New specialty model for private-pay telehealth launches

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Online telehealth service 2nd.MD has a new model for private-pay telehealth. Taking a slightly different tack from doctor-on-demand services like RelayHealth and American Well, 2nd.MD aims to help patients find, and consult with, specialty physicians.

Here's how it works: Patients use the 2nd.MD system to identify physicians by specialty, location or affiliation, and then book an appointment for a tele-health visit, explains CEO Clint Phillips. Physicians' schedules are listed on the site, broken down into 20-minute increments, and patients can choose the time that works best for them, he says. Doctors charge for each 20-minute block, anywhere from $80 to $500 or more, he adds, with one top-paid concierge neurologist's fees topping $1,300 per session.

Physicians then request any needed records from the patient, including lab results, tests, and history. Patients can upload their own records, or link to their online electronic records (if available).

For the session itself, the patient logs in, the physician logs in, and they have a video-conference visit, with the physician taking notes online, and transmitting a copy to the physician afterwards, Phillips says. The visits are direct-connect between the patient and physician. 2nd.MD doesn't provide facilitators or hosting services. The system can, however, handle up to four channels at once, so patients can involve family members or other consulting physicians in the call. The site setup is modeled on the popular Skype platform, to make it easy for patients to navigate, Phillips says.

Ultimately, one of the most important aspects of the site will be its access to subspecialty doctors who focus not only on one body system, but also on a particular segment of that system, participating physician Jeffrey Budoff tells FierceMobileHealthcare. Budoff, a Houston-based orthopedic surgeon, also specializes in upper extremity, hand, wrist, elbow and shoulder surgery.

"It can be hard to find that kind of specialty skill" set outside of a major metropolitan area, Budoff notes. He adds that he thinks the telehealth approach has its limitations, particularly with regard to the complexity and specificity of subspecialty care.

For example, Budoff can't perform the intricate, specialized physical exam of the hand or wrist that he would in his office, which could keep him from making a final diagnosis in some cases. Overall, however, he sees his role through 2nd.MD as providing possible diagnoses for patients, and some guidance on "where to go from there," rather than a final determination.

"I think everyone understands the limitations of the technology," he says. "And this is really for someone who doesn't have any other access to subspecialty care."

2nd.MD may have another challenge as it gets started--gaining consumers' trust, Sherri Dorfman, CEO of mHealth consulting firm Stepping Stone Partners, Boston, tells FierceMobileHealthcare. Gaining that trust, she indicates, may be tough without a connection to a marquee healthcare player, such as the Mayo Clinic. Phillips, though, says that half-a-dozen hospitals have asked for private-label versions of the site that they can offer their own patients, which may be the key to making just that kind of link.

Right now the system is desktop- or laptop-based, although a mobile version is on the way for patients, Phillips adds. For consumers, the idea is to allow them to connect for their visit via smartphone or tablet. But for physicians, Phillips prefers for them to log on from a laptop or desktop, so that they can view images, read records and take notes efficiently.

To learn more:
- check out the 2nd.MD.com website
- read this 2nd.MD announcement

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