Phone used as conduit for house calls

A primary care physician in Kentucky has launched a "house call by smartphone" service that he believes can cut 30 percent to 40 percent of a medical practice's foot traffic. Me-Visit, recently launched by William "Chuck" Thornbury, CEO and medical director of Medical Associates of Southern Kentucky, aims to improve a practice's efficiency, cut wasteful expenditures and enable patients to get quicker diagnoses.

And all it takes, he says, is a smartphone.

"Smartphones are safe, effective and our patients love them," said Thornbury, who detailed Me-Visit in an education session at the 2013 HIMSS Conference and Exhibition last week in New Orleans. "This is where the future is for healthcare."

Based in Glasgow, Ky., Thornbury said his rural clinic is always full, placing pressure on the workflows of its staff and, on average, leaving two or three patients a day unable to see a doctor. By creating a platform whereby a patient can confer with a physician by smartphone, he said, the clinic ensures that everyone gets to "see" a doctor, receive a diagnosis and perhaps even get a prescription.

"Distance does not diminish care," Thornbury said, adding that some 85 percent of his patients use smartphones, roughly a quarter access medical information online and as many as 27 percent do that instead of conferring with a doctor.

In front of a packed conference room last week in New Orleans, Thornbury offered an energetic appraisal of today's small practice. He said physicians have to keep up with the latest in mHealth technology to keep the attention of an increasingly mobile public, one that would just as soon get healthcare online as it would visit a doctor's office. He argued that complicated telehealth setups that make use of interactive video won't catch on with busy families who just want a quick diagnosis and a prescription.

Thornbury said he conducted a year-long study with help from the University of Kentucky, during which he fielded 188 so-called "e-visits" from patients in nine different counties. The service was marketed at a $32-per-visit rate and available 24 hours a day, he said. To take part in the program, patients filled out an online questionnaire, after which they would be contacted via phone by a physician, with an average response time of three minutes.

In that first year, Thornbury said, 5 percent of those using e-visits followed up with a visit to the doctor for an issue that couldn't be handled over the phone, 26 percent took part in another e-visit within six months, and 97 percent expressed satisfaction with the program. In addition, he said, 78 percent of the e-visits were conducted after-hours, yet 90 percent were done before 9 p.m.

"Most preferred an e-visit to the doctor's office – I didn't know how to take that, personally," Thornbury joked.

After a second year of study, Thornbury reported that the e-visit concept increased his practice's capacity by 14.92 percent while reducing per-capita costs by 14.93 percent.

Thornbury, who's now marketing the Me-Visit platform to other physicians and practices, figures the service could save upwards of $9 billion a year that's being spent nationally on after-hours care – much of that spent in clinics and hospitals by people who don't really need to be there. Many consumers, he said, would much rather have an after-hours link to their primary care provider.

"It's all about trust," he concluded.