When health care is obtained through a computer, mobile device or remote kiosk, the doctor is always in.
That’s why some medical providers are turning to telemedicine or telehealth — the treatment of patients using technology and remote diagnosis—as a way to make a doctors’ visit more accessible.
“We are finally at the point where we have really good and secure high-definition video,” said Dr. Lo Fu Tan, medical director of On Demand Medicine with Southwest Medical. “(The technology) is pretty straightforward. You just have to press a couple buttons.”
As part of the rise in services, Southwest Medical recently installed a telemedicine kiosk at one of its urgent care facilities.
“This is a pilot project we started a few months ago,” Tan said. “Once we look at the data, we plan to roll it out to other clinics.”
For traditional care at one of the six urgent care facilities, wait times can vary between 40 and 90 minutes. Instead of waiting, the kiosk gives patients another option.
“This isn’t Facetime or something that can get hacked,” Tan added. “It’s a secure and private room.”
While the patient waits at the kiosk, the medical professional who will be accepting the call reviews the patient’s history, which was completed online.
Once the live one-on-one session begins, the patient and medical professional converse via the screen on the kiosk, which also has self-administered tools to check blood pressure and oxygen levels, and administer an eye and ear exam. Through the screen, doctors can count patients’ respiratory rate and have them check their pulse for a heart rate.
Nevada Health Centers also has been increasing its telehealth services, focusing on mental health in some rural areas in Nevada.
Carrie Tallman, the manager for marketing and communications for Nevada Health Centers, said having this option makes sense for smaller populations.
“There may not be the volume [of patients] to have a full-time behavioral health specialist,” she said. So patients in those areas who use the service are connected with a clinician in Las Vegas.
And while there are more specialists in Southern Nevada, it isn’t always possible for patients to get to them.
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The use of telehealth has been discussed in the medical community for years.
Physicians such as Tan say adding telemedicine could reduce copays and help address issues such as the lack of medical professionals available within the community.
“Our state’s ratio is one [doctor] to about 2,000 [patients],” he said. “We need a lot of help to improve that.”
And telehealth isn’t just a stationary kiosk used at a medical facility. It also includes accessibility via a mobile device or computer.
Over the past four years, Southwest Medical served 15,000 patients through its NowClinic platform, which can be accessed on a smartphone or laptop. Whether it’s allergies or a skin rash, Tan said people are encouraged to use this service when seeking medical attention.
“These are people who would have used urgent care or gone to the emergency rooms,” he said. “[Using the NowClinic] means a shorter wait time and it’s not as costly.”
Co-pays for an in-person visit to one of Southwest Medical’s urgent care facilities can be $40 to $50 on average, while the NowClinic can cost between $10 and $25.
All patients who visit Southwest Medical are eligible to use this service by downloading the application or registering online. When ready to speak with a medical professional—which includes everyone from doctors to physician’s assistants—patients simply click the icon and connect to one of 370 providers within the state.
The average wait time is about four minutes.
Because patients are registered with Southwest Medical, the professional who answers the call can access their records.
“Typically, sessions last about eight minutes,” Tan said.
Though it might not sound like a lot of time, he said it’s comparable to what doctors spend on patients in person. After, doctors can send prescriptions to a pharmacy (Tan said they are prevented from prescribing opioids or benzodiazepines through telemedicine).
If the patient needs immediate care, doctors can schedule a visit with an urgent care physician. However, of the patients who have used NowClinic, less than 1 percent have needed to go to a brick-and-mortar provider after their remote visit, Tan said.
While the American Telemedicine Association has guidelines for training medical professionals who use telemedicine, there is no national standard. In addition to observing the national guidelines, Southwest Medical created its own additional program.
It’s not just medical nonprofits using this service. Private practices, both in mental health and primary care, have the option to add this service as well. According to the Nevada Division of Insurance, all health carriers in the state are required to cover telemedicine.
Seeing the future in e-health, some health care programs are beginning to incorporate this into the classroom.
Dr. Ray Alden, a provost with Touro University, said the school is adding a telemedicine component to its curriculum with virtual exam rooms.
“In my opinion, I think we are going to see this used more and more,” he said. “So I think we will also see an increase of students trained in telemedicine.”
There is already advance technology enabling this practice, which Tan only sees improving with time.
“I see the technology getting to a place in five or 10 years where there is a hologram,” Tan said. “So it will be like having the patient in the room with you.”