Phoenix Capital Management (PCM), a Scottsdale, Arizona based venture capital firm, acquired KwikMed™ in October 2001. KwikMed™ had previously been operated as a “rogue” website, based in Utah, selling Viagra® to patients without a valid physician prescription. PCM acquired KwikMed™ as part of a broad vision to create a means of delivering healthcare safely and economically via the web for the diagnosis and treatment of conditions not requiring a traditional face-to-face office visit with a physician. Immediately upon acquiring the company, PCM engaged the world’s leading experts on the delivery of online medicine and began a dialogue with the Utah Department of Professional Licensing (DOPL). PCM enlisted their help and ultimately developed a model for the safe and effective delivery of online healthcare.
In December 2002, after 14 months of working with DOPL, this revolutionary method for the delivery of online care was approved by an independent panel of six physicians and three pharmacists. The KwikMed™ “intelligent” expert-system software takes patient data collected and overlays standardized medical screening tools, including assessments of the mental health of the patient, the likelihood of the patient to have problems with alcohol, the patient’s level of anxiety, the patient’s level of depression and more. An electronic medical record is then created for the treating physician to review and determine what, if any, additional information may be needed to make a diagnosis.
Medical students are taught that a medical history is the single most important factor a physician uses to diagnose disease. A medical history represents more than 95% of a typical diagnosis yet in face-to-face settings physicians generally collect less than 50% of the recommended data.
In 2002, Utah approved KwikMed™ to sell the following five medications: Viagra®, Cialis®, Levitra®, Propecia® (hair loss treatment) and Chantix® (smoking cessation). Recently, KwikMed™ began to sell Staxyn® and ella® (emergency contraception) with Utah’s approval. All of these medications are for disorders where a face-to-face meeting with a physician is not required to make a diagnosis. These are information based disorders. Over the past 8 years, KwikMed™ has treated hundreds of thousands of patients and has not had a significant complaint filed against the company.
In 2007 and 2008, the University of Utah conducted independent research comparing KwikMed’s™ model for health delivery with traditional medicine, where a patient meets with a physician in a face-to-face setting, and concluded that KwikMed™ is safer than traditional medicine. (Mark A. Munger, PharmD, et al., “Safety of Prescribing PDE-5 Inhibitors via e-Medicine vs Traditional Medicine,” Mayo Clinic. Proc. 83(8):890-96 (August 2008).) The primary reasons for this are: 1) people are more honest when providing information to a computer than in personal settings, 2) the computer system is programmed to ask (and receive answers for) internationally recognized standard questions about a particular disorder. 3) the electronic medical record presented to the online physician provides KwikMed™ physicians with a detailed medical history of the patient and allows the online physician to focus on obtaining answers to specific questions. KwikMed™ systems allow physicians to focus on key issues for patients.
Today, more than 10 years after acquiring the company, the full extent of KwikMed’s™ vision is being recognized and is changing the face of healthcare delivery. In fact, many different business models are being developed which offer healthcare services on the Internet. Several of these companies are using webcams to provide care and others are simply providing for a complex and sophisticated physician/patient interaction on the Internet.
In early 2010, after studying online prescribing for eight years, the Utah legislature passed the first statute in the U.S. designed to regulate the online delivery of healthcare by licensing and regulating three separate enterprises: the Internet providing physician, the Internet providing pharmacy, and the Internet website which previously had not been regulated and is typically subject to state jurisdiction. The Utah statute eliminates the possibility of “rogue” websites and also allows for only approved drugs to be sold online. The Utah law now serves as a model for the safe delivery of care online.
3 Common Myths About Online Healthcare
1. “Patients lie to computers” – Dr. John Bachman, Mayo Clinic, is a leading authority on the use of computers in the practice of medicine. Dr. Bachman has published widely accepted research which has concluded that patients are significantly more honest in answering questions generated by a computer when compared to answering questions asked by a physician in a face-to-face setting. Patient’s answers are more truthful because they are not embarrassed and because they have more time to think about the answers. (The Patient-Computer Interview: A Neglected Tool That Can Aid the Clinician, John Bachman, MD, Mayo Clinic Proceedings 2003; 78:67-78.)
2. “Kids can get drugs” – KwikMed™ medicines are only shipped to adults. All shippers are required to obtain an adult signature for delivery to be made. Even the largest pharmacy benefit managers, like Medco and Express Scripts do not require adult signatures when shipping large supplies of medicines to homes. In addition there are a number of additional safeguards to ensure only adults receive KwikMed™ prescription drugs.
3. “The physician needs to see me” – It has been estimated that 20-50% of all physician office visits are unnecessary. If we could eliminate a small portion of these unnecessary office visits, our health care system could save billions of dollars. KwikMed™ only treats specific diseases which have been proven to be safely treatable using an online interaction with a physician e.g. erectile dysfunction, hair loss and smoking cessation. In 2008, the Mayo Clinic along with the University of Utah published empirical research comparing KwikMed™ patient data and electronic medical records to medical data collected in face-to-face physician/patient settings and determined that KwikMed™’s methodology is safer than traditional medicine when treating diseases where no face-to-face office visit is required. Today, there are many different types of business models offering healthcare over the Internet.