Why Online Care?
Wednesday, March 18, 2009
| Roy Schoenberg, MD, MPH
About the author - Roy Schoenberg, MD, MPH is President and CEO of American Well Systems.
In short - because using technology to “stretch” the healthcare system’s capacity is more realistic than miraculously “manufacturing” or importing the tens of thousands of PCPs we need…
Over the last decade, the need for healthcare services has grown dramatically. Aging population, obesity, stress on one hand, better-informed (demanding) patients and advanced treatment options on the other – are among the reasons fueling this growing need. Lately, the effort to bring healthcare coverage to more Americans is expected to grow this demand further.
Meanwhile, our supply has been shrinking. Physicians have been burdened by paper work, malpractice costs and daunting lifestyles to the point of exhaustion. Some of those who stay (and many young doctors who recently joined) choose specialties that offer some reward for these sacrifices. Primary care has consequently joined the endangered species list. The numbers are frightening.
It’s the little things – it takes longer to get an appointment, the appointments themselves are shorter in time, the physicians on your health plan directory are fewer and further from where you live, many of the PCPs tell you their “patient panel” is closed (it’s full), the ER in your community hospital has fewer physicians (and specialties) on call, and when you finally get to see a doctor, it costs you more. Much more.
And the healthcare professionals out there are trying their best to juggle it all and still treat everyone. If healthcare didn’t hit chapter 11 yet, it’s probably because of their dedication and passion. They would work longer hours, take calls without pay and endure a daunting lifestyle because the blanket is too short and leaving the patient in front of them without care is not an option.
So we need to find a way to restore the balance. Unfortunately, it’s hard to see how thousands of healthcare professionals (most requiring decades of training) will suddenly materialize all around the nation. It’s also unlikely that people will require less healthcare (although this is one of the key objective of the industry’s “patient empowerment” effort, essentially telling patients they need to learn how to care for themselves). And at this point of meltdown, we find creative solutions.
Online Care is among several solutions that aim at breaking the supply-demand mismatch. Minute Clinic employs nurses and nurse practitioners to allow patients to get care in pharmacies. If you call Tel-a-doc, they will find a doctor to call you back. Relay Health will help you get an answer over secure email and organized wisdom will go a long way to help you with professional advice. While their methods differ, all represent innovations in giving patients the access to timely healthcare services, access they growingly lack.
Online Care is a technology that brokers providers’ time to needing patients and establishes an informed audio-visual encounter between them. While the technology is modern, its goal is in fact more conservative than the ones employed by the solutions above. Instead of diverting patients to alternative care modalities, Online Care attempts to “stretch” the existing healthcare system, so it can cover more ground. On one hand, it makes it easier and quicker for patients to get in front of the same providers they would otherwise schedule appointments with. On the other hand, it makes it much easier for credentialed providers to offer their time to patients, capturing more “care opportunities” from the same “supply”. It is the first technology that aims to fundamentally reform healthcare not by distributing medical records, but by distributing actual medical services.
More than a sounding board, peer discussions like this one are crucial to assure the technology is used appropriately and responsibly to extend care to the people and places that lack it. We look forward to see you take an active and vocal part in guiding, shaping and realizing its potential.