Virtual second opinion development business

Few things are more stressful than undergoing a serious medical diagnosis, but pandemic-era changes in virtual care are prompting more patients to seek second opinions without leaving home.

Why is it important? The telehealth explosion has made it easier to get advice from top doctors across the country — and it’s made it easier for health systems to expand business beyond their physical footprints and even treat people who need some advice.

Issue: The clinic, a partnership between the Cleveland Clinic and telehealth giant Amwell, launched in 2020 before the pandemic began.

• According to Frank McGillin, the clinic’s CEO, the idea was to make the Cleveland Clinic brand easier for patients to connect with Amwell’s virtual devices and private insurers.

Game Mode: McGillin said patients have to run through the pitfalls to get relevant health records and test results to a new doctor and may face longer wait times. And in the background, some providers still have to deal with large physical records and scans.

• The clinic acts as a valuable concierge service that collects records digitally and pairs patients with a specialist who reviews their case and provides a second opinion within two weeks.
• The speed and convenience can be useful in the uncertain situation of cancer diagnosis or the treatment process. But now, patients not referred by one of the clinic’s insurance partners must pay nearly $2,000 out-of-pocket, not including additional tests or services.

How it works: Patients register on the clinic’s website, then have a live intake interview with a nurse care manager. After patients give their consent, the clinic collects relevant medical records for review.

• After reviewing imaging scans and laboratory tests, Cleveland Clinic specialists provide a written report via video consultation.
• At the time of the outbreak, the clinic was providing second opinions and digitizing clients’ medical records, McGillin said, as social distancing measures kicked in and in-person care was cut.
• “Digitalization has helped us survive because obviously blue links don’t work,” he said.

The big picture: This is part of the expansion of virtual specialty services during the pandemic, said Amwell CEO Ido Schoenberg.

• “The aversion to connecting digitally is very, very different than it was today,” Schoenberg said.
• Other virtual care companies have given second thoughts to the explosion of the telehealth epidemic. Health benefits company Accolade has acquired virtual secondary opinion startup 2nd.MD and covers more than 9 million individuals.
• Large insurers such as Elevance Health, formerly known as Anthem, have begun offering secondary opinion services to major national employers, Schoenberg said. Patients can access the service from around the world, making it easier for people in underserved areas to get a second opinion without having to travel.
• “It’s no longer a military patient trying to find their way through the alternative grid. It’s becoming part of the normal utility,” Schoenberg said.

business case; To date, the clinic estimates it has saved $65 million per 100,000 health plan members.

• More than 70% of second-opinion programs eliminate unnecessary tests or procedures or otherwise improve diagnoses or treatment plans, McGillin says, citing an average savings of $12,000 per change in diagnoses.
• A common example is when a patient disagrees with a recommendation for spinal fusion surgery when physical therapy would be more appropriate, he says.
• While McGillin said the second opinion service will not transfer patients to a specific facility, the health system will receive new patients through the program.
• “It’s a perfect business opportunity to help fulfill that mission by being a steward for more patients,” he said.

Yes, but: It’s still a premium for most, requiring patients to pay out of pocket rather than serving as a reimbursed visit. For self-pay patients, the cost is $1,850.

• Studies generally show that the cost-effectiveness of seeking a second opinion varies significantly by patient group and specialty.
• Patients may not like the answer they get from a second opinion, there may be confusing misunderstandings between doctors, and sometimes there may not be a clear answer.

What to see: Expansion of virtual specialty care programs that provide second opinions for critical care management.

• McGillin said the program could be a starting point for Cleveland Clinic “as we build on this approach to rethink the delivery of specialty care outside the four walls of the hospital.”
• Better management of the large population with chronic diseases, such as heart failure, will be the next step.