Editor’s note: During this TMT interview, Ms. Claudia Tellez, Executive Director of Northern Virginia Medical Society and the visionary behind DoctorsTelemedMS www.doctorstelemed.org, discusses DoctorsTelemedSM and the opportunities, challenges, and success of this early stage telehealth service for physicians and their patients.
DoctorsTelemedSM is the only network of clinicians supported by a medical society—the Medical Society of Northern Virginia. This interview will interest those involved in or contemplating development of a medical society-based telehealth program.
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TMT: What was the motivation for developing DoctorsTelemedSM? [00:00 min.]
Ms. Tellez: Doctor’s Telemedicine was created by the Medical Society of Northern Virginia, which is an organized medicine platform. We saw the need to be involved in technology because many of our members and we have over 1,600 members throughout northern Virginia: Arlington, Fairfax, Loudoun, and Prince William counties. We saw a lot of the need emerging from them from the calls we received and from conversations that we had at our educational events—and we hold over 20 events per year. And it was really a matter of, if we don’t with the program of technology.
First, it was the health information exchange and telemedicine in particular that we will just going to be left out and disenfranchised, because this is what is happening with healthcare. You know, the patients and doctor are being more disenfranchised, and they’re being pushed and wedged by insurance companies and also, now, technology, which has its pros and its cons.
So, the number one thing: a lot of our members were being hit with contract propositions. And we realized that they all require a subscription model for our physicians to access their telemedicine platform. And they are charging hefty amounts per month; and they are also taking up to 50% of the revenue generated through the platform. So, we created what we call a very socially responsible business model with DoctorsTelemedSM and so forth. And our intention was really to begin very grass root and come up with a business model that was beneficial to both physician community and their patients.
TMT: What were the goals and ground rules established by MSNVA in developing DoctorsTelemedSM? [01:51 min.]
Ms. Tellez: Number one, we definitely did not want to charge a price point to our members that was onerous. Number 2, we did not want this business to make enormous profits. So, it is a nonprofit. We will not be seeking any corporate funding or venture capital funding. And Number 3 we really wanted this platform to serve as the big hope for the physicians and patients to take control of their relationship. We were very clear with the technology partner that if we were going to do this together, this is going to be a partnership; that we were not in a position to invest a lot of money and any infrastructure; that we wanted to leverage existing technology and marry it to the needs of our members. So out of that was born DoctorsTelemedSM.
TMT: What was the process in setting up DoctorsTelemedSM? [02:41 min.]
Ms. Tellez: We started the project last year in January actually. First we came up with the criteria, then we created a committee, then the board has approved it. Then we went to a market place to look for a technology partner. So, from January to I think around June we were still vetting and evaluating different platforms; and in July we actually began working on the platform—the technology piece. But there were enhances that needed to be done related to the workflow of each physician, and how the platform had to be very intuitive. Website functionality was done in late November. And so, we had a soft-launch, and from January to now we have 35 physicians and then 10 more that need to set up profiles.
TMT: The component of telemedicine used by MSNVA is called the “live media consult”. Please explain this. [03:35 min.]
Ms. Tellez: Let me tell you the business model and the actual component of telemedicine that we have decided to actually engage in; and that is called the “live video consult”, which actually does not require any equipment. We wanted something that was mobile and that was ready to be deployed and that was scalable.
Because we were working with doctors who are members and we already have a based of patients, we marketed to their base patients first. This is the beauty of our service, because we are the Medical Society in Northern Virginia we already have access to the doctors. We have over 1600 members. Actually, we do not do much marketing in terms of getting physicians on board. It’s just really word to mouth. And since we did the soft launch in early January to begin recruiting the network, we really did not have to do much. Doctors who have signed up already, they market to their patients, and then their patients choose to enroll, and then make use of the system.
TMT: What has been the patients’ response to DoctorsTelemedSM? [04:37 min.]
Ms. Tellez: I think there is a lot of embrace on the part of consumer for our particular service, because it is regional, and again they have the piece of mind that they can always reach their physicians in person if they want to. They are not being serviced by somebody on the other side of the world, the other side of the country.
Northern Virginia is know for really high traffic, I believe it is number two or three in the country. We drive on average of 15 miles to get wherever, and then you have to factor in traffic. You could be sitting for 30 minutes to get to a place 10 minutes away from your home. So yes, it becomes a service of convenience.
TMT: What is the process by which patients and doctors join DoctorsTelemedSM? [05:28 min.]
Ms. Tellez: Patients and doctors can log into any website or any smart-enabled device, any browsers to https://www.doctorstelemed.org/. And they each sign on with their login ID and their password. Patients register, and they create their account. They have to complete their medical history, and they put in their credit card information. The doctors on their side have to come to MSNVA to be vetted and to make sure their licenses are in good standing and make sure they have the proper liability insurance coverage, which is basically the same as they have with in person visits. The patients get a code so they can set up their profile.
TMT: What is the cost to physicians who join DoctorsTelemedSM? [06:13 min.]
Ms. Tellez: The physicians only pay $250 dollars a month, and they sign up and they have three months to try the platform out. So they can also see the value and the amount of revenue that they can raise through DoctorsTelemedSM.
TMT: How does MSNVA allocate the income generated by physician membership fees? [06:32 min.]
Ms. Tellez: MSNVA centralizes all the merchant services, and we only keep 5% of any profit generated. And that basically pays for the maintenance of the staff support and also the merchant fees. And any residual goes back to the foundation, and then the foundation supports three programs with that revenue.
So, one is the scholarship fund for the rising medical students. The second one is the technology piece, so there is a health information exchange in DoctorsTelemedSM. And the third one is our charity care component, where we have a network of specialists who actually volunteer to take low-income patients from safety net clinics, one to three per year. And we are actually going to expand the charity care with the use of DoctorsTelemedSM, which will increase access to the low-income uninsured.
TMT: How challenging is the learning curve for physicians? [07:29 min.]
Ms. Tellez: And the learning curve is very minimal also, because the platform is very intuitive. Basically, they just need to how to log in, how to position themselves when they are doing a video conference call, which is not hard, and then navigate their scheduling system.
TMT: How do physicians incorporate DoctorsTelemedSM into their daily routine? [07:46 min]
Ms. Tellez: We were very careful not to be intrusive of their workload. We know how much they depend on that and we know it is a big delicate balance on their day-to-day basis.
It is not intrusive at all, most physician set up one day of the week, one to two hours on that designated day of the week, and they tell the patients I’m available online on this date. Or, some of the doctors like to make themselves available on Saturday morning. They do it from their comfort on their own. It hasn’t really changed the workload much.
TMT: Is DoctorsTelemedSM available to people when they travel for business or vacation? [08:19 min.]
Ms. Tellez: For people travel a lot for their business to have access to the doctors in real time, with the laws right now, and this is across the country, if you do not have a preexisting condition outside this DC district metro area, then you can’t access physicians via telemed. If you do have a pre-existing relationship with your provider and you do live and reside in northern Virginia then you can access your physician in northern Virginia from anywhere in the world even if you are not even outside the country. Often you may just want to consult with your dermatologist or your PCP or whomever in real time.
TMT: You refer to the “platform”. Please define that term. [09:02 min.]
Ms. Tellez: In the geeky IT world we refer to the “platform” as the technology piece that powers of DoctorsTelemedSM. So, the platform really is a technology piece that enables our physicians to connect with their patients in real time.
TMT: Do patients have access to their medical records? [09:19 min.]
Ms. Tellez: The physicians and the patients actually have the ability to download the notes from the particular consult any time they want; and if they want they can share that with their providers if they wish to. And physicians can actually download all the consults on their .cva files into their EMRs (electronic medical records).
TMT: What data will DoctorsTelemedSM track? [09:37 min.]
Ms. Tellez: We will be tracking utilization. We will be tracking the level of satisfaction from the consumer standpoint and also the physicians. But clinic outcomes, not so much, because clinical outcomes collection requires a connection to an EMR or to another enhanced module that tracts chronic care management, for instance. So, that maybe a possibility in the future, but right now it is not.
TMT: What are the future goals for DoctorsTelemedSM? [10:10 min.]
Ms. Tellez: We have a target of recruiting 100 doctors by the end of this year. We’re pretty much on target with that at 10 per month; and we would like our physician to do 1 to 2 hours a week on 50-minutes interval for their patients on telemedicine. So, those are the big major goals, and we are tracking that very carefully.
TMT: What are the future marketing plans for DoctorsTelemedSM? [10:35 min.]
Ms. Tellez: We plan to market to the entire community. We are able to extend the services to also new patients; and so physicians like that, because it will also generate new patient traffic not only to the telemedicine platform but also to their offices. And because it is only local, our patients will have the piece of mind that they can always see the doctor in person if needed. And the doctors also feel better because the doctors may want to see the patients in person at some point.
TMT: What have you learned during this process pertaining to technology vs. patients and healthcare providers? [11:05]
Ms. Tellez: Technology is amazing and it is great. It is definitely enabling consumers and physicians in many different ways they are positive; but I think that we just need to be careful not to leave the patients and physicians behind, out of the development, out of the change. And we also have to be mindful of everybody jumping into all of these startups in healthcare, and we have to wonder if that can save lives and save money in the end.
Claudia Tellez, Executive Director, Telemedicine, began her career with MSNVA as Director of Foundation Programs. During her tenure, she was responsible for the planning and development of Project Access of Northern Virginia, a program that delivers pro-bono specialty health care services to low-income, uninsured patients in Fairfax County and Alexandria City. In addition, Ms. Tellez serves on a number of boards and committees. In 2008, she was appointed by Virginia Governor Timothy M. Kaine as trustee of the Virginia Tobacco Settlement Foundation (currently The Virginia Foundation for Healthy Youth), she served as a Board Trustee for the Physicians Foundation. She has a BA in International Relations from DePaul University and certification on Disaster Preparedness and Readiness from the University of Illinois at Chicago.