Why I'm Hooked on 'Doctor-Hailing' Apps
“Is it opportunistic? Sure. There’s nothing wrong with that.”
Feeling sick? Just fire up an app on your phone, talk to a nurse or doctor and have your drugs sent to the nearest pharmacy within the hour. Sounds too good to be true, right? But that's exactly what I did on a recent evening, when I couldn't get myself to my doctor's office during a terrible cold.
They're known as "telemedicine" services, and if you haven't heard of them by now, they're one of Silicon Valley's ever-expanding ventures into the health space. As part of a larger push for a data-based healthcare system—and on the heels of the Affordable Care Act's rules and regulations—the tech industry isn't waiting around when it comes to innovating the patient experience. Because Obamacare's law includes incentives for innovation and cost-cuts, tech startups can become a booming byproduct of the looming new generation of healthcare.
But while many startups are scrambling to provide similar medical services, not everyone is impressed with tech's plans to disrupt healthcare—at least not without valid apprehensiveness—with misdiagnosis being the main concern among the medical field.
"Is it opportunistic? Sure. There's nothing wrong with that."
The prominence of apps such as Pager and Doctor On Demand proves that tech entrepreneurs are hoping to make virtual healthcare a reality for every patient. Even UnitedHealthcare has announced its own virtual care program; the latest giant insurance company joining the ranks in providing telemedicine services. While they all have their own variations on the telemedicine idea, one thing all of these apps have in common is a triage system that filters a patient's needs and eventual treatment.
In my experience, getting an instant diagnosis for your health problems becomes addicting. This is especially true for millennials like myself already used to exhaustingly WebMD'ing symptoms until we find an answer we like.
For my first "visit", I decided to use my health insurance's app, Oscar, which comes loaded with a free, unlimited "Doctor on Call" feature as part of my monthly member plan. After requesting a call through the mobile app, I received a phone call that spurred a 10-minute consultation with a board-certified physician about my symptoms. By the time I hung up, the doctor had already sent my pharmacy the prescription treatment that I agreed to try. Overall, a painless, easy experience.
Oscar CEO and Co-Founder Mario Schlosser told me that its Doctor on Call "can be a very powerful feature, and work very well, but you cannot rely on just tele-visits. Patients have to have it as part of a bigger healthcare system."
Given that these telemedicine features are being built to quickly treat common ailments and point the patient in the right direction, thus far, the benefits have outweighed the concerns. Since its inception about two years ago, Oscar's "Doctor on Call" system has already made an impact, the startup claims.
"To use bronchitis as an example, with the use of Oscar's telemedicine, bronchitis treatment increased 60 percent and general consultation increased 55 percent," Schlosser said. "In terms of cost, Oscar's telemedicine program has also caused a 91 percent increase in free and successful solutions to bronchitis."
With such positive reinforcement, I got more comfortable with the idea of trying out virtual doctors in the comfort of my own home. And so, I kept going as I saw fit for my ongoing health issues.
Of course, the idea of telemedicine is nothing new, and has been around long before tech brought it to our mobile phones. "There is literature on older ways of doing this, like telemedicine and 'ask a nurse' services that would let patients call in and ask for help with their illness. It's not too terribly different," Dr. Peter Muennig, a professor at Columbia University's Mailman School of Public Health, told me.
And so, next up was the Pager app. A beautifully designed, clean interface drew me in, but asking for help on a medical app can be intimidating, especially when I started to calculate the potential financial costs. Luckily, many of these services tend to offer a free first time "visit", which I immediately took advantage of (after which "visits" cost between $25 to $200). This time around, I wanted a second opinion about my chronic digestive issues, which often trigger vomiting spurts. Glamourous, I know. After explaining my symptoms away to the certified Pager nurse on the other side of the smartphone screen, she suggested I call my regular specialist for further consultation.
What these apps all have in common is they work exactly how I imagine a well-oiled "triage" system to operate—and so off I went with my quick advice. It feels, really, no different than asking your local pharmacist a question about over-the-counter meds. In my experience, these telemedicine apps do exactly what they're intended for. They're by no means intended for emergency diagnosis, but they get the patient that first nudge of professional opinion to start their treatment.
Pager hopes to bring telemedicine to the masses, and is going one step further by providing doctor visits to your home or office. Pager Chief Exec and Co-Founder Gaspard De Dreuzy told me that when it comes to innovating an-already struggling and wasteful healthcare system, you must implement multiple care facets.
"Is it opportunistic? Sure. There's nothing wrong with that," Boston-based pediatrician Lisa Coray said. "The solutions from Silicon Valley can absolutely improve the system, but at the same time, with the reliance on tech, if there isn't some sober realistic thinking about inherent limitations in tech-based diagnosis—not that there aren't already—systematizing these failures is a problem."
Pager acknowledges that diagnosing a patient incorrectly is a big risk that the startup is mindful of.
"Misdiagnosis can happen on a lot of levels," Pager's CMO and Operations Director Andrew Chomer said. "What we solve for is largely urgent care. If it's not urgent care upfront, we get them to the right course. That's how triage and chat-based tech can be a guide, and how our satisfaction rate is so high. It's about filtering cases right up front."
Despite all the precautions that startups are taking, along with the realities of high-tech vs. traditional triage systems provide, some traditional physicians feel that "doctor-hailing apps" just can't deliver the same type of quality as a visit to your trusted doctor's office.
"There's nothing like seeing a patient," Colorado-based family physician Dr. Mark Hailey said. "There's an art to medicine that needs human element, and a computer is merely a tool that helps us diagnose the patient correctly."
A few weeks after my Pager call, I found myself back at my primary physician's office for a follow up visit to a routine checkup. After reassessing my physical and mental health due to recent stressful life events, my long-term doctor (whom I've become close with over the years) suggested it'd be the perfect time to give the anti-anxiety medication I previously resisted. I knew it was going to be a big change, but I trusted my doctor to steer me on the right path, given the context and medical history she has on record.
What I wasn't ready for were the severe side effects. Fortunately, there weren't any signs of mania or suicide (as the label warns), but my previously-mentioned nausea problems kicked into full effect right away.
And so I found the perfect opportunity to try out the Doctor On Demand app to get some advice on calming my dizziness and upset stomach. By now, I was becoming a pro at talking to virtual healthcare professionals while in agonizing pain, and quickly entered my question following the signup prompt. While Doctor On Demand doesn't have the clean lines and design that I prefer, it still got the job done. Within minutes, I was once again offered a complimentary first video visit with a doctor, which I decided to forgo given my anxiety (ironically) about my unsightly physical state.
The near-retirement doctors I talked to may want to stick to their face-to-face doctor-patient relationships, but many members of the medical community are willing to embrace telemedicine in the name of improving America's healthcare system. For example, Pager's mission is to overhaul traditional medicine by "combining elements of house visits and virtual care."
"We have advantages for being a new company, so we can leverage new technology when it comes to concerns such as patient data," explains Pager's De Dreuzy. "We can do this at a faster pace and a lower cost than traditional health providers."
Telemedicine tech providers still have a way to go before perfecting their formulas to truly implement a perfect healthcare system, but even so, there's a sense of optimism that "virtual doctor" services can make a difference when it comes to certain medical field issues. These include the current shortage of general practitioners and wasteful ER visits that we're all familiar with.
"Doctor shortages are more common in rural communities, and this would give those areas a chance to connect to more doctors," Humza Ansari, a third-year student at Mayo Medical School, told me. "Additionally, the role of mid-level providers (nurse practitioners, physician assistants) in primary-care is growing in many states, and I would envision mid-levels playing a big role in 'staffing' primary care done through tech. At the end of the day, with or without this technology, America will need more primary care physicians, especially in under-served communities."
At this point, there is still a push and pull in what can be deemed as the Wild West when it comes to healthcare apps under the new tech era of medicine, with only time as the telling factor of whether technology can truly step up to solve the issues that the lagging medical industry hasn't been able to do for decades.
Thus far for me, using telemedicine apps definitely enhanced my healthcare experience to an extent. And when used as part of a larger aforementioned triage system, they have the ability to not only be effective, but potentially save both patients and providers time and money, like they did during my anecdotal experiment.
There's no denying that technology is seeping through our healthcare system to improve it. The decision to use these tech-based health services depends on the personal preference and lifestyle of the patient.
I do plan on using at least one of these apps in the future for its intended purposes: quick diagnosis for simple issues. However, when it comes to major medical decision—like starting a new long term prescription treatment—I'd feel more comfortable, psychologically anyway, doing it "in real life" at my trusted doctor's office.