Visiting the Doctor, Virtually

By ANN CARRNS

We’ve all wished at times that we could just chat with a doctor from our office, instead of taking time away from work to drive to the clinic. Now, a case study of medical care delivered online suggests that virtual visits can effectively treat some common ailments at a lower cost than in-person visits.

A report by the creators of the Virtuwell clinic, an online service started by the HealthPartners health care system in Minnesota that has handled roughly 40,000 cases, says that such visits were, on average, $88 less expensive than treatment provided in traditional settings. The visits also saved an estimated 2.5 hours, on average, of patients’ time.

Still, the summary of the clinic’s operations is of interest as the medical world seeks ways to make use of the Internet for patient care. The report says, for instance, that while the retail cost of a Virtuwell visit is $40, some insurance plans cover the visits at a lower co-payment for their members. Roughly 85 percent of Virtuwell visits have involved an insurance claim, the report says; in 2011 Virtuwell was the first online “convenience care” to receive approval for Medicare coverage.

Virtuwell’s Web site, which serves patients in Minnesota, Michigan and Wisconsin, features the slogan, “Sick? Click. Cured.” The service works like this: Patients go to virtuwell.com and answer questions about their symptoms and medical history, any allergies and medications they are taking. (The questionnaire begins by asking, “What do you think you have?” and features a drop down menu listing conditions like acne, flu, deer tick bite and yeast infection. Placing the cursor over the condition reveals a brief description of the symptoms.)

A certified nurse practitioner then reviews the questionnaire and writes a treatment plan − usually within 30 minutes. The patient is notified by text or e-mail when the plan is ready. If a prescription is needed, it is sent electronically to the pharmacy of the patient’s choice.

If they wish, customers may communicate by e-mail or phone to a nurse practitioner, during or after their online visit. Nurse practitioners also initiate calls to patients in about half of the cases, the report said.

The nurses evaluating the information follow well-established clinical guidelines developed by HealthPartners and other Minnesota-based health systems. In the case of a suspected urinary tract infection, for instance, the guidelines state that a low-risk patient with a typical range of symptoms may be safely treated without an in-person exam or laboratory testing. The most common ailments treated by Virtuwell are sinusitis, urinary tract infections, conjunctivitis and viral upper respiratory infections.

Virtuwell does not handle conditions in which the guidelines direct an in-person exam, lab tests or X-rays. Roughly 56,000 patients reporting symptoms outside the service’s scope were referred to in-person providers, the report says. An analysis of antibiotic prescriptions suggests that they are prescribed appropriately by Virtuwell practitioners.

Before such services can be more widely available, however, state laws and regulations must be changed. That includes laws that require doctors or nurses to be in the same state as the patient, and requiring the doctors or nurses to have had a previous face-to-face visit with a patient before treating them remotely.

After reading

Would you use an online service like Virtuwell? Discuss it with your partner.

IV. Speaking Tasks

Role-play

You will be divided into 2 groups: Doctors and Patients. Doctors are given the Doctor's Activity Sheetand the Treatment Cards. Patients are given the Patients Activity Sheet and three Ailment Cards.

For each ailment, the patients will visit two doctors and get some advice and a prescription.

But first you should make a Doctor's Appointment. You will work in pairs: a Receptionist and a Patient. Read the lists of Key Making an Appointment Phrases and Sample Conversations then act your own conversation.

Key Making an Appointment Phrases (Booking a Doctor’s Appointment)

Sample Conversations (Booking a Doctor’s Appointment)

1.

2.

Patient’s Activity Sheet

You are a patient. Visit your doctor and tell them about your condition. Write down your doctor’s recommendations in the table below. You should “get a second opinion”. Visit two doctors for each ailment.

Ailment Role Cards

Doctor’s Activity Sheet

You are a doctor and patients are going to come into your office. Ask them about their condition, prescribe some medicine, and give them some advice.

Sample Conversation: Visit to the Doctor

V. Grammar Check

The words listed in the table below are nouns. What are the verb forms of these nouns? The first point has been done for you as an example.