At Tacoma’s Franciscan Health System, employees are using a new electronic system that lets them consult a doctor from home for routine illnesses without driving to a clinic or visiting an emergency room.
At first glance, that new system would seem to make as much financial sense for Franciscan, which owns five hospitals and more than two-dozen South Sound urgent care centers and medical clinics, as a video store asking its employees to download movies instead of renting them.
But the health care system is so pleased with its Franciscan Anytime health care program that its parent company, Catholic Health Initiatives, is investing $14 million in fresh financing in the new remote consultation and diagnostic system.
That infusion of money will help a Seattle upstart company, Carena Inc., that provides the video, phone and Internet consultation network that’s the core of Franciscan Anytime system. Carena will use that money to expand the service to more locations.
And Franciscan is planning to expand the service with Carena’s help beyond its own 8,300 employees to its South Sound patients at three clinics in Puyallup, DuPont and Spanaway within 60 days, said the health system’s chief operating officer, Dr. Cliff Robertson.
The Franciscan Anytime system links a network of physicians and nurse practitioners employed by Carena with Franciscan employees seeking health care. Those employees, whose complaints range from viral infections to abdominal pain and skin rashes, call or email Carena for an appointment to see a health professional about their ills. Within short order, Carena puts them in contact by phone, email or webcam with a doctor or nurse practitioner.
That health professional chats with the patient, asks pertinent questions about their illness and then in most cases reaches a diagnosis. They can order a prescription, tell them how to treat the illness at home or even schedule a home visit by a health professional. In cases where the illness or injury requires immediate medical intervention, the doctor will advise them to go to an urgent care clinic or emergency room.
In the 18 months since it rolled out the Franciscan Anytime service to its employees, the system has handled approximately 350 remote consultations. About 65 percent of those contacts have been outside normal business hours. Of the 350 who used the service, 47 percent said that if the service hadn’t been available they would have gone to the emergency room.
For both the health care system, which is self-insured, and the employee who makes reduced co-payments for the service, the financial benefits have become clear.
For webcam consultations, employees pay from $15 to $22.50 co-pays depending on the insurance plan they’ve chosen. For a house call, the co-pays range from $16 to $101.
Compare that with the co-pay for an emergency room visit, about $150, said Franciscan spokesman Gale Robinette, and the savings to the employee can be substantial.
For the health care system, the savings are more dramatic. The cost of a video visit with a doctor is a fraction of the cost of an emergency room visit, which averages about $1,200.
Dr. Benjamin Green, Carena’s medical director, said somewhere between 70 percent and 80 percent of common illnesses that are treated in doctors’ offices or emergency rooms can be treated with a remote consultation. Sometimes that consultation will require the patient to take his own temperature or blood pressure, but sophisticated diagnostic tests are often unnecessary.
In a survey of patients who used the system, Franciscan said, all agreed or agreed strongly that the type of care they received outside the doctor’s office or hospital was appropriate for their situation.
Since 2006, Carena has offered its remote doctor visits to about 500,000 workers at major employers in Washington and California. Among those companies are Microsoft and Costco.
When Franciscan rolls out its own remotely available health care visits later this year at the three South Sound clinics, the services will be available to all patients, not just to employees of companies that have offered the service.
Once Franciscan gets the service running smoothly, Robinette said, the health care system could expand the offering to all of its 25 clinics and urgent care centers.
Offering the remote service could affect revenues at Franciscan’s own emergency departments and urgent care centers, said Robertson, if patients elect to use the service instead of the hands-on medical service at their doctor’s offices or emergency rooms.
But, if the service offers quality health care to patients at a more economic price and it cuts the amount of routine care handled by the high cost emergency departments, then the investment in the system will make sense, said Robertson, himself a family care physician.
Ralph Derrickson, a former venture capitalist with Microsoft co-founder Paul Allen’s Vulcan Inc., and now Carena’s chief executive, said he expects to see such virtual appointments to be more common as the health care industry focuses on cutting costs while maintaining services.
The remote doctor visits offer the same kind of convenience and cost avoidance to health care consumers as companies, such as Amazon.com and the nation’s banks, have long provided through phone and the Internet to their customers, he said.
The remote system could cut the need for expensive brick-and-mortar clinics and offices with receptionists and waiting rooms. Doctors and nurses could offer electronic diagnostic services from their own homes. And patients can avoid the time and expense of driving to a hospital or clinic when they’re feeling unwell to seek treatment for their maladies, he said.
Implementing such a system nationwide faces complex hurdles. The health care providers, for instance, must be licensed in the state where the patient is located. And the myriad reimbursement rules from dozens of insurance companies makes navigating the payment system troublesome.
The system also is moving cautiously not to interfere with the treasured doctor-patient relationship.
Robertson sees the remote system as an adjunct to the hands-on, face-to-face system of medical care well-established in the U.S., not a substitute for it.
“We’re walking a tightrope here,” he said. “What we always have to keep foremost in our minds is delivering quality care.”email@example.com 253-597-8663