Web Diagnosis Enables Physicians to Extend Practice

Patrick Courneya, MD, has been a Minnesota-based family physician for more than 20 years. Recently, he has seen the impact the shortage of primary care physicians and healthcare needs of an aging baby boomer population have had on his practice. Combined with increasing focus on the medical home concept, Courneya has found been confronted by a growing shortage of his own: time.

“My plate is so darned full right now, that accepting more and more responsibility for a broader array of services as the medical home concept gets implemented, I really wonder how I’m going to be able to achieve it,” Courneya says.

The solution may be in the form of a new online convenience care service called Virtuwell. Launched in October 2010 by HealthPartners, the nation’s largest consumer-governed, non-profit healthcare organization, Virtuwell may provide the relief that Courneya and other physicians seek.

Alleviating a Burden

Virtuwell provides consumers with online diagnosis and treatment for common medical conditions, and will even issue prescriptions as needed. The service is available year-round at a cost per patient of $40, or the cost of a co-pay if the health insurer agrees to cover the cost. (HealthPartners and Cigna now cover Virtuwell “visits.”) HealthPartners believes the service will help keep patients with minor ailments out of its busy clinics.

“It’s pretty clear to us that we have to figure out more creative and convenient ways to take care of some of the simpler medical conditions,” explains Kevin Palattao, vice president, Virtuwell and HealthPartners. “Virtuwell is an element of our overall care delivery strategy, and it offers a very unique solution for attending to those types of items.”

Courneya, who is also a medical director with Virtuwell, recalls a time in his career when a simple case coming into his office was considered a relief in the day. “I didn’t have to engage in too much of my clinical thought process to manage it,” he says. Virtuwell has freed up time to spend with the portion of his patient population where his expertise can be used to its fullest effect. “It’s really an extension of the 24X7 service as a physician,” Courneya says. “I haven’t invested a dollar in it, but my patients can use it.”

Keeping Physicians in the Loop

Virtuwell’s Palattao explains that there are more than 9,000 documented conditions in the clinical lexicon, and the company is targeted to treat approximately 35 of those right now. Those conditions were selected because “we feel those are the ones that can be safely treated with a good medical interview, and don’t require a lab test, imaging study, or physical exam to achieve an accurate diagnosis,” he says.

However, Virtuwell has several hundred safety protocols built into its interview algorithm, and will stop the interview if certain red flags pop up to explain to the consumer about the proper standard of care where their condition is concerned.

Take, for example, a female patient who indicates she may have a bladder infection. “Let’s say you’re going through the interview and you say your symptoms have been going on for more than seven days. We’re going to stop that interview and point out that symptoms for more than seven days may be a sign of something more serious,” Palattao says. There’s an immediate concern about kidney infection, and the standard of care there is to get a physical exam and a urine test to make sure that nothing more serious is going on, he says. If the consumer has a physician that she has a relationship with, it is recommended that she go see that person immediately; if not, Virtuwell provides a zip code physician finder that helps the patient find a facility close by.

When consumer go through the entire process and submit their interviews, a well-documented treatment plans are designed. That treatment plan belongs to the consumer, and is available online whenever he or she needs it.

“If a physician is automated, or is web-enabled, and the patient is in their physician’s office for some other reason, they can pull up that care plan right the screen with the physician using their own access to it,” Courneya says. “So, there’s a fairly quick and convenient way where a patient in the room could be sharing that care plan and the diagnosis with the physician. It’s certainly easier than for me as a physician to ask my staff to go out and contact the urgent care [facility] the patient went to last night, or the ER they went to, and have them fax over the record.”

Most importantly, says Courneya, Virtuwell has enabled him to work more efficiently while managing a larger patient population. “It’s not the best use of my time to talk to a patient about their cold when I know somebody else can do that for me,” he says.