Dr. Keswani

Anil Keswani, M.D., corporate vice president of ambulatory care and population health management, Scripps Health

A pilot telehealth project at Scripps Health is currently in its 10th month of providing all Scripps Health employees and their beneficiaries 24/7 access to physicians via the MDLIVE platform.

Since services are provided by non-Scripps physicians who are part of the MDLIVE platform, Dr. Anil Keswani, who is in charge of the project, told PNN that the next step is to have Scripps physicians use the platform to communicate with their patients. However, issues of reimbursement and workflow will have to be addressed first.

Dr. Keswani, Scripps Health corporate vice president for ambulatory care and population health management, said Scripps is looking at all business models, including cash payments by patients. Finding the sweet spot where patients are willing to pay and physicians get adequately compensated will be key.

Results from the pilot project are very promising, according to Dr.Keswani. There are currently 60 to 80 consultations a month via the MDLIVE platform. “We asked people where they would have gone if they had not used the telehealth service, and 60% said they would have gone to urgent care, 30% said they would have waited for the appointment with their primary care [physician[, and 10% didn’t comment,” Dr. Keswani noted.

Scripps is measuring the project’s impact on emergency room utilization, but Dr. Keswani said they cannot see a direct correlation yet. More data needs to be collected, but regardless of the numbers, that’s where Scripps needs to be, Dr. Keswani said, because that’s what patients will expect. “Even if it is not the most important thing today, we know where it is going in the future.”

Dr. Keswani said he is fascinated by the comments he receives from patients. One related in an email that he had been at a very challenging point in his life and would not have chosen to see a physician, but he used MDLIVE — the psychological help portion of it — and it helped him get through the tough time. “If you go back to the heart of the mission,” said Dr. Keswani, “that is exactly what it is about – a person who would not have gone to an urgent care setting who was able to connect and get their life back.”

Dr. Keswani said people don’t use just the video, they also like using the phone, and it appeals to all ages.

Scripps is talking to MDLIVE Inc., the Sunrise, Fla.-based company that created the MDLIVE platform, to explore other partnership options once the pilot ends, according to Dr. Keswani. He said they are also in talks with Google and have launched a small pilot project with Google in which Scripps nurses are available to patients at no charge. “We are testing the market,” Dr. Keswani told THNN. “We are looking for other channels out there that we can use to reach patients. We want to be where patients want us to be.”

However, for Scripps physicians to be involved, reimbursement issues need to be resolved, Dr. Keswani said. It needs to be attractive for the patients and make sense for physicians and for the hospital that has to put in the infrastructure to make it happen. Figuring it out will involve everyone and especially physicians, he said.

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