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.
The service, called virtuwell, provides patients with 24-hour online access to nurse practitioners who can help diagnose and prescribe treatment – including writing prescriptions – of conditions such as sinus infections and urinary tract infections.
HealthPartners officials said a study of 40,000 cases of patients using the online care portal found that 98 percent said they would be willing to recommend the service to others.
The findings were released 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 news release. “By reporting these findings, we hope to contribute to the further development of effective, accessible and affordable healthcare solutions that our nation so badly needs.”
According to the report, the analysis of the two-year-old virtuwell’s performance is intended to begin to answer some fundamental questions about the delivery of healthcare using an online model. For instance, can online care be delivered in a safe and secure environment and be compliant with existing regulations? And will patients embrace this method of delivering care and be happy with the care they receive?
“The delivery of healthcare 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 healthcare costs.”
The authors were cautious about 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 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, 90 percent of the virtuwell visits replaced office visits, while about 6 percent replaced the “watch and wait” home care approach. In all, the researchers estimated a slight increase in use, given the costs associated with providing virtuwell service, would only increase the cost difference between virtuwell and non-virtuwell care by 10 percent.
By demonstrating the results of a well-designed online care service, HealthPartners officials say they can 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 healthcare system.”
