MedviewMD creates network of medical studios for e-visits

MedviewMD, a telehealth company based in Chatham, Ont., is working with provincial governments across Canada to build networks of doctors who can quickly examine patients through the use of e-visits. Patients are able to connect with physicians at MedviewMD studios, which are equipped with videoconferencing and medical equipment.

Since its launch in September 2015, the company has set up over a dozen of its specialized studios for e-visits in drug stores in Ontario, and another four of them in British Columbia. It is currently in discussions with government officials in Alberta to set up studios there, so that Albertans can walk into pharmacies and interact with an online physician.

Expansion plans are under way for Saskatchewan, Manitoba, Nova Scotia and New Brunswick. By the end of 2016, MedviewMD expects to have 40 e-visit studios up and running across Canada.

Governments are pleased with the arrangement, said Dan Nead, CEO of MedviewMD, because the e-visits alleviate the problem of patients who are without a regular family physician and will often go to a hospital emergency room for treatment of minor problems.

According to Statistics Canada, 15 percent of Canadians, or about 4.5 million patients, were without a regular family physician in 2014. Services like MedviewMD can provide quick access to a GP.

“We’ve done 12,000 consults since last September,” said Nead. “We’re surprised at how fast this has taken hold.”

Nead said that MedviewMD is improving the health of Canadians while simultaneously reducing costs for provincial health ministries. In turn, the ministries are compensating MedviewMD, based on the numbers of exams that are performed.

Physicians, for their part, bill their health ministries for the services they provide. In a breakthrough arrangement, Ontario physicians are able to conduct examinations of B.C. patients using the MedviewMD telehealth system; to be paid, the Ontario doctors continue to bill OHIP, the provincial health program, while the province in turn invoices British Columbia for remuneration.

While some onlookers have questioned whether MedviewMD and other online medical services can provide the continuity of care of a regular family physician, Nead points out that patients who visit its studios can request to see the same online physician when booking appointments.

The doctor may be in another city or province, but he or she will continue to manage the patient and will be familiar with the patient’s history.

As a result, patients are more ‘tethered’ to an online physician than if they go to a walk-in clinic or emergency room, where they are likely to see a different doctor each time.

MedviewMD came up with the unique strategy of installing ‘studios’ in pharmacies, where a registered practical nurse assists the online doctor with the examination.

There is also a person booking appointments, although walk-ins can be accommodated, too.

At the Durham Drug Store, in Pickering, Ont., RPN Danielle Doering makes use of instruments such as an electronic stethoscope, otoscope, blood pressure cuffs and a vital signs monitor, along with a high-powered medical camera. “Using the exam camera, we can take detailed pictures and videos of wounds or skin problems,” said Doering.

“We can take images of the inner ear, and show them onscreen to the patients as well as to the doctors.”

The medical devices are supplied by AMD Global Telemedicine, of Chelmsford, Mass., a company that has a long history in telehealth in Canada and around the world. AMD also provides software that integrates images from the medical devices being used, and allows for easy sharing of the information among doctors and nurses.

All of the information and images are also loaded into a secure electronic medical record. MedviewMD is using the OSCAR EMR, an open system that has been tailored to its own requirements. Patients are able to gain access to their electronic records if they wish.

During the exam, the online physician guides the nurse and sees all of the patient images; the doctor and patient also see and talk to each other using standard videoconferencing.

With today’s computerized systems and medical equipment, physicians are able to accomplish a great deal even when located at a remote location.

In many cases, the patient will be given a prescription to treat common problems such as rashes, infections, colds and coughs; he or she can walk out of the room and fill the prescription at the pharmacy counter.

That’s the attraction for the pharmacy and reason why they’re willing to install the e-visit studios – they increase traffic to the stores and result in more business.

At the Durham Drug Store, pharmacist and owner Zeinab Abdulaziz says patients are arriving every day; she expects the traffic will increase during the back-to-school month of September, and in the flu season of November and December.

Awareness of e-visits at the pharmacy is growing through word of mouth and postings by Ms. Abdulaziz on the store’s web site, as well as on Facebook.

At the same time, the pharmacies are acting as one-stop shopping outlets for medical problems. Patients can be diagnosed by an online physician; they can obtain their prescriptions and medical supplies at the same location. Pharmacists in Ontario can also give flu shots to patients.

The studio, with its computer and medical equipment, is offered to pharmacies at a cost of about $80,000; it can be purchased outright or leased.

MedviewMD covers the salary of the registered practical nurse, who acts as the frontline medical professional and the assistant for the online physician.

When the problem the patient presents with is severe – such as chest pain or a severe wound – the doctor will advise the patient go right away to an emergency room, just as a family doctor would do during an in-person appointment.

MedviewMD is now adding specialists to its ranks. Nead said that mental health specialists, as well as dermatologists, internal medicine specialists and urologists are now available online. In this way, the company is expanding the range of services to patients – many of whom have great difficulty accessing a specialist close to home.

As with GPs, much of the work of a specialist can be done online.

And many GPs and specialist are happy to provide services online. “It’s not as hard as you might think to recruit them,” said Dr. Chad Burkhart, a medical lead with MedviewMD and a general practitioner who is based in Owen Sound, Ontario.

Indeed, there are many female physicians on maternity leave who still wish to work, and find they can provide online services from home. Other physicians prefer to work online part of the time, and many doctors find they can fill up empty schedules with online appointments.