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ePoster Presentations

EP-158 - Chat with a Doctor | Asynchronous Telemedicine to Engage Hard to Reach Health Plan Members

Tuesday, May 1
12:15 PM - 12:30 PM
Location: Education Zone, Booth 2416, Screen 3

Facing constant pressure to keep up with demand for access, and the desire to provide our members rapid access to medical advice and care, Kaiser Permanente Colorado sought a virtual care solution which would connect a member to a KP physician on-demand, eliminating the inconvenience of phoning for an appointment. Additionally, the solution would need to have a high level of resolution for patients to ensure their problems were addressed which would both increase patient satisfaction and help to control costs.

The Chat with a Doctor program is set up to operate as a HIPAA-compliant instant message system, so patients can chat and share images with a doctor, connecting in less than 85 seconds on average. Launched without advertising in November 2016; the virtual care program was rapidly scaled to be available to all 660,000 Kaiser Permanente Colorado members through their patient portal from 8am-10pm, seven days-a-week with no co-pay.

Chat with a Doctor has been very well received and volume is growing rapidly. In its first weeks, the program averaged 45 encounters per week, however that number has grown rapidly to upwards of 700 encounters per week; upwards of 200 patients per week are repeat patients.

In its first few months, KP Colorado physicians have effectively diagnosed and treated a wide array of conditions with Chat with a Doctor. Seventy percent of chat encounters are handled with advice only or a prescription, 18 percent are referred for appointments in the KP system, seven percent are sent to our Urgent Care centers, two percent to our acute diagnostic centers, one percent are referred to the ED, while only about three percent abandon chat prior to disposition.

One unexpected positive outcome of the program is its ability to connect to members who have been historically difficult to engage. This segment of the population-young, healthy individuals-often opt not to have a PCP and avoid the health system until an injury or unexpected illness force them to. Many of these encounters, which previously represented a significant portion of our unnecessary ED and acute care visits, have been managed via chat.
We have found this point of contact to aid us in engaging with these members, helping them to navigate our system and provide an additional level of satisfaction with the KP system. With the expansion of the service to mobile platform, we expect utilization by this younger age group to grow even further, greatly increasing the cost savings generated by it.

The asynchronous nature of the communication allows physicians to handle multiple simultaneous chat threads, leveraging the physician's time and creating efficiencies not attainable in other 1:1 encounters. Chat has become one of our highest-resolution lowest-cost care channel.

With increased utilization came an opportunity to offer more specialized advice. We have added Pediatricians, Ob/Gyn NP's, a clinical pharmacist and soon, will add a Behavioral Health Specialist in addition to support agents who assist with scheduling those patients felt to need in person care.

During the presentation, patient enrollment and physician staffing processes for Chat with a Doctor will be reviewed. Service adoption and care metrics for this unique telehealth application will be described, as well as future service line and platform development plans.

Learning Objectives:

Blake McKinney

Chief Medical Officer
CirrusMD

As a practicing Emergency Physician in Northern California, Dr. McKinney brings a unique perspective to CirrusMD and how doctors and patients can interact via chat, phone and video. Dr. McKinney trained in Emergency Medicine at UC Davis after graduating from the University of Texas Medical School in Houston. Prior to medical school, he served for four years in the US Marine Corps. He received his bachelor's in Biomedical Science from Texas A&M.

Presentation(s):

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