Iowa patients on virtual doorstep of new health care technologies

But new University of Iowa study shows many don't use it

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The health care arena in recent years has been flooded with virtual tools — from electronic medical records to telepharmacies to virtual clinics and internet-based doctor consultations.

But a new University of Iowa-commissioned survey found more than half of Iowans polled are not aware of their expanded options, and one in 10 of the respondents who could have benefited instead chose a more expensive and time-consuming option.

“That’s something we definitely need to focus on in Iowa — to improve that care component,” said UI physician Patrick Brophy, associate professor of pediatrics and medical director of UIeCare.

Brophy commissioned the survey aimed at understanding Iowans’ attitudes and knowledge about options to receive health care at home through a computer or smartphone.

“We were trying to identify what opportunities there are, who we could actually provide service to,” he said. “Clearly there’s a pretty large rural population that we could benefit.”

The challenge, he said, is educating the public about their myriad health care options, which already include visiting a family physician, phoning an on-call nurse or going to an urgent-care clinic.

“And they have the emergency department, which people still use for minor things,” Brophy said. “Obviously we would like them not to do that if there are other options.”

The 2016 survey of 528 Iowans from both urban and rural areas found 9.7 percent reported using an emergency department for themselves or a child in the past two years for a “relatively minor condition,” such as a cold or flu, earache or pink eye.

About 54 percent of respondents said they are unfamiliar with the concept of virtual care or the ability to be seen for minor conditions — without an appointment — by smartphone or computer.

The UI last year became the state’s first health care organization to launch such an option with its UIeCare virtual care service. The internet-based clinic for minor illnesses and injuries — think suspicious rash, bug bites, cough or sore throat — can be accessed by computer, tablet or smartphone any time, on any day, by anyone in Iowa.

Users, who don’t have to be UIHC patients, login by answering a few identifying questions. The system also asks screening questions to make sure virtual care is appropriate.

If it’s not, users are referred to the emergency department, and Brophy said that’s happened on several occasions since the system’s launch in May 2015.

“They are triaged very quickly and then sent to the emergency department, if necessary,” he said. “In one case, we actually called ahead to the emergency department to try and expedite the patient being seen. That’s first and foremost. You want to provide patient safety when using these technologies.”

Users who are approved for virtual care could wait five to 30 minutes, but Brophy said the average wait is within 15 minutes. Once they’re through, they sit virtually face to face with a UI-credentialed health care provider to discuss their symptoms.

The doctors are certified to diagnose patients and prescribe medicine. Because the system is integrated with the UI’s medical record provider, results of virtual visits are sent to primary care providers.

Among those polled in the recent survey, 90 percent in urban areas reported urgent care within 20 minutes of home. But 32 percent of Iowans in rural zones lacked the same access, and many respondents expressed appreciation for any added convenience online visits might provide.

“No one wants to leave the house when they aren’t feeling well,” Brophy said. “Iowans with sick kids or who have difficulty traveling will find the virtual care service very beneficial.”

The sooner Iowans get onboard with the new technology, the faster it will expand, as Brophy said he doesn’t see any other way forward.

“I don’t think you can really imagine any health system over the next 30 years not having at least some kind of centralized component of telehealth, including patient monitoring at home,” Brophy said. “I don’t think that there’s a model that works without having that sort of technology in place.”

UnityPoint Clinic, part of UnityPoint Health, last summer began offering virtual care through a system that’s used elsewhere nationally, called “MDLive.”

And UI Health about six months ago began piloting a service that would allow patients to interact virtually with their doctors over MyChart — the patient-access online medical record application.

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