Pesky minor ailment at an inopportune time? There's an app for that

April 15, 2016

Smartphones are everywhere. So are the germs that cause colds, pink eye and flu.

Mobile device users, especially younger Americans, are used to getting information and services quickly and with their fingertips, wherever they are. Health systems are trying to build connections to them by developing apps and web-based services to treat minor ailments.

"I'm part of the generation that expects to get health care at any time of the day, on our terms," said Mandy Bell, 32, quality and innovation officer for Avera eCARE, the division focusing on telemedicine for Avera Health in Sioux Falls, S.D. "That is one of the groups we are trying to serve."

Fast and convenient
Avera Health; Bon Secours Health System of Marriottsville, Md.; Centura Health of Englewood, Colo.; KentuckyOne Health of Louisville, Ky.; Milwaukee's Ministry Health Care; and SCL Health of Broomfield, Colo., are among the Catholic health systems that offer medical services that patients can access from smartphones, tablets and other handheld electronic devices. Patients can get a diagnosis and treatment plan within minutes; most services offer around-the-clock access. The services are for people with nonemergency conditions, such as allergies, colds, coughs, the flu, sinus infections, pink eye, skin conditions, back pain and urinary tract infections.

Patient Lauren Prezioso uses her cellphone camera to show Dr. Andreya Risser her throat during a medical consult via the Bon Secours 24/7 mobile app.

For most of these online services, patients spend several minutes on a secure connection registering and then completing questionnaires about their symptoms and medical history. Then, typically, an algorithm determines whether the service can handle the case or whether the patient should be seen in person. If the medical concern falls within the service's scope, a clinician receives the patient's information and then connects with the patient, usually through videoconferencing.

The clinicians normally are physicians or advanced practice providers that are part of the health system's clinical staff or that are employed by a partnering company.

The online consultations usually last less than 20 minutes; some patients will be advised to see a clinician in person. The clinicians can provide follow-up care plans and many can write prescriptions for a limited formulary of drugs. The visits normally can be charted in patients' electronic medical records.

Ministry providers say they view the services as supporting patients' relationships with their usual primary care providers.

Patients pay a set, per-session price — which is usually under $50 and which is sometimes covered by private insurance (government insurance programs normally do not cover the visits). Patients normally do not pay if the session does not produce a diagnosis and treatment plan.

Described as a "mobile video visit app," Avera Health's service began in June and is available within the system's five state service area. All Avera providers staffing the service are licensed in those states: Minnesota, Iowa, Nebraska, and South and North Dakota.

Avera Health said it takes about two minutes or less to start a visit with an on-call provider after the request is made, and the visit generally lasts under ten minutes.

Dr. David Basel, of Avera Medical Group in Sioux Falls said Avera Health requires the video contact because it "provides us with so much extra information — their body language, how sick they appear to be. We get a better feel for the situation by watching them."

Basel said the service is ideal for the largely rural area Avera Health serves. "We know that we have to make health care more accessible and convenient to our patients," he said. "We have to keep pace with the times."

AveraNow participants don't have to be Avera Health patients already, and people visiting the states served by the health care system can use AveraNow.

Bon Secours 24/7
In January, Bon Secours Health System launched Bon Secours 24/7, its mobile app for virtual medical visits.

Depending on the condition and clinicians' availability, Bon Secours 24/7 patients can choose whether to be connected with a physician, nurse practitioner or physician assistant.

Bon Secours President and Chief Executive Richard Statuto said, "What Bon Secours is really doing is increasing the access points for health care in the communities we serve and making it as easy as possible for patients to access a provider in an appropriate way."

Centura Health's virtual care service
Through a partnership with telemedicine technology and staffing company MDLIVE, Centura Health just launched a virtual medicine connection for people in Colorado and western Kansas. Users can access a board-certified physician around the clock via online video, mobile app or voice connection over the phone or computer. The service can assist people in locating a primary care provider for follow-up care.

Centura says the service includes "robust phone support" for patients who are not computer-savvy.

KentuckyOne's Anywhere Care
Launched in November 2013, Kentucky-One Health's Anywhere Care provides phone and video consultation with a board-certified family practice provider, for new or established KentuckyOne patients and KentuckyOne employees and their families.

Kathy Love, KentuckyOne strategy and business development representative, said when people have convenient options, they are more likely to seek help, which can prevent serious illness from developing.

Ministry Health Care's HealtheVisits
Since November, Ministry Health Care has offered HealtheVisits to people age 2 to 65. It is available every day, from 7 a.m. to 10 p.m. Patients must be in Wisconsin to participate, and tourists can use the service.

Select Ministry Health doctors, physician assistants and nurse practitioners make up the team fielding HealtheVisits inquiries. Patients complete an online questionnaire, and then the appropriate clinician is alerted to the inquiry and responds within an hour with a diagnosis and, if warranted, a prescription, said Josh Ice, director of primary care for Ministry Medical Group, an affiliate of Ministry Health.

Ministry Health chose not to pursue video visits, because of the time required of patients to schedule and complete them, according to Ice.

SCL Health's Doctor on Demand
Through a partnership with Doctor on Demand, a privately owned video medicine provider, SCL Health has been offering on-demand physician video visits to SCL Health associates and the general public since late last year.

Users can access a board-certified primary care physician from anywhere there is an Internet link, according to information from SCL Health. Doctor on Demand physicians staff the line; in the future, SCL Health plans to enable its employed physicians to do so.

SCL Health employee Eileen Quist used Doctor on Demand in November, when her then-11-year-old son Kolby came down with a fever, inner ear pain and a sore throat.

Quist said Kolby sat comfortably at home, wrapped in a blanket during the visit. "He felt very comfortable with it," Quist said of the virtual office visit. "Kolby liked that (the doctor) made huge efforts to connect with him, and she was very compassionate with him."


Copyright © 2016 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Copyright © 2016 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.