Second Opinions Via Telehealth Have Value to Patients and Providers

The Clinic by Cleveland Clinic is using telehealth to offer second opinions, a service that benefits not only the patient but the primary care provider as well.

Telehealth is making the second opinion much more meaningful.

While patients and healthcare providers have been using connected health for years to both research and support diagnoses and treatment plans, the platform has gained value over time as a way to not only make sure everything is proper, but to more fully explain complex medical care to patients and give providers the access to specialists they need to bolster care management. Nowadays that so-called second opinion is really just the next step in care coordination.

At The Clinic by Cleveland Clinic, the Cleveland Clinic has partnered with Amwell on a joint venture that’s designed to give patients advice on their diagnoses and help providers map out the right care plan via telehealth. The health system is one of several high-profile health systems around the world using telehealth to make their experts available to anyone anywhere.

“We’re removing any and all barriers for the patients,” says Peter Rasmussen, MD, Chief Medical officer at The Clinic. By engaging with a patient via virtual care, “the patient has the opportunity to talk directly to the expert.”

The Cleveland Clinic, which has been using telehealth for several years, recently expanded The Clinic's platform to include multidisciplinary case analysis, and important factor for patients with complex concerns – as well as for their primary care providers. The plaform is now able to pull in a team of experts to review a case and recommend treatments.

“We chose to enter into the multi-disciplinary opinion space by offering services for brain tumor and prostate cancers because there are multiple treatment options for these patients,” Rasmussen said in a May press release announcing the expanded program. “Given that these cancers can be treated with surgery, chemotherapeutics and/or several different types of radiation, one physician isn't able to deliver a holistic opinion. Only multiple physicians from multiple specialties can provide the best recommendation to yield the highest quality of care and thereby the best value care. Our goal is to give patients access to Cleveland Clinic’s vast medical expertise from a variety of different perspectives for the best patient outcomes.”

That type of backup is important. According to a study published by the National Institutes of Health and cited by the Cleveland Clinic, more than 40 percent of patients diagnosed with breast cancer and seeking a second opinion saw a change in diagnosis through a multidisciplinary panel review, and those panels spotted additional undiagnosed medical concerns in 23 percent of patients.

Rasmussen says a telehealth platform is a significant improvement on the old way of doing things, when patients had to travel to a health system or hospital to get a second opinion. Now, they can schedule a virtual visit with specialists or have a team review the case online and send a report via e-mail.

It’s also a growing service. With a telehealth platform, more patients are choosing to get a second opinion – and more providers are advertising their availability for reviews.

“Telehealth is a very viable solution for many conditions and concerns,” Rasmussen says, noting The Clinic has been aggressive in marketing its capabilities around the globe. “We’re hoping that this will scale and grow.”

And while the platform offers an important service for patients, it’s also a valuable asset for care providers.

While the idea of patient seeking a second opinion may have once seemed off-putting, it’s becoming part of the care management routine. Primary care providers and specialists, especially in light of the challenges cast by COVID-19, are overworked, even stressed. Telemedicine gives them an opportunity to not only consult with colleagues and specialists, but have their diagnoses and care plans reviewed by and fine-tuned by experts.

The benefits are compelling. Patient care management plans are reviewed by specialists, ensuring that those plans offer the best chance for positive clinical outcomes. This also assures payers, who want to make sure the care delivered is complete and free of wasted steps or expenses. And providers who can offer this option to their patients not only improve their standing with their patients, but could learn from those consults as well if the patient shares those recommendations.

“Physicians are used to patients seeking a second opinion,” says Rasmussen, who figures a third of all requests fielded by The Clinic result in a differing opinion.

And with telehealth, they could ensure they’re offering optimal care.

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