Can Virtual Medical Consultations Expand and Improve Health Care?

For 44 million people, health care is a luxury beyond reach. No wonder, then, that health care reform is the topic du jure across the country this year.

As Washington politicians debate an expansive and expensive universal health care bill, many are looking for ways to bring the cost of health care within reach of those left behind. How many are looking at the ways virtual world technology is evolving to lower the cost of physician consultations and medical screening?

Pixels and Policy investigates.

Virtual Health I.T. and the Decreasing Cost of Consultations

One of the major incentives of health insurance comes in the form of low-cost preventive care consultations with general practitioners. With most insurance plans, a concerned patient can see a doctor for between $20 - $75, with any prescription drugs or further medical procedures available at a steep discount.

But what about those bound down by multiple jobs during the day, or those who lack a quality care provider in their area? This is where virtual worlds come in, filling a hole in the medical field by bringing qualified care providers to busy urban households and isolated rural areas alike. U.S. News and World Report ran a great article about the cost-effectiveness of doctors consulting with patients using secure, confidential virtual world software. In other words, don't expect your medical information to go out to the Second Life community.

The technology isn't as speculative as some like to think. The Hawaii Medical Service Association currently hosts their own private virtual world dedicated to doctor consultation with patients. By implementing webcams in addition to live chat and virtual representations of both doctor and patient, physicians can make decisions on non-emergency conditions and prescribe pills or limited treatments digitally. It's both a cost- and time-effective way to conduct routine consultations.

What about cost? HMSA's program is surprisingly cheap. According to U.S. News and World Report, the cost is nothing more than what you might spend on your cable and phone bill:

Patients in the Hawaii program receive care from doctors scheduled to be reachable at that moment. A 10-minute "visit" costs $10 for members and $45 for nonmembers, paid with a credit card. HMSA says thousands of patients have registered. Health plan members like Gano are pre-enrolled; nonmembers create an account and key in their medical history and other data to establish a record.

Virtual consultations won't be very effective for emergency conditions, but they provide essential preventive care that can help make emergency room visits less frequent.Some forward-thinking health care providers are even implementing virtual technology into the surgical process. As the New York times recently reported, potential plastic surgery patients can post their medical histories, requested surgeries, and problem areas online and allow qualified surgeons to compete for their work.

Patients can get consultations on more than just a face lift. The San Francisco Chronicle has an interesting article about how the esteemed UCSF Fetal Treatment Center now offers comprehensive online consultations for expectant parents whose fetus runs the risk of complications. A concerned prospective family need not fly to San Francisco for a potentially pointless consultation - virtual communication saves both time and money.

As the San Francisco Chronicle notes, the people most likely to benefit from these services are those who lack the funds to travel across the country and receive them through traditional means:

"Before we'd have them drive four hours from Fresno to see us. Now they're getting immediate feedback" said Dr. Ilona Frieden a professor of clinical dermatology and pediatrics at UCSF. "It's giving a level of care to an underserved population that they wouldn't otherwise have access to."

By implementing virtual world and digital communication technology into the medical field, patients are no longer restricted by the quality of care available in their immediate geographic area. An expectant mother worried about an aberration in her ultrasound no longer has to plan for thousands of dollars in travel expenses for a consultation. An elderly Hawaiian with limited mobility needn't panic if they run out of a prescription and can't get an appointment with their usual physician.

In new and exciting ways, proactive health care professionals are using the communication power of the Internet to meet with patients too often left out of the medical care loop. Research by the Robert Wood Johnson Foundation finds that expanding preventive care visits creates a more cost-effective medical system by catching preventable chronic diseases. Virtual conferencing lowers the cost of preventive care consultations, expanding the number of patients with access to quality health services before chronic diseases set in.

Roadblocks to Virtual Preventive Care

There are policy roadblocks currently in place that make a full-on transition to digital consultations more complicated than it may seem. Foremost among industry concerns: If a surgeon in California is giving medical consultations to a patient in Iowa, the surgeon must be licensed in Iowa. Providing medical advice to a patient without licensing in their state is a crime that unintentionally limits the spread of virtual consultations.

The New York Times comments on this pre-Internet limitation:

Offering a surgical recommendation to a distant patient may violate state laws, if the plastic surgeon isn’t licensed in the home state of the patient, according to the Federation of State Medical Boards, a nonprofit group representing 70 boards in the United States and its territories.

While it is understandable that doctors and surgeons must be licensed in states in which they plan to perform procedures, it seems unnecessarily restrictive to limit their ability to provide valuable initial recommendations and consultations on procedures patients may need.

The hodgepodge of differing state laws makes it complicated for medical facilities to roll out virtual consultations and adds to cross-border paperwork. Promoting one set of standardized regulations would greatly assist the rollout of virtual medical consultations. This would eliminate the risk of legal liability for surgeons and doctors as well as simplifying an already daunting set of administrative regulations for hospitals in general.

This is not an insurmountable obstacle. In the midst of a massive health care reform push on Capitol Hill, integrating virtual consultations as a cost-cutting, effective measure should be common sense. Pushing full force into virtual consultations provides an opportunity for virtual conferencing companies to innovate, as well as adding new technologically-literate jobs during an economic downturn.

More importantly, virtual consultations offer hope to an entire section of the population previously cut out - by cost or geography - from essential preventive care. That should be reason enough to investigate the technology's great promise.

Comments

[Paula]

I shared this on Facebook. Mahalo!

[Just Some Guy]

Sorry, no - as with virtual business meetings, it doesn't make any sense.

It's not a question of whether travel (and associated costs) are skipped: If you could skip the in-person visit, you could skip it just as well in a chat or webcam session as you could in a 3D environment. In other words: You didn't have to be there, to begin with.

It's a misrepresentation to say the 3D is what saved the time (or funds) here - it's the internet that saved the time, and it would have with or without the 3D involved.

There /are/ compelling applications relevant to healthcare that leverage virtual worlds to benefit both the patient and the provider...but this is not it.

In time, that will become more obvious.