24/7 virtual visits: also in medicine?

Elena Torrente

A few days before Christmas, I went to London. It was freezing cold and the heavy snow made it difficult to access the big city. In Piccadilly Circus, the street musicians resisted the low temperatures and the Christmas lights adorned the city. When I took the subway, I was surprised by an advertisement: "An NHS family doctor visits you for free 24 hours a day, 7 days a week."

The Babylon Company has reached an agreement with the NHS to offer video consultation services. Citizens can download the application and request a visit with an NHS doctor 24 hours a day, with a response time of about two hours. According to the program website, face-to-face visits can also be scheduled if necessary and prescriptions are sent to the pharmacy of the user's choice. The family doctors attending the video consultations are from the NHS and have about ten years of experience.

In recent years there has been a proliferation of start-ups that offer these services: Babylon, Dr Now or Push Doctor are examples of this. The business model is based on offering virtual consultations for a single payment per visit or monthly subscription, and they offer a variety of additional services such as medical prescriptions or delivery of medicines at home.

In the case of Babylon, what was surprising to me is that they have achieved scalability with the NHS. In fact, WIRED magazine already pointed in 2016 as one of the most promising emerging European companies and at the beginning of that year the company made 25 million dollars.

Everything points to the fact that the use of telemedicine is beginning to be generalized. Although there is still not much evidence of the results of this type of interventions in terms of health, I consider that the maturity of the technology, the demands of accessibility on the part of the citizenship and the appearance of new actors in the digital health sector are encouraging their deployment.

From the experience that comes to us from the United States, we know that virtual visits are very successful. In Kaiser Permanente, in 2015, 14 million virtual visits were made (this includes the resolution of medical problems through email) and 15 million face-to-face visits. It’s estimated that in 2018 the volume of virtual visits will exceed that of face-to-face visits.

According to data from a US telemedicine provider, Teladoc, patient satisfaction with these services is high. In 86% of the cases, users stated it was an easier access to medical care and 90% would use it again.

However, telemedicine is not translating into a reduction in health care costs, quite the contrary. According to this study, virtual visits are not replacing face-to-face visits or emergencies, but are responding to new demands or needs. If we analyze the behaviour of 300,000 respiratory patients over three years, only 12% of virtual visits replaced visits to other providers, and the remaining 88% were new uses.

But there is also evidence of the potential of telemedicine to reduce waiting times. In this case, these are asynchronous telemedicine interventions that, in appropriate circumstances, are appropriate to reduce waiting list times in specialized outpatient services.

In any case, it's a trend that has no turning back. In this same line, in DKV we have just launched an online visit service through videoconference, call or chat, which allows contact with doctors at any time of the day. The application also incorporates a symptom evaluator based on artificial intelligence algorithms that gives a list of possible diagnostic orientations. In addition, users can share documents, images or analytics with doctors to assess them during the video conference and save them in their health folder.

Given this wave of new channels of access to health care 24 hours a day, 7 days a week, I believe that the challenge will be to achieve a balance between the increase in accessibility and the humanization of health care that has been claimed in other articles of this blog.