Rise in 'Virtual' Doctor Visits Sparks Need for More Clarity

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More than half of U.S. hospitals are turning to telemedicine to provide clinical services in a range of settings, in some cases enabling patients to consult a physician directly from home with a few taps on their smartphone.

However, the head of one large national company says Louisiana’s telemedicine regulations are ambiguous, and that Louisiana State Board of Medical Examiners inquiries into some physicians’ practices could stymie the industry’s growth in the state.

Other in-state health care providers also are seeking clarity from state regulators as they look to dive deeper into providing telemedicine services directly to patients.

With the advent of new technology come questions about how it should be regulated to ensure that patients receive the same quality of care from a distant doctor that they get in person.

Some of the concerns center on whether adequate equipment is being used to diagnose, monitor or treat patients outside a medical facility and on the potential use of third-party doctors unfamiliar with patients.

Telemedicine technology already is being used in different ways by several of the state’s big-name health care providers, including Ochsner Health System and LCMC Health, which manages University Medical Center and Children’s Hospital, both in New Orleans.

Industry supporters argue that, if used correctly, telemedicine can improve access to health care services, especially in rural areas, and can save patients the time and expense of traveling to a doctor, particularly for some routine visits, while reducing congestion in doctors’ offices and lessening a patient’s exposure to illnesses.

Additionally, they say, it can improve outcomes and lower costs. For instance, Blue Cross and Blue Shield of Louisiana’s telemedicine platform, BlueCare, bills just $39 or less per online visit, depending on the patient’s health plan. Patients can download apps that connect them to a doctor and get prescriptions sent to a pharmacy in minutes.

Asked about concerns over telemedicine, Blue Cross Chief Medical Officer Vindell Washington said the insurer is having “collaborative, ongoing communication” with all the parties involved to ensure “the ongoing, appropriate availability” of online doctor visits through BlueCare.

‘Working out wonderful’

One believer in telemedicine is Zachary resident Breshaunya Young. After having surgery last summer, the 24-year-old has been able to use her smartphone to seek medical advice from Dr. Aaron Martin, the clinical director of Children’s Hospital’s and LSU Health New Orleans’ telemedicine-to-home programs.

“I had never heard of it, and after I tried it out the first time, I actually enjoyed it,” said Young, whose surgery was done at Children’s Hospital.

Young has avoided the long trek into New Orleans since September. Instead, when she has questions — like when a blister recently appeared near her incision — she can send Martin a photo, and he can recommend a course of treatment.

“Right now, with it being flu season, I’m trying not to go to a doctor’s office,” she said. “This app is working out wonderful.”

While such programs are operating successfully, the Boston-based telemedicine firm American Well, which provides telehealth technology to insurers, hospitals, health systems and employers, says the Louisiana State Board of Medical Examiners has begun probing whether some physicians are flouting rules, even though they believe they’re operating within the prescribed limits.

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