In cities like Los Angeles, there are thousands of doctors that a patient can choose from for an acne evaluation. The patient can read some reviews online and select a doctor in their city that fits the preferences.
When they call the office, the receptionist is able to fit them in at the end of the following day due to a cancellation. Sounds great, right? There is only one thing standing between them and their appointment, traffic.
Rather than endure the misery of idling in rush hour traffic for an hour, wouldn’t it make more sense to take a few photos of their acne with a smartphone and send it to a local dermatologist via HealthLens’ secure telemedicine platform? More and more patients are starting to think so.
So before you book an office appointment for 4 pm across town, consider using HealthLens to have your skin condition evaluated online by a doctor of your choosing. These online visits are covered by most insurances and patients typically get a diagnosis and treatment plan within 2 business days. If the treatment plan includes a prescription, that prescription is sent directly to the patient’s pharmacy.
As a dermatologist, the possibilities of telemedicine were evident early in my career. You did not need a patient to make a diagnosis. You just needed a good picture.
Telemedicine was initially promoted as a benefit to patients. It would increase their access to specialty care and surmount geographic barriers. Unfortunately, the only reimbursed format at the time was live interactive video, which was too impractical for widespread use. Patients also had limited access to the technology. Telemedicine languished.
During this dark time, I was involved with a few unsuccessful start-up telemedicine platforms that focused on direct patient access to specialists. There was a lot learned from the experience but there were no compelling reasons for physicians to adopt the practice.
That changed 2012 when California’s own telehealth law (AB 415) went into effect. Now physicians of all specialties would be beneficiaries of telemedicine. The new law authorized physicians to collect for all forms of electronic interaction. This means you could now be reimbursed for all the free care that you normally give out via the phone or email by using store and forward telemedicine.
The largest benefit, however, is the savings that will occur when physicians no longer have to shoulder the burden of rent, staff, and other expenses when providing care that can be done outside the boundaries of an office. As a result, physicians should explore what aspects of patient care can be responsibly provided online and then try to move patients in that direction. Any progress physicians make in moving portions of their practice online will be protected by the parity law. It requires that online visits be reimbursed at the same full level as an office visit. Telemedicine is now very practical.
Physicians should be wary of many of the telemedicine sites that are out there. Most of the ones you read about in the headlines do not meet the California Medical Association’s (CMA) Principles of Telemedicine. These are the anonymous doctor banks, prescription mills, and sites that use physicians in foreign countries.
Fortunately, there are telemedicine sites that closely adhere to the CMA’s telemedicine standards. Store and forward platforms like HealthLens (Author is a founder), Azova, and SkyMD enable physicians to practice online in a medically sound and ethical manner.
The primary standard is allowing patients to receive online care from their established physician. This enables follow up with that particular physician and a physical location if an office visit is necessary. Another CMA principle is that the patient’s medical insurance should be used to cover the visit. The CMA adherent platforms also provide secure messaging between patient and physician so the visits can be interactive.
Most commercial insurance companies including Blue Cross, Blue Shield, Cigna and United Healthcare cover store and forward telemedicine. Medicare only covers it in Alaska and Hawaii but there is legislation in progress to expand to all 50 states. To get reimbursed for store-and-forward telemedicine visits, just attach the GQ modifier to your CPT code; e.g. 99203 GQ.
In my practice, I see about 60 online patients per month. Acne, eczema and seborrheic keratoses make up the majority of the conditions I diagnose online. Time sensitive conditions like shingles are not uncommon online diagnoses and it is much easier to get patients on antivirals within that 72-hour window of opportunity when they don’t have to wait for an office visit.
I even see new patients on the internet. According to the Medical Board of California, you can evaluate a new patient online and establish a physician-patient relationship as long as the photo(s) submitted by the patient allows the physician to perform a physical examination that is adequate enough to reasonably make a diagnosis. Established patients, who make up the majority of my online visits, can be evaluated and treated without a photograph. This works out well for prescription renewals.
Medical research will also benefit from the shift to online care because of the data that telemedicine provides. In the short time HealthLens has been in operation, we have amassed a large library of clinical images, corresponding diagnoses, treatments and, most importantly, outcomes. The granularity of the data will allow for unprecedented levels of analysis.
Veering from long practiced norms is a troubling process for the medical community. However, the opportunity to eliminate so much of the expense involved in patient care cannot be ignored. Physicians should be leading the charge in shifting patient care online. We will be among the beneficiaries.
This is a guest post from HealthLens co-founder Christopher Schmidt, MD.
Last year, HealthLens say an array of patients using its platform to connect with their provider remotely. Many of the online visits were for skin checks; however, there were a number of other use cases that presented themselves throughout the year. As more patients use HealthLens, we expect to see even more interesting cases from patients all over the world.
Last year a patient traveling through India was able to connect with his dermatologist in San Jose. HealthLens offered a prompt response to his concern about a newly developed rash.
The oldest patient treated on HealthLens was 81 years old and she used her iPad to submit the visit without the assistance of anyone. HealthLens saw a number of Medicare patients use the service even though Medicare does not cover store and forward telemedicine….yet. These Medicare patients often cited the convenience of not having to travel to the doctor’s office as the main reason for using HealthLens.
The youngest patient treated on HealthLens was 10 years old. This girl, with the help of her mother, was able to submit a virtual office visit to her doctor. HealthLens also connected hundreds of college students with the doctor they grew up visiting.
2016 showed steady growth both HealthLens and for the telemedicine market. Many HealthLens patients are continuing to use the platform over and over again. 2017 promises even more growth as more people are warming up to the idea of visiting their doctor online. HealthLens is excited to help facilitate this connectivity with the providers that patients know and trust.
HealthLens is pleased to welcome to Dr. Kjartan Armann and Dr. Sima Stein to the HealthLens community of doctors. Patients for both doctors will now be able to send “virtual visits” to their respective doctors online via HealthLens’s secure telemedicine platform.
Dr. Armann is a pediatric physician located in Los Gatos, California. For over 30 years, Dr. Armann has been providing pediatric care for all children from infants to teenagers. Regarded highly by his colleagues and parents, Dr. Armann has a track record of healthy patients and warm reviews. Dr. Armann uses HealthLens to evaluate dermatological conditions and refill prescriptions online.
To start an online visit with Dr. Armann, head to KJKID.com and click on “Online Visits.”
Dr. Stein is a distinguished pediatrician with practices in both Mountain View and San Jose. Her practices are dedicated to providing the highest quality medical care to infants, children, and young adults of all nationalities. There are not many other pediatrician offices that can provide services in English, Chinese, Hindu, Russian, Spanish, Ukrainian, and Vietnamese.
Dr. Stein uses HealthLens to evaluate patients who are out of town, at school, or just too busy to come into the office for an evaluation.
To start an online visit with Dr. Stein, head to Doctor-Stein.com and click on “Start an Online Visit.”
Many times patients are curious as to why they have to supply a general appearance photo along with their condition photos when submitting a virtual visit on HealthLens. A general appearance photo is essentially a “selfie” and it serves a couple of important functions during the online evaluation.
Foremost, the general appearance gives the doctor an up-to-date look at the patient’s overall health. If the doctor has never seen the patient before in their practice, this picture provides them with a foundation to compare the patient’s overall skin quality to the skin quality in their condition photos. It is a simple way to gauge how much sun damage the person may have. If it is an existing patient but the doctor has not seen him or her in their practice for a substantial period of time, the general appearance photo allows the doctor see if there have been any dramatic changes to the person’s health or skin quality besides normal aging.
A secondary purpose is that the general appearance photo helps the doctor instantly identify which patient they are evaluating. At a busy practice, there are usually a few patients who share the same name. Likewise, many doctors see multiple siblings from the same family in their practices. This photo eliminates the chance of the doctor getting two patients with the same name mixed up.
The general appearance photo is a vital aspect of your virtual visit on HealthLens. The best way to provide your doctor with a quick snapshot of your overall health is to provide the most recent photo possible. A “selfie” taken while completing the visit works great! So the next time you are submitting a virtual visit on HealthLens to your doctor, keep in mind the comically catchy lyrics of The Chainsmokers’s EDM hit song, “#SELFIE,” which go “But first, let me take a selfie.”
In an age where almost all consumer goods and services can be hailed instantly from the customer’s phone, prompt access to a medical doctor through a smartphone seems to be an appropriate fit for today’s “Uber Economy.” It’s one of the most touted benefits of telemedicine. Patients can connect with a doctor quickly and more conveniently than a traditional office appointment. But like with all new technology, there is a trade-off. In exchange for urgent medical advice, patients are connected with healthcare providers who they have never seen before, and will most likely never see again after the telemedicine visit.
This puts the providers in a tough situation as they feel compelled to take a “worst case scenario” approach to their diagnoses and treatment recommendations. The fear of underdiagnosing a patient outweighs the consequences of prescribing medications that the patient might not need. The most common example of this is the unfettered prescribing of antibiotics by telemedicine doctors. Instead of waiting for confirmation that the patient is not reacting to a virus, these doctors will usually prescribe antibiotics just in case it turns out to be a bacterial infection.
So how can telemedicine companies combat the overprescribing of antibiotics and other prescriptions? The solution is quite simple. Connect patients with doctors who can monitor the patient’s progress over time. At HealthLens, only doctors who are active members of a practice can join. This allows the patients to select a doctor in their area so they can visit their office for additional tests and procedures if necessary. HealthLens also allows the patients to ask the doctor questions after the diagnosis has been made, which improves adherence to treatment plans and, consequently, patient outcomes.
By lengthening the care window from 10 minutes to however long it takes for the patient’s outcome to improve, HealthLens’ telemedicine platform helps doctors make more accurate assessments and recommend more appropriate treatment options.
To find a doctor in your area who uses HealthLens to evaluate their patients online, visit HealthLens.com.
The new school year is right around the corner for most college students. With 100% of their time and energy focused on finding the proper balance of good grades, work, social life, and sleep, their health can easily fall to the bottom of their priority list while at school.
When health concerns do arise for college students, many of them are reluctant to seek medical attention – citing their busy schedules as a common excuse. Even though their campus health clinic is a nearby option, many students prefer to seek treatment from the doctors with whom they have pre-existing relationships. They know that their doctors back home have a much better understanding of their health and lifestyle than a new doctor who won’t have the time to really get to know them.
That’s why Michael, a student at UC Davis, and many of his classmates, use HealthLens to be evaluated by the doctors they know and trust. “A few weeks ago, I went mountain biking and a couple days after the ride I developed a rash on my calves, thighs, and forearms. I assumed it was just a reaction to poison oak, but after a few days the rash kept getting worse and worse. I decided to use HealthLens to send pictures of the rash to my dermatologist in Los Gatos. He confirmed it was a bad poison oak reaction, and recommended a cold compress and prescribed prednisone to a pharmacy in Davis.”
A growing number of millennials like Michael are turning to telemedicine to address their medical concerns. “It’s convenient, fits my budget, and was as simple as sending an email,” said another UC student who used HealthLens to have an ominous mole evaluated by her dermatologist. “Best of all, I knew who would be evaluating and caring for me, my doctor.”
If you are one of the many students who prefers to be evaluated by their own trusted doctor, but doesn’t want to spend Thanksgiving break in their waiting room, try HealthLens and connect with your own doctor.
As you get older, it’s no secret that your toes can become rather unsightly, especially if you’re a guy. The culprit is toenail fungus. Toenail fungus causes nails to become thicker, more brittle, ragged, and crumbly. Your spouse and kids will describe the sight of your toes as grotesque.
Fortunately for them, and you, help is on the way. Podiatrists are now using HealthLens to evaluate patient’s toenail problems remotely without the need for an office visit. Patients are taking 1-3 sharply focused photos of their toes, answering a few questions, and sending the case to their podiatrists. Within a day, the patient receives a diagnosis and treatment plan from the doctor. If the treatment plan includes a prescription, it has already been sent to the patient’s pharmacy.
If you have some unsightly toenails, give HealthLens a try and connect with a podiatrist near you. Your spouse and kids will thank you.
Dermatologists use telemedicine to evaluate moles and rashes from afar. Surgeons use telemedicine to perform wound checks without an office visit. Pediatricians are also beginning to employ telemedicine in their practices to evaluate rashes, moles, cuts, and much more online. Their patients love the convenience and it saves pediatricians and their staff from spending much of their day on the phone with concerned patients and parents.
Time and time again, we hear pediatricians describe an all too familiar occurrence. A parent calls the pediatrician’s office and informs the staff that their son Billy has contracted a rash and it’s imperative that the doctor evaluates his rash ASAP. The problem is the doctor does not have any available appointments for the next few days and Billy’s schedule is too busy to take advantage of any last minute cancellations.
The solution is simple, it’s telemedicine. If the pediatrician uses a telemedicine service like HealthLens, Billy’s parent can snap some photos of his rash, answer a few questions, and securely send it over to his pediatrician. When his pediatrician has a break in the action, he or she can log into HealthLens, evaluate Billy’s online visit, render a diagnosis, create a treatment plan including a prescription, and send it back to Billy and his parent. The whole process takes about 5 minutes for both parties and Billy’s parent can rest easy knowing a diagnosis from Billy’s own doctor will come in less than 48 hours.
The next time you need to have something evaluated by a doctor, check to see if they offer online care before going through the tedious process of scheduling an office visit.