An online clinic launched in 2010 by non-profit HMO HealthPartners for the diagnosis and treatment of 40 simple medical conditions showed an average savings of $88 per episode over care in a traditional setting, providing hope for the future of online medical care.
The service, called virtuwell, provides 24-hour online access for patients to nurse practitioners who can help diagnose and prescribe treatment – including writing prescriptions – of conditions such as sinus infections and urinary tract infection. Further, after studying the results from 40,000 cases of patients using the online care portal, 98 percent of patients said they would be willing to recommend the service to others.
The findings were released this week in the February issue of Health Affairs.
"Thoughtful, well-designed online care can save costs and increase access to care, but it must never be at the expense of safety, effectiveness or a great customer experience," said Patrick Courneya, MD, lead author of the study, a family physician and HealthPartners health plan medical director, in a press release. "By reporting these findings, we hope to contribute to the further development of effective, accessible and affordable health care solutions that our nation so badly needs."
According to the report, the analysis of virtuwell's performance since it began operation two years ago is intended to begin to answer some fundamental questions about the delivery of healthcare using an online model. For instance, can care delivered online be delivered in a safe and secure environment and be compliant with existing regulations? And will patients both embrace this new method of delivering care while also being happy with the care they received?
If the two-year history of virtuwell is any indication, the answer is a qualified yes.
"The delivery of health care online is relatively new," the report noted. "However, early indications suggest that it can improve the experience of care for patients and the health of populations, along with reducing per capita health care costs."
That said, the authors were cautious about broadly applying their findings to other models of online care, but noted that the potential to provide significant cost savings is enticing.
Specifically, the study analyzed both medical and pharmacy data of thousands of virtuwell visits and compared them to care delivered in traditional healthcare settings. Costs measured were total insurer and customer payments for full episodes of illness including pharmacy costs. The analysis showed an average savings of $88.03 per episode in virtuwell-treated cases.
Treatment costs for three common conditions (sinus infection, urinary tract infection and pink eye) averaged:
- $20-$30 less than convenience clinics,
- $80-$142 less than office visits,
- $82-$124 less than urgent care visits; and
- $159-$469 less than emergency department visits.
The authors also studied whether the 24/7 availability of the virtuwell service led to an increase in demand for the service, which would then eat into the savings reported. Based on their findings, fully 90 percent of the virtuwell visits replaced office visits, while about 6 percent of the virtuwell cases replaced the "watch and wait" home care approach. In all, the researchers estimated this slight increase in utilization, given the costs associated with providing virtuwell service, only increase the cost difference between virtuwell and non-virtuwell care by 10 percent.
The hope is by demonstrating the results of a well-designed online care service, HealthPartners can help push for broader adoption, as well as a re-examination of government regulations that may provide a roadblock to establishing this method of care.
"The possibility of extrapolating such savings to larger volumes of cases is compelling," the report states. "We suggest a need for regulatory reform, particularly around state-level statutes that create barriers to the expansion of online care delivery, such as those that require clinicians to be located in the same state as the patient and those requiring clinicians to have had a previous face-to-face visit with a patient. Such reforms would encourage further innovation and lead to cost reduction and improvements in access and convenience for consumers throughout the health care system."