The Virtual Doctor Can See You Now

Out-of-state telemedicine companies wasted no time offering their services in Arkansas after a law went into effect in August that eased restrictions in the way telemedicine is delivered in the state.

On Aug. 1, Doctor on Demand of San Francisco started providing services in Arkansas, the last of the 50 states the telemedical company appears in.

Teladoc Inc. of Purchase, New York, which suspended its service in Arkansas in November 2014 because of Arkansas State Medical Board restrictions, restarted offering its products in Arkansas on Sept. 1.

Arkansas’ rules for telemedicine were once considered among the most restrictive in the country. Last year, however, the Arkansas Legislature amended the state’s telemedicine law governing the way virtual care is delivered. The law now allows patients to receive telemedicine services wherever they happen to be, rather than having to visit a health care facility.

The amended law also required, as of Jan. 1, that health benefit plans reimburse for telemedicine services as if the patient were seen in person. The earlier version of the law required only that the telemedicine doctor would be paid.

Jason Tibbels, vice president of health services for Teladoc, said that while the regulations have made it easier to practice telemedicine, there’s still room for improvement, such as relaxing the rules involving establishment of a doctor-patient relationship. The regulations allow for a doctor-patient relationship to be created by video, but not by phone.

Tibbels said this can leave people without a strong broadband connection unable to access the service. “There are many, many ways to help patients where the video component may not be necessary.” He said Arkansas’ telemedicine laws are “still restrictive. … Almost every other state does not have that requirement” to establish a relationship.

Still, Teladoc and Doctor on Demand have reported increasing numbers of customers in Arkansas as telemedicine gains momentum as a diagnostic and tracking tool for providers and patients.

Phyzit of Little Rock began offering telemedicine services in 2015, but its software is focused on monitoring patients for 30 days following their discharge from a hospital.

Phyzit has around 70 practices in six states using its product, CEO Keith Moore said in an email to Arkansas Business. “We estimate a few thousand potential readmissions have been avoided so far through the use of our application,” he said.

Demand for Services
By the end of September, Doctor on Demand had added two companies that provide its service as a covered benefit as part of their health plans, Hill Ferguson, the CEO of Doctor on Demand, told Arkansas Business. He declined to reveal the names of the companies.

“We knew there was a lot of demand there with access [to doctors] being a problem for a lot of folks,” Ferguson said.

Teladoc said it has more than 600 companies that provide its service as a covered health benefit to more than 100,000 Arkansas employees.

Teladoc, which is publicly traded, reported preliminary unaudited 2017 results that included revenue of $232 million, which was up 88 percent from 2016. Teladoc, which touts itself as the nation’s largest telehealth company, reported a loss of $62.4 million in the first nine months of 2017 compared with a loss of $60 million during the same period in 2016.

For this year, Teladoc projects it will have total revenue of $350 million to $360 million and total membership of 22 million to 24 million, a 20 percent increase from 2017, according to a news release.

Gary Capistrant, the chief policy officer for the American Telemedicine Association of Washington, said more companies and people are turning to teledoctors, which “keeps people out of a more expensive setting, notably the emergency room.”

Capistrant said more people are embracing telemedicine. “It obviously doesn’t take care of everything,” he said. “But people are pleased with the service.”