When Blake McKinney was a young physician 10 years ago, he experienced first-hand the concern that came with “swine flu,” or H1N1.
“I remember the aggression that people had when they came into clinics, aggressively demanding they be tested,” McKinney told Denver Business Journal. “It would normally go like ‘a kid in my kid’s class had the swine flu’ and they wanted their whole family tested. There’s a hysteria to that. But what existed 10 years ago, where the world was, is different today. Ten years ago, there was not a readily-available telemedicine option for most people.”
McKinney is still a practicing physician, working nights and weekends. But he’s also the co-founder and Chief Medical Officer of CirrusMD, a Denver-based telemedicine company that specializes in chat-based conversations between patients and doctors.
Telemedicine has changed in those 10 years, but a new virus in the form of a coronavirus, called COVID-19, has shown that concern is universal.
But McKinney said that telemedicine now, particularly the way his company does it, is poised to make a big difference during the COVID-19 epidemic.
“I worked this last weekend in an emergency room, people are beginning to flood in with concern for the new coronavirus,” he said. “What’s tough for people to distinguish is that it’s impossible for physicians to distinguish between a seasonal cold or flu from the new virus.”
The hospital experience
He said that currently the CDC is not issuing tests for ordinary clinics, urgent care or hospital emergency rooms.
“Nobody who walks into a U.S.-based clinic, urgent care or hospital is going to be tested at the door for the new coronavirus,” he said, adding that it is currently only the sickest of the sick — those being hospitalized in the ICU — who are being tested in hospitals.
On March 2, the State Laboratory at the Colorado Department of Public Health and Environment announced it could test for COVID-19, but was not testing the general public. Tests would be administered to those who are showing symptoms but they also needed to meet other criteria: either they had been in contact with someone confirmed to have the illness, had traveled to a place where infection rates are high or are showing fever and respiratory symptoms and have had other diagnoses ruled out.
McKinney said people are coming into hospitals looking to get a test they cannot take, and meanwhile they’re exposing themselves and others to illnesses.
Telemedicine has an opportunity to clear up some of that hysteria and unnecessary exposure, McKinney said.
“There’s a very interesting psychological dynamic there,” he said. “If someone is able to connect on their couch at 11 p.m. at home with their doctor, have a fast connection with them, then in that context they’re going to be very amenable to reassurance. If that same person at 11 p.m. uplifted their children [and] drove to the hospital emergency room, they’re going to be less amenable to physician reassurance. They believe they need testing; they came all that way to visit; they’ve paid a $150 copay. They want a test and they’re not amenable to hearing me say there’s not a test.”
The telemedicine difference
McKinney said telemedicine doctors can reassure patients of that, and can do a lot more. First, he said that unlike some legacy telemedicine services, doctors using CirrusMD respond in a matter of seconds, not hours. Then, doctors can answer questions about coronavirus for someone who has no symptoms but lives in an area where there have been cases; answer parents’ questions about whether they should send their kids to school or whether masks are effective; and discuss any symptoms they have.
“A lot of telemedicine encounters are often a five-minute call, but ours are open ended with no time-bound format,” he said, adding that it was critical to him that CirrusMD not incentivize doctors to go through patients faster to earn more money.
Doctors who use CirrusMD are paid a flat hourly rate.
He said through a text-based conversation, physicians are able to gather a lot of vital information.
“In the case of a respiratory illness [like COVID-19], they’ll ask if someone is breathing comfortably, if they can walk upstairs no problem; those are vital signs,” he said. “Today, are you up and about or sick in bed? If a patient says they’re at work right now, that gives a great amount of information about that person. If they have to go to a meeting and want to pick this up in 30 minutes, not only can that happen but it helps the physician understand a lot about how well that patient is doing.”
Scaling up a business
Because CirrusMD believes telemedicine can be a game-changer in an outbreak situation like coronavirus, the company is scaling up its business. McKinney said the company is staffing up — there are about 250 doctors who have been pre-qualified by the company and are in a queue of doctors available to work.
“We have a bench of prequalified physicians who are ready to come on at a moment’s notice,” he said. CirrusMD has a network of about 1,000 physicians who are using its platform, either directly hired by the company or who are using it through a network partner such as Kaiser Permanente or the VA.
McKinney also said that the technology behind the platform is ready for increased use.
“Our tech is stress-tested at scale for going on five years as we’ve been operating at an enterprise level with very large clients,” he said. “We have the ability to implement very quickly with new member populations. We have a rigorous, rapid, deployable platform.”
When it comes to customers, McKinney said employers and insurance companies are looking for a telemedicine solution that works. Over the about 15 years that telemedicine has existed, McKinney said the industry has evolved from earlier models that take about two to three hours to connect with a doctor to about the 30 seconds it takes for a CirrusMD physician to respond.
Now, with a health crisis occurring, McKinney said it’s time people take advantage of telemedicine.
“The challenge for us in terms of disaster response is that we want people to be able to access a doctor,” he said. “If your employer doesn’t offer a telemedicine solution, we want you to ask them why not. If what’s offered isn’t good, we want people to demand that it becomes so. Telemedicine is not ubiquitous now because earlier models only let you access them for five minutes at a time or wait several hours for a call back. But the American experience-driven economy says we’re not cool with that anymore. From a business perspective, we want people to demand from their benefits they have a better experience and we stand ready to provide that.”