With primary care physician shortages across the state, one Houston area health care provider is looking to improve access to medical care by advocating for telemedicine.
Telemedicine connects patients to physicians through a variety of electronic means, including video conferencing, email and electronic messaging platforms, without the commute and lobby wait times, telemedicine advocates say.
Kelsey-Seybold Clinic, which is headquartered in Pearland, launched an e-visit electronic messaging platform in September and a video conferencing program this January. Since the launch of its two telemedicine initiatives, Kelsey-Seybold has seen 1,800 e-visits and 100 video visits, according to the clinic. Kelsey-Seybold has clinic locations in Cypress, Katy, Kingwood, Sugar Land, The Woodlands and the Houston area.
“The care providers don’t have to take off work; they can do it from home. That’s a real win,” said Donnie Aga, medical director for health care innovation at Kelsey-Seybold. “Some of those patients do need to come in for biopsy or examination, but most can get diagnosis and treatment remotely.”
Not every medical concern can be diagnosed outside of the office. At Kelsey-Seybold, nine adult and nine pediatric symptoms—allergy, flu and cough, pink eye, urinary tract infection, gastroesophageal reflux, back pain, diarrhea and constipation, and vaginal discharge—are treatable via e-visits. Patients fill out a symptom-specific questionnaire after choosing a condition they are seeking care for. A doctor responds within an hour with a diagnosis, treatment plan and, if necessary, a prescription.
“These things add convenience to patients, it gets care in a more timely fashion, and I think it’s a real win for the patients,” Aga said.
Additionally, 50 adult symptoms are treatable via video visits with an internal medicine physician assistant, according to the clinic. Since the video conferencing experience more closely replicates an in-person visit, more complicated conditions are treatable, such as postoperative orthopedic care, shingles, bronchitis and bladder infection.
“We see it as a savings to be able to offer telehealth in the long run as far as lowering the total cost of care,” Aga said. “The savings is one, there’s overhead costs for the patient who does not have to come into the doctor’s office. Savings No. 2 is really avoiding the emergency room, the urgent care, the grocery store clinics that are very expensive. That’s where most of the savings is, accessing care outside of the primary care space.”
Texas ranks near the bottom for access to primary care physicians, coming in as No. 47 in the U.S., according to the latest report from physician search and consulting firm Merritt Hawkins published in 2015.
The Texas Medical Association, a physician advocacy group, has lobbied state legislators to pass telemedicine reform and end some restrictions. The reform is expected to improve access across the state, especially in rural communities.
“It allows families to stay where they are and patients to get the same access as if they lived in Houston. As we move forward, instead of making patients commute long distances, we can have them stay in their hometown,” said Gerald Callas, an anesthesiologist and chairman of the Texas Medical Association Council on Legislation.
Senate Bill 1107, authored by orthopedic surgeon Sen. Charles Schwertner, R-Georgetown, would lift tight regulations on virtual office visits that require doctors to conduct an in-person visit prior to electronic consultation and prescriptions.
The Texas Medical Board set the restrictions in response to legal disputes with Dallas-based Teladoc, a telemedicine company that provides 24/7 access to a network of nationwide physicians.
“Do we have a perfect bill now? No. But I’m excited that we’re moving in the right direction. This is something that needs to be done for the future delivery of health care,” Callas said.
The bill passed through the House and Senate as of May 10. Gov. Greg Abbott signed the bill into law on
May 27.
SB 1107 would allow physicians licensed in Texas or a state-licensed health professional under the supervision of a physician to provide telemedicine services without an initial in-person consultation and allow for insurance reimbursements for telemedicine care.
But insurers do not have to add telemedicine coverage in their health care plans.
“I think we finally solved that technology has to be somewhat of an answer to access to care,” Callas said. “The big obstacles right now are the overall health plans don’t want to pay for it.”
Editor's note: The bill was signed by Gov. Greg Abbott on May 27.
