As telemedicine become more of the norm in ambulatory care and extends beyond a narrow range of patient care services (see: A New Perspective on Telemedicine: Patient Visits with Multiple Providers), the need arises to integrate telemedicine with e-prescriptions and lab test orders. A recent HIStalk note alerted me to the fact that Doctors on Demand is integrating its televisits with lab testing orders from the two largest reference labs, Quest and LabCorp (HIStalk News 5/5/17). Below is the item from Mr. HIStalk:
Video visit vendor Doctor On Demand integrates its system with those of lab companies Quest and LabCorp, allowing its doctors to order lab tests and for its patients to choose a lab based on insurance coverage, availability, and location. The company — co-founded by TV psychologist Dr. Phil and his TV producer son – has raised $87 million in three funding rounds, although the largest and most recent was nearly two years ago. Among its investors are Athenahealth’s Jonathan Bush and Virgin’s Sir Richard Branson. It offers medical sessions for $49 along with ongoing psychology and psychiatry counseling.
A couple of items caught my attention when I visited the Doctors on Demand web site. The first is that the company describes the service that is is offering to patients as a video visit. The second point is that the home page lists the "top" conditions seen including cold and flu, allergies, sore throat, eye, skin, sport injuries, UTI's, vomiting, anxiety, depression. These are complaints similar to those prompting visits to any CVS' MinuteClinic. What took me somewhat aback, however, was the inclusion of anxiety and depression in the list. However, this web site may provide the anonymity that a depressed/anxious patient might be seeking. Also and as noted in the excerpt above, Doctors on Demand offers psychology and psychiatry counseling.
Most of the conditions described above as commonly treated by the physicians at Doctors on Demand would not generally require lab testing. However, my guess is that the company desires to extend the range of services it provides to more complex acute cases and patients with chronic diseases (see: Treatment of Patients with Chronic Diseases: Important for the Future of Telemedicine). For me, one of the advantages of televisits is that the patient interacts with a physician without leaving his or her house, a distinct advantage for less mobile patients with chronic diseases. If the goal of Doctors on Demand is to extend its reach to, say, patients with chronic diseases, offering lab tests would be necessary. In summary, on-line telemedicine companies are now competing with walk-in drug store clinics and health systems like Cleveland Clinic that are offering televisits for $49 dollars (see: Cleveland Clinic Express Care Online). Cleveland Clinic is also promoting its Express Care Online for follow-up visits for its own patients.