HSHS Medical Group to Launch Virtual Care Program for Internet-savvy patients

People who want their minor illnesses checked out by an HSHS Medical Group doctor with the option of receiving a prescription will be able to do so without walking into a physician's office — if they have a smartphone or webcam-equipped computer and are willing to pay about $50.

The not-for-profit medical group, a wing of Hospital Sisters Health System, plans to launch its Virtual Care program sometime in April.

The group will join a small but growing number of medical providers statewide and nationwide offering electronic visits, or e-visits. It appears that the service will be the first of its type among Springfield's major group physician practices.

"We are trying to push the envelope the best we can and keep up with current trends and be innovators," said Dr. Loren Hughes, president of the Springfield-based group.

To be offered through a link on the group's website, hshsmedicalgroup.org, HSHS is calling Virtual Care "the 21st century version of a house call."

Regardless of whether the patient has an established relationship with a doctor at the medical group, he or she will be able to talk online immediately with an available doctor at any time of the day or night and receive a diagnosis and treatment plan for a variety of nonemergency medical issues.
Those issues could include colds, fevers, flu, headaches, respiratory and sinus infections, urinary tract infections, rashes, bites, and stings.

Being able to see the patient in real time — through a computer webcam or other technology such as Skype or Apple's FaceTime — will help the HSHS doctor on the other end make a diagnosis, Hughes said.

Virtual Care's doctors, who will be HSHS primary care physicians in Springfield and other Illinois locations, will be careful to suggest patients seek a regular office visit if they need blood tests, X-rays or a physical exam, he said.

Doctors won't hesitate to suggest care in an emergency room if the symptoms warrant, he said.
Virtual Care "isn't going to be for the acute abdominal pain, for the patient who's having chest pain," he said.

Most insurance plans don't pay for e-visits, at least not yet. A specific charge hasn't been set yet for each Virtual Care encounter, but the amount probably will be about $50 and will be collected when the patient punches in a credit card number at the beginning of the e-visit, HSHS officials said.

Patients 'don't want to wait'

HSHS, the parent organization of Springfield's HSHS St. John's Hospital, established its medical group five years ago and is continuing to add primary care and specialty doctors, nurse practitioners, and physician assistants.

HSHS expects Virtual Care to primarily attract customers who don't have a regular doctor and are comfortable with technology, Hughes said. Established patients will be welcome, too, he said.

Virtual Care could convince more people to become regular patients of HSHS doctors, he said. But the main reason the service is being set up is because marketing surveys and other measures indicate patients want it.

"When we listen to the voice of the consumer, we hear loud and clear that they don't want to wait for a lot of things," Hughes said. "They want it now."

HSHS doctors try to make same-day appointments for patients who call during the day, but that's not always possible, he said, and the group's Priority Care clinics aren't open 24 hours.

"We wanted to have that ability that you could have your problems taken care of acutely rather than going to an emergency room or waiting sick at home with a urinary tract infection or something when you could have been treated otherwise," Hughes said.

In the past, many doctors have been leery about making conclusions or issuing prescriptions without seeing and examining every patient in person, Hughes said.

Doctors want to provide the best care, so they don't want to miss anything; they also don't want to put themselves at risk of malpractice lawsuits, he said.

But the success of e-visits has been demonstrated in other parts of the country in recent years without excessive legal risks for doctors, he said.

It's not unusual for some doctors to talk with patients by phone outside of office hours and occasionally issue prescriptions, Hughes said. Virtual Care formalizes that system and provides better record keeping and access, he said.

Electronic medical records that let doctors to view information on established patients and make a record of interactions with new patients provide comfort for the HSHS doctors in Springfield and other Illinois locations who will conduct the 15-minute Virtual Care visits, Hughes said.

He noted that patients from other states and countries could use the service, as well.

The American Academy of Family Physicians supports e-visits as long as certain conditions are met, including secure communication systems, payment for services and proper documentation.

The academy recommends that e-visits be confined to established patients. A doctor could be unaware of important details during an e-visit with a patient who hasn't had a previous in-person exam, said Dr. Santina Wheat, a Chicago physician who sits on the board of the Illinois Academy of Family Physicians.

HSHS Medical Group's doctors are comfortable with offering e-visits to all comers because of the increased access to health care that the service provides, group marketing director Craig Brace said.

Not widespread in Illinois

Only a handful of physician practices in Illinois are offering e-visits, and the format can vary.

Primary care physicians in the Decatur Memorial Hospital Medical Group have conducted e-visits for three years, said Dr. David Baumberger, DMH vice president of medical affairs and quality.

The visits, which cost $35 apiece, don't take place in real time and are in the form of secure electronic messaging, he said.

E-visits are available only to established patients of DMH doctors and the hospital's Express Care clinics. There's no real-time or video component available, though DMH doctors, physician assistants and nurse practitioners respond to patients' messages within about an hour, Baumberger said.

Providers sometimes call patients if they have more questions. And if they end up directing patients to an ER or a doctor's office for care, the patient isn't charged for the e-visit, Baumberger said.

Patients using HSHS' Virtual Care won't be charged if doctors refer them immediately to an ER, Brace said.

Springfield Clinic plans to begin Telemedicine visits in May or June in a format similar to Decatur Memorial's e-visits. Whether to charge and how much haven't been decided, according to clinic officials.

"If we're going to charge something, there has to be value," said Mark Kuhn, the clinic's chief administrative officer.

Clinic officials view e-visits as complementing, not replacing, face-to-face interactions, he said.

The for-profit clinic is studying real-time video e-visits as a future option, chief information officer Shashi Tripathi said.

"This is not easy. This is fairly complex," he said.

Telemedicine, at least a more basic form, isn't new to Springfield Clinic, Kuhn said. The clinic's TeleNurse telephone service is more than 20 years old, he said.

That live service — available at 528-7541 or (800) 444-7541 — is staffed 24 hours a day by registered nurses, and it's free, he said.

HSHS doesn't offer such an after-hours, live service.

Elsewhere in Springfield, SIU HealthCare is "laying the groundwork" for offering some form of e-visits, CEO Dr. Jerry Kruse said. "We know it's part of the future of medicine," he said.

SIU HealthCare is the group practice of experienced doctors at Southern Illinois University School of Medicine.

Kruse wouldn't say when SIU might launch e-visits or provide more details. But he pointed to the medical school's recent hiring of Nina Antoniotti as executive director for telehealth and clinical outreach — a new position — as one indication that SIU is committed to embracing new methods of serving patients. Antoniotti is a registered nurse with a master's degree in business administration and a doctorate in organizational systems.

Memorial Physician Services, a large practice of doctors associated with Memorial Medical Center and Memorial Health System, declined to comment.

— Contact Dean Olsen: dean.olsen@sj-r.com, 788-1543, twitter.com/DeanOlsenSJR.


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