About 40,000 patients have received treatment plans from virtuwell, and another 56,000 patients with symptoms beyond the scope of the service have been referred to in-person providers, according to the researchers. More than three-quarters of those using the service have been female, and most have been aged 24-45.
When measuring total claims costs, the researchers found care provided through virtuwell cost an average of $113.13, compared with $201.16 for care provided through traditional channels. Virtuwell treatment for the three highest volume conditions – acute sinusitis, conjunctivitis, and lower genitourinary system infections – cost $20-$30 less than that of convenience clinics, $80-$142 less that of office visits, $82-$124 less than that of urgent care visits, and $159-$469 less than that of emergency department visits.
In addition, there was no evidence of increased patient demand for health care services, despite round-the-clock availability of the online service. Postvisit surveys indicated that at least 90% of virtuwell visits displaced in-person visits, and only about 6% displaced a "watch and wait" or home care approach.
Dr. Calman noted in an interview that the study offers one indication that "we are at the beginning of a revolution in health information technology."
The shortage of primary care providers nationally, predicted to worsen in the coming years, necessitates a major effort to provide information to people to help them determine when an acute office visit is needed, he said.
"This is not rationing care, but rationalizing care," Dr. Calman stated. "It will save time, save money, and save valuable physician time so that more patients who really need face-to-face care will have it available."
Even if patients opt not to engage in virtual clinics, the Internet gives patients the ability to investigate symptoms and determine if they need to seek care at no cost to the medical system, said Dr. Calman, who is also professor and chair of family medicine and community health at Icahn School of Medicine at Mount Sinai in New York.
Eventually, Dr. Calman said, it may be possible for patients to use algorithm-driven sites similar to virtuwell at no cost to determine whether they need care, potentially saving the price of many office visits. "The more people who do this, the more people will be able to care for themselves. We’re democratizing medical information – taking it out of the hands of the medical community," he said.
Dr. Courneya, Dr. Cain, and Dr. Calman reported that they had no relevant conflicts of interest.