Without moving an inch, anyone in Alabama can now use their phone, computer or tablet to connect virtually to a physician or nurse practitioner in minutes any time of day or night through St. Vincent's OnDemand service for a nominal fee of $35. "It's the first tool in Alabama with the video component," Andrew Taylor, vice president of regional growth at St. Vincent's Health System, says.
St. Vincent's decided to offer the service to fill the gap when primary care offices are closed and to reach those not wanting to take time off for appointments. "We felt that there was an appetite for this in the market, especially among tech savvy people who want speed of access," Taylor says.
The patient starts by visiting the OnDemand website at www.stvondemand.com or calling 205-939-7550. They complete a brief questionnaire, which helps weed out emergency cases. "We've done a lot of work to screen out potential cases that we know we can't take care of," Taylor says. "We have a lot of faith in our clinicians and use robust clinical guidelines with a lot of fail-safes to protect the patient and ourselves as well."
Once the caller decides whether to video chat, facetime, or talk on the phone with the clinician, their credit card is charged the $35 fee. "We wanted to keep that cost to what you would spend as a copay to see your physician," Taylor says. "If we determine that we're not going to treat that condition, we refund that money."
The caller then holds for a clinician. The average wait time currently averages about 11 minutes. Once connected, the physician or nurse practitioner provides a consultation, diagnosis, and treatment on the condition. Any notes are sent to the caller's primary care physician.
The virtual service is meant to aid those with common ailments, such as upper respiratory infections, rashes, coughs, stings, eye infections, flu, and colds. So far, about half of the calls revolve around urinary tract distress, such as cystitis and dysuria. Other frequent calls cover stomach issues and sinus. "This is when the tool really helps because it can give you peace of mind or relieve some pain until you can make it in to see your physician," Taylor says.
Launched the end of July, the virtual care service is getting off to a slow start. "It's a new way to access healthcare and people are still learning what this means," Taylor says.
Right now, the most frequent calls come early in the morning between 5:00 and 8:00 or on the weekend from the "alpha daughter" demographic --the 26 to 39-year-old female who makes the healthcare decisions. "They're usually married and making those decisions for parents, family, and themselves," Taylor says.
About 50 percent of callers do not have a primary care physician (PCP). "We are careful to educate clinicians and patients that this is not meant to replace a primary care relationship," Taylor says. "If you're hesitant as to whether you should go to an emergency department and everything is closed, this is a useful tool. It's a great convenience option, but by no means should replace a PCP."
St. Vincent's follows up with all the OnDemand users. "We want to give that warm touch and ask about their experience," Taylor says. They also try to ensure follow-up with a primary care physician. If the patient doesn't have a PCP, St. Vincent's offers to connect them with any of their employed practices or any of the over 800 physicians allied with their system.
St. Vincent's reports no experience with criticisms from healthcare professionals. "There was hesitancy with some clinicians, because at first glance, it looks like a replacement for a primary care physician," Taylor says. But once understood how the tool was to be used, concerns dissipated.
"We're excited to see where this technology goes from here," Taylor says, adding that nothing immediate can be shared, but St. Vincent's does have plans for down the road. "What it will look like, we don't know. But we're going to pour resources into it and focus on growing it."