Thursday, December 14, 2017
Health

Need to see a doctor? There's an app for that

Dr. Sherri DeHaas makes house calls without ever leaving her house.

The family doctor puts on her white coat, sits down at the desk in her Vermont home in front of a computer monitor and starts seeing her patients — virtually.

She's one of the doctors available via Tampa General Hospital's Virtual Care app. Patients can use their computers, tablets or smartphones to teleconference with a doctor.

Welcome to the telemedicine industry's fastest growing line of services: one-time, on-demand visits with physicians 24-hours day, seven days a week via phone, video or email.

BayCare Health System recently launched its own app that bay area residents can use, BayCare Anywhere.

"We've clearly passed the tipping point of this," said American Telehealth Association CEO Jonathan Linkous. "It's going into private practice as well.

"If your doctor doesn't have this available, you need to find one who does. Why would you want a bank that doesn't offer an ATM?"

The association estimates that last year about 1 million people had virtual doctors' appointments and projects 30 percent growth this year.

Video calls are the latest development in the growing field of telemedicine, which is any tool that allows doctors to exchange records or diagnosis patients electronically rather than in person.

The apps have limits, however. They're not designed to treat serious conditions or medical emergencies. Rather, they can offer patients a convenient alternative to treat minor ailments.

Tampa General was the first in the bay area to enter this growing market about four months ago; BayCare followed soon behind in July. Both apps were developed with American Well, a telehealth provider that provides communications systems for hospital systems across the country.

Anyone can use the app — even those who don't live in Florida or whose doctors don't work for Tampa General or BayCare. Both charge a flat-rate: Virtual Care is $49 and BayCare Anywhere is $45.

As of July, Tampa General said 2,319 people had signed up for the app and 395 had doctors' visits or "e-visits." The average user, according to Tampa General senior vice president Michael Gorsage, is a woman under the age of 50 using a smartphone.

Although the apps have obvious appeal to a generation of young users already comfortable with services and apps such as Uber and GrubHub, Linkous said virtual doctors appointments have the potential to appeal to a broader audience.

Older patients, for example, are already used to being able to call their doctor at night if they have a question.

"The range ages who are calling is across the map," Linkous said. "For millenials it's certainly a no-brainer. But for people who are older it's a no-brainer, too."

Gorsage said the goal of the Virtual Care app is to make obtaining basic health care more accessible: a video chat with a doctor while in bed battling the flu is easier than coughing and sneezing in a waiting room, waiting to see a physician.

"Telehealth or telemedicine was never designed to replace the relationship with your primary care physician," Gorsage said.

Both apps tap into a network of doctors provided by American Well. BayCare's physicians are available through its app. Gorsage said Tampa General hopes to soon add its own doctors to its app.

Users can use the services via a website or download the app. They register an account and enter a credit card. When they login, they'll see which doctors are available immediately, or how many people are waiting for a specific doctor. Patients aren't charged until they actually see the doctor.

But what ailments should be treated virtually? The patients and doctors need to figure that out together "using common sense," said Jay Wolfson, a health law and public health professor at the University of South Florida.

Doctors who talk to patients online know there's not much they can do for a bad cut or a broken bone. But for a patient who lives far from a hospital, say in a rural area, that virtual consult could help spur them to go to the doctor or hospital.

But digital physicians also have to be aware of the app's limitations, Wolfson said. They can't physically examine patients, which can be vital to making the right diagnosis. And there's an insurance issue: many of the malpractice policies that doctors carry do not cover video appointments.

Anyone using the app from the bay area will be matched with doctor licensed to practice medicine in Florida who can prescribe medication — like Dr. DeHaas.

The 51-year-old physician got her undergraduate degree and her medical degree from the University of Miami. For the last four years, she's been treating patients via video calls.

"I thought at the beginning that it would be very different; it's more similar than you'd imagine," DeHaas said comparing the service to an office visit.

"Of course, you can't touch the patient to do a physical exam but you develop skills so the patient can help you do the exam."

Using her computer screen, DeHaas said she can examine children with stomach aches and they don't have to leave their beds. She's prescribed medication for hundreds of sinus infections. She's diagnosed head colds, sore throats, rashes and the flu.

Once she diagnosed a case of appendicitis — then told the parents to rush that child to an emergency room.

She's learned some telemedicine tricks along the way. If someone else is in the room, they get to aim the smartphone's camera. She reminds patients they can use the flash on their phones to better illuminate themselves if the room is too dark.

She coaches patients on how to examine themselves. She'll stand up and move her hands along her own body, demonstrating so that the patients on the other end of the call can mirror her movements. She tells them how pressure on certain spots should feel; the patient will tell her if they feel any pain or discomfort.

Sometimes, she even has them do jumping jacks.

"If they laugh," she said, "they probably don't have appendicitis."

Contact Sara DiNatale at [email protected] Follow @sara_dinatale.

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