Web Visits for the Podiatrist?

This article in the New York Times highlights the potential uses of the world wide web for doctors to conduct home visits, or “web consults” in the patient’s own home.  While one can argue the risks of non face-to-face examinations, couldn’t the benefits outweigh the risks?  What about patients who have poor access to specialists because of geography?  How about the established patient that needs a quick follow up?  In our field, determining if a wound is infected and requires immediate treatment or can wait until next week could lessen the burden on doctors and patients alike.

The AMA revised the CPT code manual this year to include code 99444 which reflects an online visit (via email or other electronic method) to an established patient which can only be billed once in a 7 day period.  Some insurance companies like Aetna and Cigna are already covering such services.  I have used this code in a couple instances already.  One for a patient who is out of state, but receiving wound care under my direction after a face-to-face consultation.  The patient emails me photos of the wound and I can direct the home care nursing.
On a similar front, web-learning for physicians is advancing.  SALSA and earlier CLEAR with our group in Des Moines are using Apple iChat Theater software to bring distance learning to traditional medical conferences.  A lecturer can deliver a presentation live from across the globe via the web.  The lecture is viewed on the projection screens and the audience can interact with the lecturer.  (See the second article here)

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