Telemedicine and the Coronavirus

Coronavirus could be a boon for telemedicine, as health industry hopes to keep ‘worried well’ out of the hospital

By: Christina Farr (Published on CNBC)

As the coronavirus continues to spread across the U.S., hospitals and insurance companies are expecting a swell in visitors to clinics and emergency rooms.

But the crisis could provide a bright spot for one sector of the health industry that has struggled to gain widespread acceptance: Telemedicine.

Virtual services, like online symptom-checking tools and remote consults with doctors, could keep the so-called “worried well” from flooding hospitals. If the healthiest people don’t show up in emergency rooms, that could mean that more resources are available to treat the sickest and most vulnerable patients.

Official recommendations from both the Centers for Disease Control and the World Health Organization encourage the use of telemedicine apps. Public companies that offer telemedicine, including Teladoc, have seen their stock surge in the past week, and many private start-ups, from AmericanWell to Plushcare, tell CNBC they are bracing for increased usage.

Insurance companies are starting to follow suit. Anthem, one of the largest insurers, is ramping up its telemedicine tool, called LiveHealth Online, with a greater volume of physicians and other health professionals lined up to consult with patients who are concerned about the coronavirus, according to two people who are familiar with the company’s plans but not authorized to speak publicly about themThe health insurer is also expanding the availability of its SMS messaging tools for members who want to ask questions, these people said. A spokesperson for Anthem did not respond to a request for comment.

United Health Group said it has services already available for members to book virtual consults, including via its free app, but did not comment on whether it’s planning to do anything additional related to the coronavirus. Aetna offers video visits through the CVS MinuteClinics, which is a cash-only service. Aetna, which merged with CVS in 2018, also has a telemedicine benefit through Teladoc, which takes most forms of insurance.

“Virtual care options such as video visits can be an effective way to evaluate and treat viruses from the comfort of one’s home, while minimizing exposure to other potentially contagious viruses,” an Aetna spokesperson said.

Avoiding a run on the health care system

Telemedicine providers are updating their services regularly as public health organizations release new information.

Some apps like Buoy are using symptom-checkers based on guidelines from the CDC. Other apps, like American Well and Doctor on Demand, offer patients a way to book an online consult with a doctor or nurse to help them determine if they should see a doctor in-person, go straight to the emergency room or to urgent care.

Execs behind these apps say that many healthy people are using the apps to look for reassurance.

“We are seeing an uptick in patients worried about COVID-19 (who are) booking visits, with some demanding a stockpile of inhalers, home oxygen, and antibiotics,” said James Wantuck, the co-founder of the telemedicine start-up Plushcare. Wantuck said that the company is instead recommending that patients without symptoms should buy hand soap and sanitizer and a 90-day supply of their current medications.

“It’s much better to triage people remotely so you can…only send the cases with complications to the hospital,” said Allon Bloch, the CEO of K Health, which provides a symptom-checking service. “This way you can avoid a ‘run on the bank,’ where everyone wants to see a doctor.” Anthem has a partnership with K Health to scale out its symptom checking and medical chat app, which it is making available to members.

For those who do feel sick, Wantuck and his team of doctors are assessing signs of respiratory illness, including coughing and hacking, as well as a high fever. If they are concerned, they’ll send patients to get chest x-rays or to the lab for blood tests.

Many lawmakers believe that telemedicine apps like Plushcare have a lot of potential, especially during a health outbreak. But there are still challenges to widespread adoption, including the lack of reimbursement and the physician licensing requirements that vary state-by-state. Most states, for instance, will not allow physicians to practice across state lines. That has been challenging for patients in rural areas, where there are fewer licensed physicians.

“If we are doing it (telemedicine) to address the coronavirus there would need to be more dramatic action like…guaranteeing reimbursement,” suggests Wantuck.