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We Do Video Visits

Kaiser Permanente research finds that members appreciate being able to connect with their doctors online

Mary Reed’s research is showing that Kaiser Permanente members feel video visits strengthen the doctor-patient relationship.

Kaiser Permanente members who chose video visits were overwhelmingly satisfied with this new way to “see” their doctor, according to research correspondence published today in the New England Journal of Medicine.

“Many patients reported that the video visit actually improved the relationship with their clinician,” said lead author Mary Reed, DrPH, research scientist at the Kaiser Permanente Northern California Division of Research. “One of the strengths of this option is that you can maintain a stronger relationship with your own doctor through video.”

Kaiser Permanente Northern California began offering video visits across the region in 2011, and they became widely available in mid-2014. Members can now self-schedule video appointments online at kp.org and communicate face-to-face with physicians on a mobile phone, computer or tablet.

The study, “Real-time patient-provider video telemedicine integrated with clinical care,” looked at more than 200,000 video visits conducted in 2015, 2016 and 2017 in Northern California, and included an online survey of nearly 1,300 members who chose to schedule a video visit with their physician. At the time of the study, Kaiser Permanente did not charge any co-payments or deductibles for video visits.

“The evidence on integrating video visits into ongoing clinical care is limited,” Reed said. “We think this is the largest analysis of video visits in an integrated health care setting.”

Co-author and Kaiser Permanente podiatric surgeon Craig Wargon, MD, is medical director of the TPMG Technology Group.

Who is using video visits?

Kaiser Permanente employs a number of different methods for interacting with patients via telemedicine, including phone, secure email message, and video. Video visits accounted for a small proportion during the study period — less than 1 percent.

Three-quarters of those video visits were in primary care (internal and adult family medicine), pediatrics, dermatology, after-hours care and psychiatry.

Co-author and Kaiser Permanente pediatrician Rahul Parikh, MD, says video visits can work well for parents who have a difficult time getting their kids to the doctor.

“Pediatrics are a nice place for video to work, because parents have a hard time getting their kids to the doctor,” said co-author and Kaiser Permanente pediatrician Rahul Parikh, MD.

“They are also working quite well in behavioral health,” added co-author and Kaiser Permanente podiatric surgeon Craig Wargon, DPM. “Clinicians can see the patient and how they are feeling, but there’s nothing physical that they need to examine.” Parikh and Wargon are leaders in The Permanente Medical Group (TPMG)’s Technology Group.

Video visits “very satisfying”

Among the study’s findings:

  • * 93 percent of patients who scheduled video visits said their health care needs were met.
  • * Patients used smart phones for 74 percent of the video visits, while 20 percent used a computer and 6 percent used a tablet.
  • * The average length of the typical video visit was about 8 minutes.
  • * 60 percent of TPMG clinicians used video visits, and less than 5 percent of patients.
  • * About 66 percent of scheduled video visits were successfully completed; however, patients and clinicians who weren’t able to communicate by video were almost always able to complete the visit another way.

“We’re finding that patients find video visits very satisfying,” Dr. Wargon said. “Physicians who do a lot of video visits also find them beneficial. Though further research is needed, the study shows that video visits are an efficient way to practice medicine.”

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