A relatively new primary care practice based in Brooklyn, New York, is using new ways to serve the un- and under-insured communities in its own neighborhood. The practice, Hello Health, is based on membership and pay-per-visit office fees from patients instead of insurance, and encourages patients to communicate with their physician via instant message, email and video chat. But critics of this model say internet communication is often misinterpreted and cannot be relied upon to build a solid physician-patient relationship. Dr. Jay Parkinson, co-founder of Hello Health, describes his new model for healthcare and his plans for expanding the internet-based primary care practice model. Is this model really the way of the future? Dr. Michael Greenberg hosts. You can visit Hello Health here.
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Technology and Instant Communication: New Visions for Primary Care
Health insurance goes more complex and cooperative by the minute. What if you as a physician get to manage your own practice based on communication with patients directly through instant messages, e-mail, and video chats. Circumventing the entire health insurance system, is this a viable healthcare model? You are listening to ReachMD Radio on XM160, The Channel for Medical Professionals. Welcome to Clinicians Roundtable, I am your host Dr. Michael Greenberg, joining us to discuss Technology in Instant Communication, New Visions for Primary Care, is Dr. Jay Parkinson, Cofounder of Hello Health and Membership-Based Primary Care Practice in Brooklyn, New York.
DR. MICHAEL GREENBERG:
Welcome, Jay.
DR. JAY PARKINSON:
Thank you for having me.
DR. MICHAEL GREENBERG:
Hum, thanks, tell us about yourself first. Give me a minute of where you were trained and how you got into this idea and tell us what the idea is in the first place.
DR. JAY PARKINSON:
Ha, sure. The Hello Health is mainly a sort of technology that takes a lot of information from e-bay and Flickr and Facebook and it is really like a social network to connect you with your patient's friends and as a matter of fact, you have a direct connection to all of your patients so that you can coordinate and provide medical care both in person and online.
DR. MICHAEL GREENBERG:
Where as you as a doctor of connection?
DR. JAY PARKINSON:
Yes, exactly.
DR. MICHAEL GREENBERG:
The patients are communicating back in for.
DR. JAY PARKINSON:
No, the patients also have a direct connection to you. So, it is a two-way communications. Its like, you can imagine the social networking features of Facebook and communication in Facebook, IM, but in addition, we have also video interviews.
DR. MICHAEL GREENBERG:
You are talking and seeing your patients online, and do you ever seen them initially in the flash.
DR. JAY PARKINSON:
We always see people initially in the flash and that's when everyone we have that regular normal relationship, we just augment that relationship, both in person and online communication.
DR. MICHAEL GREENBERG:
Okay, can you say your practice, how the Health Cares for the on and under insured living in and around Brooklyn? Can you take us to the model little bit more what it's look a like to the patient? Membership cost? Cost for visit etc.?
DR. JAY PARKINSON:
Right now, patients simply signup online, just like signing up for a network, put in their medical information, they pay $35 a month to be a member, although we are going to be introducing some different price plans that are lower than that in the next few months and then they pay anywhere from $100 to $200 per office visit and about a $100 for an online visit.
DR. MICHAEL GREENBERG:
So, now they are paying $35 a month and that is just for the video communication and a visit at 150, right?
DR. JAY PARKINSON:
Right, exactly.
DR. MICHAEL GREENBERG:
Do they have to have an initial visit with you?
DR. JAY PARKINSON:
Yes, we require that just because I think it is best to have a personal relationship with your patient.
DR. MICHAEL GREENBERG:
Okay and how long is that visit?
DR. JAY PARKINSON:
Well, our standard visit right now is 45 minutes, so you pretty get, you know, time for your money.
DR. MICHAEL GREENBERG:
Why did you decide to do this?
DR. JAY PARKINSON:
You know, I am a big fan of _____ processes and just looking at the process of health care delivery, there is just so much _____. Then, I figured you know the Internet is coming along to cut all these middle _____ and we are all starting to communicate differently now a days and whenever you communicate differently, you really change society. So, I figured with all of my friends who didn't have insurance, they would always set me up on IM or e-mail asking medical questions and I figured Hey, I think there is a business around this. So, I just went out it on my own. I was free technology and then along came really a software company that has some years of experience in health care, called Myca, and we are now building this platform to enable doctors across all over America to practice this way.
DR. MICHAEL GREENBERG:
Are you looking to franchise this or just have doctors be able to do it on their own?
DR. JAY PARKINSON:
Well, it's not so much of franchise as it is doctors who want to do this on their own. For instance, you know may be hospital practices Hello Health. Of course, that's going to be much more exciting for them in terms of, you know, not having with insurance companies. But you know, whenever you think about there is 47 million people who are uninsured. They have to pay cash and oftentimes, you know they definitely are not poor, they just do not see the value in spending you know, $6000 to $7000 on health insurance every year.
DR. MICHAEL GREENBERG:
Okay, so for my $35 a month, how often can I IM you?
DR. JAY PARKINSON:
You could IM me as many times as you want. Now, keep in mind, the communication that we have setup as scheduled times like IM visits and video visits. Those are actual visits, you actually pay for that. The E-mail it is free.
DR. MICHAEL GREENBERG:
How long will it take you to get back to my e-mail if you are swamped with 1000 or 2000 patients?
DR. JAY PARKINSON:
Well, since the communication aspect of what we do is sort of integrated into the practice style, the goal is to keep your inbox zero, at all times in between patients. It is a mixture of in person online and online interactions, so you have an opportunity to really catchup.
DR. MICHAEL GREENBERG:
And I want to get this clear so. If I want a video conference with you, that is a visit and I pay for that, right.
DR. JAY PARKINSON:
Yes.
DR. MICHAEL GREENBERG:
How much is that? depends upon the time or is it always a 45-minute visit?
DR. JAY PARKINSON:
I mean in the video conference presumably you are dealing with much simpler problems, so just depending on how long it takes, and normally it is about 20 minutes or so.
DR. MICHAEL GREENBERG:
Okay. If you're just tuning in you're listening to Clinicians Roundtable on ReachMD Radio on XM160, The Channel for Medical Professionals. I am your host Dr. Michael Greenberg and joining me to discuss Technology in Instant Communication, New Visions for Primary Care Dr. Jay Parkinson, who is a Cofounder of Hello Health and Membership-Based Primary Care Practice in Brooklyn, New York.
So, I want get back to this video conference. One thing that I would be concerned about even video conferencing is, don't you miss some of the medical communication the actual physical being with a patient, definitely I think what some people might say about that of kind of visit.
DR. JAY PARKINSON:
Well. When you think about it video conferencing is strictly verbal communications, so about 50% of the time, I think at the end of the video conferences, as you said, and you know what I am using to come and see you and then we apply the money that she has been on the video conference to the quick visit to establish that in person's physical exam in the office, so we apply that money towards a physical exam.
DR. MICHAEL GREENBERG:
You have a actual physical _____ office?.
DR. JAY PARKINSON:
Yeah, definitely. The first runs here in _____ Brooklyn and about March 1st we are opening a second one in the West, and then soon after that we will be in _____ Philadelphia, but these are just the initial practices. These are a sort of Flagship Stores if you will to prove out that technology and just to show doctors and other health professionals had this really great with practice medicine. You cannot doctor technology in these where you are.
DR. MICHAEL GREENBERG:
Okay, so what about your patients now get it by a bus? and what happens to them then? Should they have insurance beside this?
DR. JAY PARKINSON:
Sure, once of the services that we offer, is to take a look at and how you use health care, look into your financial status and saying, you know, this is the best policy for you. Often times, younger people they just hide _____ Health Insurance. So that's we have recommend for the vast majorities people.
DR. MICHAEL GREENBERG:
Okay, what are the limitations of your system?
DR. JAY PARKINSON:
Well, to me, I think the major limitations are in the traditional system and since that, all you have is a 8-minute office visit and that chose 3000 years old and you really can't have that direct connection to that person besides, sometimes you' phoned after they leave. So, I think this is just enabling a much more intimate, much more efficient, much more effective way of practicing medicine, so you know, I mean the main limitation would be a your patients don't use the internet, but the few internet they make life foundation just release today actually that 31% of people over the age of 71 on the internet to 41% over 65, so the internets obviously catching on amongst everybody in the world.
DR. MICHAEL GREENBERG:
You have some critics out there, what are the critics saying about you and how do you answer them?
DR. JAY PARKINSON:
It's mostly because of ignorance that they don't understand, they've never been on Facebook, they never used the internet as a tool for efficient communication between groups. So lots of people think that it's not private or secured but they are not definitely mistaken because we have put many, many dollars towards security of making this completely private. Do you know privacy is more about control, but it is secrecy and I think people are understanding lot more and more now a days and they knew what your bank records online, you know almost everything of about you is published, the different here is that everything that is published about you. You're in control who sees it.
DR. MICHAEL GREENBERG:
While there are some people would say that this is just boutique medicine with the cellphone. How do you respond to that?
DR. JAY PARKINSON:
Well, boutique medicine often charges a significant more monthly or yearly fee than what Hello Health does, we are actually having a free membership in the next few months that will be rolling out. So it's not boutique medicine because boutique medicine often target just wealthy. We are targeting all comers.
DR. MICHAEL GREENBERG:
So, you are going to offer services. Who gets the free services? I would like to signup for that?
DR. JAY PARKINSON:
Well, it's not free services, it's free monthly membership.
DR. MICHAEL GREENBERG:
Free monthly membership, okay, and then what they're going to pay in that?
DR. JAY PARKINSON:
Now it would be much more expensive per episode but that's for people who are just in town and looking for accessible doctor or just people who don't need to go to the doctor except every very few times a year.
DR. MICHAEL GREENBERG:
Okay, so what's your feature vision for this? What are your plans to expand or where do you expect to see yourself in 5 years and then 10 years with this?
DR. JAY PARKINSON:
I look at this as an opportunity to expand just like an e-bay expanded, I mean e-bay is a community of people of buyers and sellers and as that's exactly we are creating as a community of buyers as the patients and sellers the health professionals. So I would like for out platform to be the go to space online to connect with people who take care of you and that is primarily to doctors, nutritionist, that's acupuncturist, that's any health professional or any legitimate, but you know sound health professional that you trust him, allow to have relationship with.
DR. MICHAEL GREENBERG:
When you say buyers and sellers, have you now stepped away from doctors and patients but it just seems one more step away from the human part of medicine into e-bay.
DR. JAY PARKINSON:
No, definitely not. Buyers are the patients, you know neighborhood and sellers are doctors, another health professionals in that neighborhood.
DR. MICHAEL GREENBERG:
When you use that terminology, I don't mean to play double _____ here but aren't you taking one more step toward the dehumanization of medicine and not the communicative human side andwhat are youlooking at here? I mean when a guy starts with a e-bay, if that's your vision, he retired, he is living in Paris with his 40 million dollars, is that what you want to do here or if you want to really practice medicine, I don't need to put you on that spot, but the language and hearing from you is that of commercialization, not one of carrying any communication.
DR. JAY PARKINSON:
Well, this is the beauty of the Facebook but is that connects people. It connects your best friends, it connects people you don't even know. The internet is now being used mainly for communication rather than strictly information. So, I look at the way people are communicating online as a real opportunity to enhance the relationship, so we just drilling tools for doctors to enhance the relationship with their patients, but on the back end there is a world, we're providing an easy way to get paid for your services. I mean medicine is a business, so that's exactly what we're enabling this, a doctor another health professional. To make living of communicating on the internet and seeing that patients in person.
DR. MICHAEL GREENBERG:
So, do you see us moving to this model or part of our practice is moving or using as a tool or model, what do you see 10 years down the road?
DR. JAY PARKINSON:
Well, I duly it would be our entire practice that would communicate this way just because it is so efficient. I mean when you look at the health care delivery process of Hello Health, you know it is a third of the steps of the traditional health care delivery system. If we can get as many doctors and other professionals online so that people have an entire team of health professionals taking care of them, I think we have something _____ for ourselves.
DR. MICHAEL GREENBERG:
Say so, what about for us all views as you think that the facebook because totally born and you hate communicating that way? and really like to see people face-to-face and hold their hand and touch them and hug them, are we going to be out of the loop?
DR. JAY PARKINSON:
No, not at all because you can communicate as much as you want online.
DR. MICHAEL GREENBERG:
Where do people find if they want to communicate with you?
DR. JAY PARKINSON:
They will see my profile on hellohealth.com
DR. MICHAEL GREENBERG:
I would thank my guest from Hello Health Primary Care Practice, Dr. Jay Parkinson who had been speaking about a new technologically oriented model for primary care.
I'm Dr. Michael Greenberg. You have been listening to Clinicians Roundtable on ReachMD, The Channel for Medical Professionals. You should visit our website the reachmd.com featuring on demand podcasts of our entire library including on this show and we truly thank you for listening.
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Overview
A relatively new primary care practice based in Brooklyn, New York, is using new ways to serve the un- and under-insured communities in its own neighborhood. The practice, Hello Health, is based on membership and pay-per-visit office fees from patients instead of insurance, and encourages patients to communicate with their physician via instant message, email and video chat. But critics of this model say internet communication is often misinterpreted and cannot be relied upon to build a solid physician-patient relationship. Dr. Jay Parkinson, co-founder of Hello Health, describes his new model for healthcare and his plans for expanding the internet-based primary care practice model. Is this model really the way of the future? Dr. Michael Greenberg hosts. You can visit Hello Health here.
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