Improving access is central to conversations about health care in 2014. In the U.S., the deadline to sign up for health insurance through the Affordable Care Act (ACA or “Obamacare Health Plans”) is March 31st. Citizens worldwide are seeking solutions. The U.S. Department of Health & Human Services says that the ACA allows consumers to be in charge of their health care and have the flexibility and stability they need so that they can make informed decisions. In Canada, with socialized medicine, most citizens can get the care they need – it’s just a matter of time, or in some cases, distance. Virtual medical consultation is invaluable in certain instances, such as need for immediate feedback. Last week, a UK hospital announced that they will use Skype to facilitate doctor consultations, leading the way in Europe as the first to do so. This practice has precedents in other parts of the Western world.
Companies in the U.S. which design virtual doctor consultation software programs have names such as MeMD, Consult A Doctor, and iCliniq. In Canada, the Canadian Medical Association established a health portal so that patients can get information from their doctors. Coming in on the ground floor of this revolution is a Vancouver, British Columbia (B.C.) company, Medeo, which seeks to reinvigorate the practice of doctors making house calls à la 2014: via webcam. Medeo is a secure virtual care tech company that is enabling interactions between hundreds of doctors and thousands of their patients.
Ninety percent of Canada’s population lives in ten percent of its land. The other ten percent of the population may live at a distance where they cannot easily reach a doctor. Medeo uses technology to connect doctors with patients in rural B.C., as well as patients who are senior citizens, have disabilities, or have difficulty getting to appointments due to busy schedules or chronic illness. A chief focus of their work is building the necessary infrastructure to ensure patient privacy and security. What differentiates Medeo is the Physician Advisory Board that advises the technology.
The way Medeo works is for patients to sign up on the website, provide a basic medical history, and describe the symptoms they are having. A coordinator then engages the patient through secure video conferencing and either connects them directly with their doctor or helps them to book a virtual appointment with their own private doctor, if available, or by another physician, for a follow-up video consultation. (See video below.) Patients do not pay a fee to Medeo as the doctor who sees them virtually receives payment for the visit through the provincial government’s Medical Service Plan (MSP) insurance.
The benefits to the system are several – patients without a family doctor can be seen relatively quickly and efficiently, on average in less than 10 minutes. This reduces emergency room wait times and allows the doctors to see more patients. As Medeo develops its programs, it is looking to expand across Canada and eventually to the U.S. and abroad. Michael Smit, Chief Strategy Officer, states that, as is the case in the referenced UK example, while Skype and generic email can provide basic functions, advanced secure software designed with the input of physicians and patients can do more for a healthcare platform. Regarding accessibility, Smit notes that the province of B.C. is a forerunner in enabling physicians to bill for this service, which creates the innovative environment that has allowed Medeo to develop its product.
While Skype and email have been virtual precedents in health care settings in the U.S. and now the UK, a key concern is security challenges, especially as they are used over the public internet. Even with patient consent, the data transmitted can be “hacked” and codes broken, which can have serious repercussions at later dates. Medeo’s system is a leader in this regard, having designed and built with rigorous testing using bank-grade security, and adheres to HIPAA regulations. Medeo supports data interoperability utilzing Health Level 7 (HL7) standards. To ensure compliance, the architects and stakeholders of Medeo have designed a software solution that exceeds privacy legislation in Canada as well as the U.S.
Other concerns in earlier implementations of telemedicine relate to lack of patient oversight in virtual consultation. A grave example is that six months ago a U.S. doctor was reprimanded when a mental health patient died under his virtual care. Smit speaks about Medeo’s utilization of medically-appropriate technologies. For example, it is very appropriate for patients being seen for a follow-up visit related to a chronic disease.
According to Smit, “Skype and email are fantastic leading innovations. However, they have their limits, in particular, as they relate to security in health care settings.” Medeo’s virtual care technology solution precedes the recent deployments of Skype in UK hospitals and is soon expanding its services to enable more doctor-patient virtual care relationships across Canada and to the U.S. Could the UK be next?
By Fern Remedi-Brown
U.S. Department of Health & Human Services
Dr. Jonathan Gruber, key architect of the Affordable Care Act (“Obamacare”) and the 2006 Massachusetts health care insurance reform law, Lecture at Simmons College, Boston, MA, February 25, 2014
Guardian Liberty Voice
Email communication with Michael Smit, Chief Strategy Officer (CSO), Medeo.ca, March 17-21, 2014
Life Sciences British Columbia