How Cleveland Clinic’s virtual second opinions program saves thousands per patient

Clinicians don’t always get it right, and their mistakes can be costly: Studies show misdiagnoses lead to roughly 800,000 patient deaths or permanent disabilities each year in the US and cost the healthcare system an estimated $20 billion annually.

Cleveland Clinic is using telehealth to try to combat misdiagnoses via its virtual second opinions program, which has saved an average of $8,705 per patient by avoiding unnecessary treatments, according to an analysis released in March.

“Our objective is, ‘How do we make it as easy as possible for that individual going through a complex medical condition…to make the right decisions for their healthcare?’” according to Frank McGillin, CEO of The Clinic by Cleveland Clinic, a joint venture between the health system and telehealth provider Amwell.

How it works: Patients from anywhere in the world can sign up for the virtual second opinions program, which the health system started in January 2020, McGillin told Healthcare Brew.

The typical patient is one who recently received a “serious” or “complex” diagnosis, like cancer or heart failure, and who wants to make sure their diagnosis is accurate and their proposed treatment plan is the best option for them, he said.

The patient starts with a virtual intake with a Cleveland Clinic nurse where the nurse gathers as much information as possible about the patient’s condition. Cleveland Clinic then matches the patient with a specialist and schedules a second video visit where the patient can ask questions and talk more in-depth about their diagnosis and treatment plan. Following the second visit, patients receive a written report with the specialist’s second opinion and proposed treatment plan, according to McGillin.

A small percentage of patients who participate in the second opinion program are Cleveland Clinic patients, with most coming from other health systems, McGillin said.

“What we’re trying to do is not let geographic location get in the way of accessing world-class medical expertise,” he said.

The program is typically covered by patients’ insurance, but those without coverage can pay out of pocket, according to McGillin.

Study results: The cost savings from the second opinions program come from avoiding unnecessary, expensive treatments like surgery and chemotherapy.

Cleveland Clinic specialists recommended a change in diagnosis or treatment plan for 67% of patients seen in the virtual second opinions program, according to the analysis. For patients who had initial treatment plans recommending surgery, Cleveland Clinic specialists recommended an alternate treatment that avoided surgery 85% of the time. The specialists also recommended hospitalizing patients 62% less frequently, according to the analysis, which was conducted by third-party research firm Vital Statistics and evaluated 300 random patient cases from the past year.

“When you’re dealing with your own health, having all the right information in front of you and the best information really helps guide the patient to the right decision,” McGillin said. “Our mission is all about helping people access the world’s best medical expertise.”