In a bid to provide quick, convenient access to care for common, easy-to-diagnose ailments, UW Medicine—the University of Washington’s healthcare organization—began an online virtual clinic in January using telemedicine services from Seattle-based Carena.
People in Washington can schedule a face-to-face visit with a doctor or nurse anytime of the day or night for help with minor illnesses and injuries, from acne to flu to warts. It costs $40 a visit, conducted via Web cam on a computer, smartphone or tablet usually within a half an hour of scheduling. The healthcare providers can write prescriptions for some medications.
The UW Medicine Virtual Clinic is aimed at introducing new patients to the healthcare organization—a sprawling collection of hospitals, neighborhood clinics, the UW School of Medicine, and more—while also providing quality, convenient, lower-cost care, says Dr. John Scott, medical director of telehealth at University of Washington.
It’s designed for acute issues rather than ongoing care, and is not meant to replace a patient’s primary care physician—but it could be a way to connect with one.
“So many people now have health insurance, and they may not have a primary care doctor,” Scott says. “It’s another way for us to help them find a primary care doctor and start working on some of those preventative health care things.”
In its first month of operations, the virtual clinic has seen more than 150 unique patients, Scott says.
Despite decades of experience with telemedicine, UW Medicine chose a private company for this effort.
Scott heard about a similar service Carena provides to Tacoma, WA-based CHI Franciscan Health shortly before he became the medical director of UW Telehealth in fall of 2013.
He says he was impressed by Carena’s focus on quality of care through the use of virtual clinic practice guidelines based on research and adapted from national standards; programs to track and reduce antibiotic prescription rates; and follow-up with patients after five days.
Carena is also focused on collaborating with local health systems, handing off care to a patient’s primary doctor, or, if the patient doesn’t have one, helping him or her find one. Scott was also eager to have UW Medicine work with a local company.
Carena has been around since 2000, raising a $14 million Series C funding round in 2012 led by Catholic Health Initiatives (CHI) to fund expansion. Later that year, it launched CareSimple, offering the general public the virtual clinic services it provides to big health plans and employers. Its competitors include Boston-based American Well; MDLIVE, based in Sunrise, FL; and Teladoc in Dallas, TX.
The UW Medicine Virtual Clinic is actually staffed by Carena doctors and nurses for the time being. Toward the end of the year, UW Medicine physicians will get training from Carena on how to do virtual consultations and will take over the service in 2016, Scott says. [Disclosure: My spouse is a UW Medicine employee but has no involvement in telemedicine.]
There’s an art in conducting a physical exam without laying hands—or instruments—on the patient, Scott says. Healthcare providers have to coach their patients to be the doctor’s eyes, ears, and hands, he says, feeling for swelling, for example.
But not everything can be diagnosed via the virtual clinic. About 30 percent of the time, Scott says, the virtual clinician will direct the patient to the emergency department or urgent care clinic. Even that has value because
