Oct 25, 2012
On the website Vitals.com, people can read and write reviews about 870,000 doctors and thousands of insurance plans. They can also submit symptoms and then search for the type of doctor who can treat them. Visitors get feedback from others who have had surgeries and other procedures to compare rest times and side effects. The site started almost five years ago and has more than 11 million visitors a month.
“There are certain places in life where you have to go from a novice to an expert really fast, and the world of medicine is like that. There are not many tour guides,” says Mitch Rothschild, CEO of Vitals.com. He says more people are getting suggestions about doctors, procedures and the costs of insurance online, adding to the “Yelpification” of the health-care industry. “You can go online and know if a restaurant is good or if a hotel is good. But why not a doctor?”
More people are using websites like Vitals.com to help them with health-care decisions. The buzzword for this emerging online business is called telehealth or telemedicine. The industry includes web services that provide reviews and pricing information as well as connect patients with doctors. It also assists larger, established health-care providers communicate with their patients digitally. For example, a service called RelayHealth allows patients to directly email their doctors with questions, request appointments or get prescription refills.
For consumers, having healthcare information at their fingertips is often more convenient and engaging than waiting to hear from a doctor. According to a 2012 study by the New York-based consulting firm Makovsky Health and Kelton, 90 percent of adults use personal computers to research health information online. Most point to WebMD and Wikipedia as trusted sources for medical information. “Whether they want guidance for an informed conversation with their doctor or the support of a larger community coping with the same illness, consumers seek trusted sources for health information,” said Gil Bashe, executive vice president of Makovsky Health.
A growing number of Illinois residents who go without or can’t afford health insurance use telehealth to bargain shop. In July, Illinois implemented Medicaid changes that increased copayments, limited prescriptions and payments to pharmacies while decreasing services such as preventative dental screenings for adults.
In September, the unemployment rate in Illinois swelled to 8.8 percent, a percentage point higher than the national rate, according to the Bureau of Labor Statistics. Nearly 17 percent of Illinoisʼs workforce is classified as underemployed–people who have low-paying hourly jobs with no insurance or have stopped looking for work. For these people, comparing prices for out-of-pocket health-care services online is often a necessity.
Touré McCluskey is the founder of OkCopay.com, a website that prices medical services in Chicago and Milwaukee. He says the site attracts 25 to 35-year olds who are unemployed, have jobs that have gaps in insurance or have no insurance at all. “In downtown Chicago someone could go to a hospital that will charge them $2,300 for a MRI or could walk down the street and pay $350 for the same test,” said McCluskey. He worked in pricing, strategy and marketing at Eli Lilly Co. before launching OkCopay last year.
Consumers also can search through cosmetic and dental surgeons, dermatologists and urgent care centers using search tools on McCluskeyʼs site and compare prices on services based on ZIP codes. He plans to expand OkCopay.com throughout the Midwest. “Twenty years ago consumer products in health care werenʼt needed. But now there is a lot more information for people to sift through,” said McCluskey. “The consumer empowerment trend is a lot more prevalent in health care because the financial risks to the consumer are greater.”
Telehealth is not without its drawbacks. Thereʼs a lack of common standards and concerns about security, privacy and medical liability. Government agencies, which account for 60 percent of health care spending, also have been slow to reimburse patients for many telehealth services. For example, Medicaid and Medicare will only cover technologies and procedures that are “reasonable and necessary,” and usually require face-to-face doctor appointments.
“Payment has always been a struggle when it comes to telemedicine,” says Ben Forstag, spokesman for the American Telemedicine Association in Washington D.C., which has 5,000 members. He says many elderly patients or those who live farther from specialists often use the web to meet with doctors via Skype or other online videoconferencing services. “Medicare is often reluctant, but other government organizations are being more open. Private insurers see the advantages of expanding to include telemedicine because it broadens their customer base,” Forstag said.
A 2009 study by the U.S. Department of Commerce noted that if the telehealth industry could overcome these barriers, it could balloon to $1.8 billion by 2013, growing 56 percent per year after that. “Telemedicine used to be a lot of smaller companies but much of the growth is due to international players like Siemens and Bayer and that makes it a win-win for providers and customers,” says Forstag. For example, health-care giant Bayer offers videoconferencing to doctors that can monitor vital signs, scheduling and other at-home care for patients.
Jason Gorevic, CEO of Teladoc.com, says that telehealth websites are a solution for a shortage of primary care physicians across the U.S. “There are downstream effects of a massive primary care physician shortage and our website gives people high-speed access and alleviate cost pressures,” he said.
For $38, people can log on to Teledoc.com at anytime and make an appointment with a doctor in their state who will contact them within the half hour. Consultations take place via video conferencing or phone for non-emergency medical issues including colds and flu, allergies, pink eye and ear infections. If needed, doctors can prescribe medicines. Gorevic sees the website as a cyber urgent care center. “A younger patient may be more apt to use our video conference features, but older patients still suffer from a lot of these relatively minor conditions where people end up going to the emergency room,” he said.
Teledoc.com started in 2002 and now has 4 million members nationwide. Many of the doctors are licensed in multiple states and Gorevic says the website follows hospital-required security and privacy laws. The
website has doctors with more than 500 licenses. He says the majority of his members are businesses from small operations to Fortune 50 companies that offer the service as a complement to traditional insurance.
“The telehealth industry breaks down time of day and geographical barriers,” he said.