Walgreens, insurers push expansion of virtual doctor visits

Millions of people will be able to see a doctor on their smartphones or laptops for everyday ailments once the nation's largest drugstore chain and two major insurers expand a budding push into virtual health care.

Walgreens said Wednesday that it will offer a smartphone application that links doctor and patients virtually in 25 states by the end of the year. That growth comes as UnitedHealth Group and the Blue Cross-Blue Shield insurer Anthem prepare to make their own non-emergency telemedicine services available to about 40 million more people by next year.

Doctors have used video feeds and other technology for years to treat patients in rural areas or remote locations. But experts say growing smartphone use and customer demand are fueling a rapid expansion of the practice, called telemedicine, into everyday care the family doctor used to handle. Now this push is gaining an additional boost from health care companies with broad, national reach.

The American Telemedicine Association estimates that about 450,000 patients will see a doctor through the Internet this year for a primary care consultation. That's a small slice of the roughly 15 million people who will have care delivered by telemedicine, which has mostly been used by specialist doctors. But the primary care portion has probably doubled over the past couple years, said Jon Linkous, CEO of the nonprofit association.

"I would say without a doubt it's the fastest area of growth in telemedicine," he said. "There's this convenience factor that makes it so compelling to consumers."

Drugstores, grocers and big retailers like Wal-Mart have been opening clinics inside their stores for years now, giving patients several less-expensive alternatives to a doctor's office when they need help. Internet doctor visits aim to offer even more convenience by providing care wherever the patient is located.

Programs offered by Walgreens Boots Alliance Inc. and the insurers give customers around-the-clock access to doctors who can diagnose and treat conditions like allergies, a sinus infection or pink eye that don't require a physical exam.

The extent of the care a patient receives can vary by state. Some regulators prevent a doctor from using a telemedicine visit to write prescriptions for controlled substances or abortion-inducing medicines. Some states also require a doctor to have an established relationship with a patient, which might include a physical or mental exam, before allowing them to do a telemedicine visit.

These virtual visits can cost around $49 for patients with no coverage or insurance that makes them pay a high deductible. That compares with typical prices of $70 for a clinic or more than $100 for a doctor's office visit.

Walgreens started testing its app last December on smartphones and is expanding it to both tablets and personal computers.

UnitedHealth Group Inc., the nation's largest health insurer, just started covering telemedicine visits earlier this year for about a million people with employer-sponsored health plans. The insurer aims to expand that to 20 million customers next year.

Anthem Inc. started its LiveHealth Online service in 2013 by offering it to a few thousand people. It now provides the service in 44 states and also expects 20 million of its customers to have access by next year.

Doctors say telemedicine can help improve access to care for many patients, as long as the care is good, a record of the patient visit makes it back to that person's regular doctor and safety isn't compromised.

Dr. Robert Wergin expects to do more telemedicine visits in the future as more insurers begin to cover it. The Milford, Nebraska, doctor said it can help many of his patients who are older and have a hard time getting out of the house.

"I can see a real benefit there," he said.

But the president of the American Academy of Family Physicians also cautioned that telemedicine has limits. He noted, for instance, that one of his patients recently wound up having quadruple bypass surgery after coming to see him for a burning sensation in his chest. The physician could rule out acid reflux as a potential cause by examining the patient's abdomen, something a doctor couldn't do in a virtual visit.

Walgreens said the doctors in its program are trained to quickly determine whether a patient needs more care than they can provide during a virtual visit.

"We're very careful in only using telemedicine for certain conditions that are amenable to this," Walgreens Chief Medical Officer Dr. Harry Leider said. "We're not treating heart attacks."

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