Virtual care has cemented itself as a mainstay of the American healthcare system. More patients want remote access to care. More physicians want to provide convenience. And most major insurers are now paying for it.
The technology is responding. High-quality smartphone cameras, faster internet connections and connected medical devices let providers replicate an in-office primary-care visit at a much lower cost.
But while video visits help busy patients or those in rural areas, they do little to address the nation's growing problem with physician burnout, said Dr. Ray Costantini, founder of Portland, Ore.-based virtual care startup Bright.md.
Costantini, who became “a little disenchanted with telehealth” during his time heading up digital health services at Renton, Wash.-based Providence Health & Services, said that telehealth often takes more time than an office visit. And time is something busy physicians do not have to spare. So in 2014, Costantini created Bright.md's SmartExam platform to make each virtual visit two minutes long. To compare, physicians spend about 13-16 minutes with a patient in an in-office primary-care setting, according to a 2016 Medscape physician compensation report.
SmartExam works like this: Patients log into the platform and answer a series of questions about their symptoms and health history. They can upload images of a rash or take a guided physical exam. Patients then fill out their pharmacy and billing information. The process takes about eight to 12 minutes.
Then, SmartExam combines the patient's responses with information pulled from their medical record to come up with a likely diagnosis. It sends all of the information in a chart-ready note to the physician who can then select the appropriate diagnosis and treatment plan—or enter a new one—and send a prescription to the patient's selected pharmacy, if needed. All the information is added to the patients' medical record. The process takes just two minutes.