Concierge telemedicine, the future house call

Healthcare costs continue to spiral out of control and yet still achieve relatively poor outcomes, says Richard A Kimball Jr (pictured), CEO of HEXL…

It’s a dysfunctional system that I believe is primed for change. A new incentive paradigm is emerging. The era of preventive medicine and home health monitoring is on the rise. An interesting concept has come to light recently as telemedicine continues to improve and evolve. Due to the variety of ways technology can be utilised in patient care, now the traditional house call – which seems to have gone a little out of practice in recent years – is being brought back through concierge telemedicine.
“Due to emerging technologies, a “new” version of the house call is becoming more and more prevalent. Telemedicine will likely make house calls increasingly characteristic of modern healthcare delivery,” wrote Russ Allan Prince for Forbes. “Currently, telemedicine is being embraced by a number of concierge healthcare providers. Research with family offices and other cohorts of the wealthy, for example, find the ability to connect with their physicians anytime, anywhere to be an extremely or very important characteristic of their concierge medical provider.”
There are four basis models of concierge healthcare: travel medical assistance, private health advisories, private physician practice, and the total care platform. Prince has noted that the “most compelling and personally tangible additional service these concierge healthcare providers deliver is immediate routine and emergency telediagnosis and treatment.” He then points out that “[w]ith the rise in popularity of telemedicine related healthcare options,” there are factors that differentiate between them as well. For example, many “’phone-a-physician’ telemedicine service[s], while fast and useful, don’t put patients in touch with doctors who know anything about them or their health history. Additionally, many concierge services do not practice telemedicine, which means a client is required to make a trip to the office before they can receive care.” However, there are, of course, services that manage to bridge this gap. Herein lies the future of telemedicine.  
Prince reported that, according to Daniel Carlin, MD, president of WorldClinic and a pioneer in the field: “Telemedicine, paired with mobile technologies, allows the doctor to come to the patient quickly for diagnosis and treatment, if needed. So there’s no waiting in line and no getting lost in the shuffle. Concierge telemedicine practices know their patients and their families and have access to their entire health history and records are on hand to reference. Furthermore, a physician will follow up on all transpired events.” This type of hands-on care is akin to patients receiving house calls from their family doctors in the past.
“An emerging part of Carlin’s model is the use of simple, unobtrusive monitors that can be used to track a patient’s vital signs and the behaviours that can improve his or her health. With the Smart Phone acting as the bridge, the information generated by these devices is tracked by WorldClinic physicians who can then respond clinically to the patients’ progress, often prescribing new therapies and stopping ineffective ones,” wrote Prince.  According to Dr Carlin: “Right now, inside WorldClinic, we are running a small Smart Phone-based ‘virtual’ clinic for our patients with hypertension and cardiac arrhythmias. The data these monitors generate is far beyond what we would get in an office-based practice. Not surprisingly, our clinical decisions are better, but most importantly, we see the immediate effect of our management decisions. This is a big deal. In the very near future, we’ll be able to, in real time, monitor and manage a patient’s health status to maximal effect. The benefit to the patient will be measured not in years, but in decades of meaningful life.”
This type of specialised care doesn’t come cheap of course, but it is reminiscent of the kind of in-depth care a family physician, who knows the patient’s medical history, can provide. “And, as these technologies are developed and refined in current concierge medical practices, they will likely become increasingly normative for everyone,” wrote Prince. Indeed, Kimball has noted that “the focus will shift away from health repair to real health care. Improvements in technology paired with reimbursement for either telemedicine or health itself through capitation will push the full integration of telemedicine in our healthcare delivery system. We will see more and more people turn to telemedicine.”

Richard A Kimball Jr is a financial executive with expertise in the healthcare industry and n various capacities including investment banking, venture capital, research, distribution and public policy. He is currently a Fellow in Stanford’s Distinguished Career Program and building a healthcare technology start up HEXL.COM. He graduated from Yale University with a BA in Economics.

To learn more about Richard (Rick) Kimball please visit his WIKI.

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