copyright © relayhealth corporation 2003. all rights reserved. what happens when doctors and...

Copyright © RelayHealth Corporation 2003. All rights reserved.

What Happens When Doctors and Patients Can Communicate

Securely Online?

A Review of Results for Physicians, Patients and Payors

Prepared for the the MCOL Healthcare Web Summit

Eric ZimmermanSenior Vice President

Product MarketingRelayHealth Corporation


Key Questions

How do physicians respond to secure online patient communication in a reimbursed environment?

How does it affect patient satisfaction? Access? Perceived quality?

How does it impact utilization and cost?


95% use the Internet; 65% do so daily.

MDs online spend and average of 3 hours/week on medical activities.

23% interact with patients online. 60% of these MDs discuss symptoms or treatment options online.

66% use the Internet (U.S. Adults)

76% seek health information online; 39% do so monthly

90% of those online want to communicate with their doctor online – over 50% say online access would influence their choice of health plan or doctor

Physicians Patients

Sources: Deloitte Research/Cyber Dialogue, Dec. 2000; Boston Consulting Group (Harris Interactive Survey) Sep 2001; Deloitte Research/Fulcrum Analytics, Nov/Dec. 2001; Harris Interactive, April 2002.

Doctors and Patients Online


73% of physicians rate

reimbursement as critical

to adopting on-line

consults

37% of online consumers

would be willing to pay out-

of-pocket to communicate

online with their own doctor

(~ $5-7)

Patients

Sources: McKinsey & Co., 2000; Harris Interactive, April 2002, Jupiter Research, May 2002; Forrester Research, October 2002

Reimbursement MattersPhysicians

Will Payors Bridge the Gap?


• HIPAA compliant?– Not secure– Limited audit trail– No access control

eMailHIPAA ready

Secure servers, firewalls, 128-bit SSL encryptionFull audit trailRestricted access

• One-to-one exchange without workflow support

• Free-form

• Non-chargeable

• Limited feature set Clinical featurese-Prescribing, e-ReferralsClinical content and templates

Clinically structuredAccompanied by PHR

ReimbursableAdvanced workflow support

Message routing by typeDistinct roles/proxy rights

eMail vs. Secure Web MessagingWeb Messaging


How do webVisits® Work? Patients Starts a Message from a Customizable Menu of Options


How do webVisits® Work? Patients select from 140+ Common Symptoms or Chronic Conditions

Allergic Symptoms


How do webVisits® Work? Patient Completes an MD-Authored Interactive Online Interview

I’ve been sneezing and wake up with itchy eyes.


How do webVisits® Work? Physician Receives Concise, Structured Message with Summary Health Record


How do webVisits® Work? Physician Replies using Time-Saving Tools


How do webVisits® Work? Patient Receives Physician Treatment Instructions and Attached Materials


What Are Doctors and Patients Talking About Online (in webVisits)?

Low acuity symptom (52%)

Medication management issue (21%)

Follow up on visit or test result (14%)

Chronic care management (10%)

Consultation about a procedure (3%)


What Kinds of Symptoms/Issues?Low Acuity Symptoms

Colds/FlusHeadaches/MigrainesSinus Pain or PressureBack PainAbdominal PainCoughingUrinary SymptomsAllergic SymptomsMuscle Aches and PainsSore Throat

Chronic ConditionsChronic Pain

Allergies

Depression

Hypertension

Diabetes

Thyroid Disease

Asthma

Arthritis

Anxiety Disorder

HRT


The RelayHealthwebVisit® Study


Study BackgroundIndependent study designed and analyzed by

• Paul J. Gertler, PhD – University of California, Berkeley• Laurence Baker, PhD – Stanford University

California and Connecticut• 3,688 member treatment group + matched control group• 282 MDs

Participating Health Plans• Blue Shield of California• ConnectiCare• 10 self-insured employers and 4 ASO carriers

Reimbursement• Insurers pay $25• Patients pay copayment of $0-$10


MethodsClaims Analysis (Treatment vs. Control Group)• Pulled claims data (6/1/00 – 5/31/02) – 100,000+ patient months

• Analyzed utilization and costs pre- and post- intervention

• Compared treatment group with matched control group

Telephone Surveys (Treatment Group Only)• Random sample MD survey (n=54, 61% response rate)

• Random sample patient survey (n=367, 16% response rate)


Results: Cost and Utilization

Net reduction in office-based claims > $1.50# PMPM

• Net reduction in total claims > $3.00† PMPM

• Patients who used RelayHealth to communicate with their doctor (vs. those that hadn’t) were:

– 36% less likely to report having called the doctor’s office

– 45% less likely to report having had an office visit #

– 50% less likely to report having missed work due to illness #

#p < .01†p < .05


Results: Patient Satisfaction

Ease of Use

78%

89%

Convenience

78%

95%

Quality

95%

71%

Access

52%

66%

Patients with doctor response by next business a.m. (statistically significant vs. those with later response, p<.01).All patients


Results: Physician Satisfaction

Likely toContinue

72%78%

93%

Satisfaction

63%

87%

100%

Ease of Use

72%

93%

74%

Prefer toOffice Visit*

56%

67%57%

* For patients with non-urgent medical needs

Physicians with 30 or more RelayHealth messagesPhysicians under age 45All patients


Summary

Pent-up patient demand

Payor reimbursement stimulates physician adoption

Independent controlled trial demonstrated:

• Significant reduction in healthcare spending

• Strong patient satisfaction

• Strong physician satisfaction

• A shared preference for webVisits for non-urgent medical needs


Future Directions: QI, Compliance and Pay for Performance Platform

ITInvestment

ClinicalMeasures

Asthma mgt.Diabetes mgt.CAD mgt.Breast CA screeningCervical CA screeningChildhood immunization

PatientSatisfaction

Desired serviceEnhances communicationImproves accessDemonstrated impact

Low costEasy to implementPaves way for other IT initiatives

Automated remindersTargeted educationSelf-monitoringEnhances communication with clinicians


Thank You!For more information contact:

[email protected]

copyright © relayhealth corporation 2003. all rights reserved. what happens when doctors and...

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