Virtual healthcare is becoming a credible alternative to more traditional forms of healthcare, finds Maggie Williams

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You can’t sleep. Your head is hurting and your feet feel like lead. And, there’s this strange mark on the back of your leg…

What do you do next? If your answer involves the world ‘Google’, then you’re already part of a fast-developing healthcare trend, even if you’re not exploiting it in the most efficient or medically reliable way.

Virtual healthcare – using technology to encourage greater well-being, support staff when they are ill, and help them get back to work more quickly – offers access to services that can complement and build on ‘real world’ support from GPs, pharmacists and other healthcare providers.

Instead of taking your chances with a search engine, you could speak to a GP over a phone or video conference link. That consultation could lead to a quick, accurate diagnosis with a prescription delivered to your home or workplace, all without having to visit a physical surgery.

Apps, online health checks, even gamification techniques are all extending the ways that individuals and healthcare professionals can prevent, diagnose and treat illness.

“There are comparisons with personal finance,” says MartinuNoone, managing director at Legal & General. “People manage their money online more than ever, and that will eventually happen in healthcare as well. But in the UK, there is still a belief that everything should be face to face. It needs a cultural change.”

The benefits are tangible

However, at a time when the NHS is struggling to deliver services within available budgets, the continued expectation of a free face-to-face GP service comes with strings attached. Research carried out by doctors’ website Pulse in spring 2016 showed the average waiting time for a GP appointment was two weeks. With many employees working a significant distance from their doctor’s surgery, time out of the office to manage even relatively minor illnesses quickly starts to mount up.

That delay has cost implications, too. The CIPD’s 2016 Absence Management Report showed that the median annual absence cost per full-time equivalent employee is £522.

Take those absence costs, combine them with reductions in productivity caused by presenteeism, and offering virtual healthcare services “could end up costing less [than absence], and lead to happier and more productive staff”, says Noone.

“However, many businesses view health benefits generally as just another expense. The employee isn’t at the heart of the process. It surprises me employers haven’t thought more about how to manage their workers’ health in a cost-effective way.”

Virtual GP/care services

Remote access to GPs may have been slow to catch on in Britain, but in other parts of the world, such as the US, telemedicine (healthcare supported by remote technologies such as phone, email and video conference) is commonplace. In 2016, the US-based National Business Group on Health found that 74% of large employers offered access to telemedicine.

To convince UK consumers to take the plunge, the technology used to support virtual consultations needs to make the process as natural as possible, replicating that face-to-face experience.

As broadband speeds have increased to enable smoother, more natural video consultations, complementary tools such as remote blood pressure kits have become more accessible, and smartphone apps have evolved to measure anything from sleep patterns to pulse rates, so the range and quality of diagnoses that can be handled virtually has increased.

Getting employees familiar with the idea also means overcoming potential concerns around confidentiality. “We make sure that the customer understands that we are bound by the same rules as any doctor when it comes to sharing information,” says Bippon Vinayak of virtual doctor service Square Health.

Vinayak believes that there will be a tipping point where people are so familiar and comfortable with remote consultations that it will no longer be questioned. “I see it as a natural evolution – people who have tried it then see the convenience.”

Nicola Johnson, senior product manager at SimplyHealth, believes that the NHS and government could also encourage greater familiarity with online services, alongside other real-world options.

“The government is struggling with reliance on GPs. There are lots of other options, such as NHS 111 and pharmacists, even within the NHS. There could be some education of the population, as well as better opportunities to work with the private sphere and virtual tools.”

“We see this as a supplement to, not a replacement for NHS services,” says Vinayak. “In addition to GP services, there are ways of using similar tools remotely, which can also help the person to be more productive at work, or take less time off.”

Even if virtual or phone-based support sounds like a good idea in principle, when someone is ill, the last thing they may want to do is experiment with a new approach to healthcare.

Christine Husbands, managing director of phone-based long-term advice and support service RedArc, says one of the biggest barriers to using remote or virtual services is simply getting started.

“People are often vulnerable when they’re ill and don’t want to make the first step. Where appropriate, we encourage insurers to make proactive referrals to us. We can then make that first contact with employees.”

Inevitably, there will also be some situations that can’t be managed through an online consultancy. “If the GP in the virtual consultation considers the problem is more serious than originally thought, they can refer someone to a GP in the ‘real world’ or to a hospital,” says Noone.

For employers that do offer access to remote health services, there can be positive engagement benefits. Husbands says: “When people are off long-term sick, employers often want to fulfil their duty of care, but are worried about how to keep in touch. Offering support services can give employers the comfort that they are involved in that care. It’s also useful for employees to have someone to speak to who isn’t from the employer – people are often anxious about being off work.”

Apps and online services

Virtual GP services might require a shift in thinking for new users, but using smartphone and tablet apps as part of healthcare support should bring many into more familiar territory. There is a plethora of free health apps, such as the NHS’s Change4Life, that provide focused support around better eating, taking more exercise or monitoring alcohol consumption.

In addition, many health cash plan and private medical insurance providers have now developed comprehensive apps that act as a gateway to services that they offer.

“It’s part of using technology to manage their health in one place and on the go,” says Michelle Rae, head of product at health providers Cigna, which offers a range of apps.

“In the past we would have used paper packs and posters, or face-to-face sessions to pass on information to employees,” says Brian Hall, managing director of BHSF. “But if someone who could have benefited from a service wasn’t at work that day, they were unlikely to find out about what was on offer.”

He adds that putting that same information on to a smartphone app makes it accessible when a person needs it.

Another area of healthcare that lends itself well to technology and apps is gamification – encouraging healthy behaviours through competition and/or rewards. “Some employers and providers have really understood gamification, perhaps also using it as a teambuilding exercise,” says SimplyHealth’s Johnson.

“But it requires proper understanding. For example, anything that requires regular logins is unlikely to work. It needs to be front-of-mind to work effectively.”

In addition to developing one-stop-shop apps, virtual healthcare also encompasses specialist tools that focus on a specific aspect of health, such as eye care. Research from the US-based Society for Human Resources Management shows that 90% of VDU users say they regularly suffer from symptoms of digital eye strain, including headaches, sore or tired eyes, and  problems with close or long-distance vision.

Vision specialists VSP Vision Care has developed eScreen, offered through its eye care plans. The service enables employees to carry out a 10-minute test at their desk on their VDU, which can then be used as the basis for any further eye examinations they need.

Jeremy Chadwick, managing director EMEA at eScreen, says: “We tend to defer going to the optician unless we have to and we don’t change prescription often enough. eScreen can bring productivity advantages and can also help to manage the risk of more serious illnesses such as diabetes that can be spotted with an eye test.”

Return on investment

Predictably, the extent to which employees use any kind of virtual healthcare depends on the attitude and culture of the company. “Where employers are supportive and there is an active workforce, we see take-up rates of around 60%,” says Hall.

He points out that there is genuine payback for everyone: “Virtual services can help both employers and employees. Their needs might not be the same, but the right product can give the outcome that both parties need.”

The benefits for businesses are clear. But Rae cautions: “This won’t work simply by giving people an app. It’s about access and engagement.”

Use of virtual healthcare tools is far from universal. Services such as virtual GPs assume that employees have access to reliable broadband services and smartphones, which may not be the case for many individuals or workplaces. There are cultural barriers to be overcome, and encouraging someone to get to grips with a new method of healthcare when they are unwell is hardly the ideal introduction.

But as virtual healthcare becomes more commonplace and as traditional GP services continue to struggle, its usage can only be expected to increase. “The key thing is access to credible information and support,” concludes Johnson. Taking advice remotely from proper experts has to be better than a Google self-diagnosis.