Wednesday, January 07, 2009

State Watch

Hawaii To Offer Online Physician Appointments for Some Patients

      The Hawaii Medical Service Association -- the state's BlueCross BlueShield licensee -- on Jan. 15 will launch American Well, a Web service that will allow patients to visit physicians online via webcam or text chat, the New York Times reports. Roy Schoenberg, co-founder and CEO of Boston-based American Well Systems, said the service is aimed at individuals seeking easier access to physicians because they are uninsured or do not want to wait for an appointment or travel to clinics.

Patients can use the service by logging on to participating health plans' Web sites. Doctors hold 10-minute appointments that can be lengthened for an additional fee. Doctors also can file prescriptions and view patients' medical histories through the system. American Well is working with HealthVault, Microsoft's electronic health records service, and Aetna subsidiary ActiveHealth Management, which scans patients' medical history for gaps in their previous care and notifies doctors during the online appointment. Hawaii Medical Service Association members will pay $10 to use the service and the insurer will provide the service to uninsured patients for a $45 fee. Insurers pay American Well a license fee per member and a transaction fee of about $2 each time a patient visits a doctor through the service.

Mike Stollar, vice president of marketing for the Hawaii Medical Service Association, said the system is well-suited for the state because the islands are remote, it takes time for people to travel among them and it is difficult to recruit physicians to rural areas. According to Schoenberg, American Well insurers in other states soon will offer the service.

Critics of the online appointments are concerned about the lack of a physical examination involved in the doctor and patient consultations, according to the Times. Critics also are concerned that low-income and uninsured people will not have access to broadband connections or webcams required for consultations (Cain Miller, New York Times, 1/6).