Managed Care - March 2009 - (Page 32) Plans and Physicians in Hawaii Experiment With Online ‘Visits’ Some doctors say that far from cutting waste, online visits create it. Others are signing up and giving it a try. By John Carroll Contributing Editor thing off as an added and costly wrinkle in an already badly fragmented health care system. Where it all goes will have a lot to do with the American Well experience in the Pacific. Under the American Well design, it is up to the doctor to take the first step. “Physicians can, for the first time, make themselves available to patients at their discretion whenever and from wherever they R oy Schoenberg spent a big part of January in Hawaii, but he wasn’t working on his tan. Schoenberg, a physician, was on a mission to boot up a health care revolution. Two years after he launched American Well, Schoenberg was on hand in the Pacific paradise to help open an online “virtual clinic” that he created for the Hawaii Medical Service Association (HMSA), the state’s Blue Cross & Blue Shield licensee. American Well — the Well is shorthand for wellness — has licensed the program that more than 140 of HMSA’s network-affiliated doctors use to meet patients over the Internet, either through webcams or instantaneous online text chats. “Two minutes into the go-live, we saw the first encounter,” says Schoenberg, whose company is entirely focused on using the Web and phone service to increase access to care. “And since then, it’s been used daily.” American Well says the online visits can overcome barriers presented by distance, physical impairment, and hectic schedules. For some patients, the new service is billed as a convenient shortcut to a doctor who could well be an island, and a flight, away. For others, it is a chance to consult a specialist now rather than when his office schedule opens up in two or three months. Others could live within walking distance of a doctor’s office but be physically incapable of making the trip. An added wrinkle? Analysts say the 2.0 version of managed care can offer an opportunity for a health plan to distinguish itself in any market by expanding a convenience niche that has already witnessed an explosion of retail health clinics to all comers, including members of other health plans and the uninsured. At least one professional society, though, is writing the whole “The largest national plans are in active discussions about deploying online care,” says Roy Schoenberg, MD, who launched American Well with his brother, Ido Schoenberg, MD, to provide a “virtual clinic” to Hawaiians. 32 MANAGED CARE / MARCH 2009
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