveHealth Online to be a money saver, so it won't increase the cost of insurance.
WellPoint also plans to offer its primary care doctors another version of the LiveHealth Online platform that they could use to treat their own patients remotely. The company has been meeting with medical groups across the country for several months to sound them out on this program. In general, the reaction has been positive, according to Jesser, but there have been some age-related and geographical differences in how the idea has been received.
Allscripts recently integrated American Well's telehealth platform into its EHR, and WellPoint welcomes this development. "The Allscripts integration is a great first step, and there will probably be others to follow," Jesser said.
Insurance companies and physicians alike were less than enthusiastic when secure online messaging came along a decade ago. One reason that doctors like telehealth better, Jesser said, is "the ability to visualize the patient." Current technology allows "Cisco-quality high-definition video on a browser," and it's also possible to connect medical devices such as digital otoscopes to computers.
Jesser envisions the emergence of "virtual worksite clinics" in the future. Instead of doctors needing to drive from one worksite clinic or skilled nursing facility to another, he said, they could perform virtual visits with many patients, using a nurse and some telehealth equipment to provide the information they need.
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