Virtual General Practitioners – the Future of Healthcare? By Paul Andrews, Mercer The international medical world lends itself well to technology and has always looked to incorporate virtual General Practitioners (GP) into service offerings. Video technology is increasingly being used for GP consultations and access to other medical professionals. Some International Private Medical Insurance (IPMI) insurers are at a test phase, whereas others already have an established service up and running. The leading providers in the US have been offering video consultations for several years; however, in Europe this is a more recent introduction. Last year in the UK, a company called Babylon amassed headlines by launching a pilot with the NHS in London providing a service called GP At Hand. This service provides a 24/7 online video consultation within two hours and drug prescriptions are sent to a pharmacy of choice. Commentators note that this could potentially revolutionize how healthcare is accessed and not just in the UK. Last month, BUPA UK launched a similar service to their corporate clients aiming to provide a quicker and potentially easier access route to treatment. So How Does This Work? Instead of waiting for a doctor’s appointment usually during the work day, a member can go online to find and book a convenient time. This can be almost immediately or outside of work hours. At the relevant time, you video chat, usually via a secure app, with a doctor, and the treatment journey begins. For an international insurer where members may not be registered with a doctor or clinic, trying to navigate an unknown health system in a different language is difficult; an online consultation seems an ideal solution. Who Is Active in the International Space? While only two international medical insurers, namely AXA and Generali, have a full service offering via Advance Medical, most are looking at implementation. Cigna and Allianz appear to be building towards an imminent launch, and Bupa has indicated that they have plans for later in 2018. Meanwhile, Aetna is looking to build their own network using their hubs and selected local partners. While still in the build phase globally, some locations are online for use with clients and include prescription services. The one area that has proved popular is the use for second opinion services and reassurance for members allowing them to speak to a qualified medical doctor for further advice and guidance. So Why the Relatively Slow Adoption? The complication of prescribing drugs locally is one major impediment to wider adoption. Speaking online to a qualified doctor is simple, but to prescribe drugs, that doctor needs to be registered and qualified in the location of the member. At present, most companies are using central resources or triage, then linking into local health systems or medical professionals for prescriptions. In the longer term, global medical networks of doctors may emerge though these are limited at present. AXA and Generali who appear to be leading the way are positive about the impact this is having for their clients and is worth the upfront investment. Initially this is in terms of service and early savings on GP consultation costs. The advantages of video consultations are numerous. To the individual member, they can schedule an appointment when it suits them and with a qualified doctor who speaks their language. This could result in a quicker treatment path as well as reassurance to them on the care they are receiving. In addition to this, an insurer can ensure that a member receives quality and appropriate service and medical treatment in line with their goals. Over time we would expect to see this to be an effective cost containment alternative to the high cost of GP consultations around the world. The result could lead to a reduction in claims, costs, and ultimately a client’s health insurance premium. Medical clinics and surgeries could be forced to review their costs to compete for business in locations where there are high numbers of international ‘expats.’ At present, the limited competition gives medical facilities the upper hand in setting costs to the detriment of both insurers and clients. Naturally, not everyone will be comfortable with online consultations or the technology that supports this. However, in the international mobility space, the workforce is often younger and tech savvy, so there is likely to be higher take up. Generali notes that this is certainly the case across their membership but with lower than anticipated take up among members older than 35. That said, the assignees of the future will expect this as a standard option in the same way that instant access is now available to a wide range of services online. If you have any queries, please do not hesitate to contact Paul Andrews.