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New Survey Questions the Value of Virtual Visits to Patients, Doctors

As reported in JAMA Dermatology, a small study of patients with severe acne found that they'd prefer monthly video consults for a prescription - but they's only pay $25 for it.

By Eric Wicklund

- A small study of patients suffering from severe acne has found that they’d prefer to see their doctors online for monthly checkups – but they wouldn’t pay much for the convenience.

The survey, conducted by researchers at the University of Pittsburgh School of Medicine and reported in JAMA Dermatology, focused on patients who’d been prescribed isotrentinoin by their doctors. Because of the potential for serious side effects, dermatologists can only prescribe this pill on a monthly basis, thus requiring monthly appointments, and all doctors, pharmacists and patients must register with the U.S. Food and Drug Administration on the iPLEDGE website.

During those monthly visits, doctors offer birth control counseling, perform pregnancy tests and check for side effects before issuing the next month’s prescription.

According to the survey of 62 adult patients and 43 caregivers for patients younger than 18, conducted in 2014, almost 70 percent of the patients and almost 60 percent of the caregivers said they had no concerns about safety if the monthly doctors’ visits were done via e-visits. About 16 percent of the patients and 21 percent of the caregivers said they were concerned about the safety of such visits.

"I think electronic visits are feasible in the setting of isotretinoin use in terms of safety and patient and caregiver comfort with the safety of those visits," Dr. Timothy Patton, of the University of Pittsburgh School of Medicine and lead author of the study, told Reuters.

Cost considerations, however, painted a different picture. The study found that most of those surveyed estimated they’d miss two to three hours per month of school or work, which cost between $32 and $42 per person. When asked what they’d pay for an e-visit, the responses averaged out at $25, well below the $49 to $49 charged by Pittsburgh-area doctors for an e-visit.

That disparity highlights the difference in perception of the convenience of mHealth to a consumer and a provider. A doctor who isn’t reimbursed or who can’t charge the same rate for online care as for an office visit won’t likely adopt the technology; their patients, on the other hand, may gravitate to a doctor who does offer e-visits if convenience outweighs cost.

In a survey conducted almost a year ago by Harris on behalf of Boston-based telehealth provider American Well, 64 percent of those contacted said they’d be willing to see a doctor by video, and at least 70 percent said they’d prefer video over in-person visits for a prescription. And more than 60 percent of the 2,000 adults surveyed said such a video visit should cost less than an in-person visit (only 5 percent said it should cost more).

In that same survey, when asked if they’d switch to a doctor who does offer e-visits, 7 percent said they would – though that number jumped to 11 percent among ages 18-34, suggesting that the younger generations are more likely to change providers.

While the University of Pittsburgh study focuses on a specific population that requires monthly visits with a doctor, it’s worth noting that those surveyed valued an online visit at roughly $25, far below what a doctor would value the visit.

“Doctors, patients and the FDA need to assess the burdens of iPLEDGE in their ‘ongoing dialogue’ about the program's ‘evolution,’ the researchers said, according to Reuters


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