Telehealth Saves Lives, Reduces Costs: A Physician’s Perspective

February 9th, 2012
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Wireless technology is evolving in positive ways. It’s now more affordable, more accessible (thanks to broadband capacity), and more portable (via devices such as tablets and smartphones). And it is no exaggeration to say that this technology has made a life-saving difference for many patients who otherwise would not get care.
At the Center for Telehealth and Cybermedicine Research at the University of New Mexico, we studied the ability of telehealth tools (e.g., video connections, conference calling, electronic record sharing) to improve access and outcomes of rural New Mexicans suffering from a variety of health problems. In that role, we have been the incubator for several applications of telehealth designed to integrate the technologies that address important healthcare needs and gaps in access. One example was hepatitis C. While this disease is curable, multiple treatments are required and patients must be monitored for adverse effects. Project ECHO (Extension for Community Healthcare Outcomes) was initially incubated in our Center under the leadership of Dr. Sanjeev Arora. That project was recently published in the New England Journal of Medicine demonstrating how the program provided community healthcare providers with the expertise and tools they needed to treat hundreds, if not thousands, of people who previously were receiving no care for hepatitis C. In addition, outcomes of these remote patients were as good as outcomes of patients who traveled (often hundreds of miles) to the University’s medical center in Albuquerque.

This model was successful enough that it is now being expanded into other treatment areas, such as cardiology, rheumatology, and even adolescent psychiatry. For example, adolescents on Indian reservations, who have very high rates of suicide, are benefitting from counseling. Once the patient and practitioner are familiar with the technology, online counseling sessions are very similar to face-to-face encounters.
In addition to improving patient outcomes and access to care, telehealth can reduce costs in the clinic. At the University of New Mexico, our head of neurosurgery worked with The Center to set up a system where surgeons could view patient CT scans through a secure web portal. Because of this system, 44 percent of risky patient transfers were avoided, simply by looking at the scans remotely before surgery.
In rural New Mexico, the access improvements of telehealth appear obvious (though telehealth doesn’t work in every situation, an issue I’ll discuss in a future post). But the technology can also work in urban areas, bypassing transportation and traffic congestion problems by bringing virtual care to the patient. This is health care where it’s needed, when it’s needed.
One effect of health care reform that isn’t making headlines is that increased demand for services will be placed on a limited resource: existing health care providers. But telehealth systems will help meet this new demand by providing services to nearly everyone. For example, Dr. Arora, one of the few liver specialists in New Mexico, stated as we helped start his project that he couldn’t personally treat the 30,000 New Mexicans with hepatitis C at that time. But with the help of specialists—such as Dr. Arora and his team—at the touch of a button or the click of a mouse, community practitioners can readily access experts.
What do you see as the limitations of telehealth? Is rural New Mexico a truly unique niche for this technology? In my next post, we’ll discuss the importance of setting up an operating plan, and more cost-cutting benefits of telehealth. In the mean time, if you have any questions about my telehealth study or work, please post them here.

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Popper and Company takes a comprehensive approach to helping our clients leverage information to improve the efficiency of healthcare delivery. We’re a team of diverse professionals – physician entrepreneurs across multiple disciplines, engineers, scientists, and clinicians – each with a unique perspective and problem-solving capabilities.

4 Responses to “Telehealth Saves Lives, Reduces Costs: A Physician’s Perspective”

  1. evan says:

    Telemedicine is GREAT for those in rural areas. Gives more access to specialty doctors they otherwise would not have simply by finding a doctor online.

    I think the main limitation of telehealth and telemedicine is reimbursement. And I hope it will be adopted soon enough into employer benefits and even with health insurance companies.

    • Dale C. Alverson, M.D. (guest blogger) Dale C. Alverson, M.D. (guest blogger) says:

      Thank you for your comment. Reimbursement is certainly an important consideration with regard to most health care options. Payment options are likely to shift from a “fee for service model” to a “pay for performance model” base upon preventive care and keeping your patients as healthy as possible, avoiding costly complications, use of emergency services and hospitalizations whenever possible and appropriate. The return on investment should come through improved access to appropriate care, improved health outcomes and lower overall costs. This will constitute the ROI for adopting HIT and Telehealth and should be the basis for making the business case. In the meantime, we need to demonstrate the value to the payers, including CMS, that care can be improved and costs reduced when using these technologies effectively. With that data, the payers should be willing to reimburse for telemedicine services as they would for physical face-to-face encounters and healthcare provider organizations should be interested in bundling HIT/Telemedicine into their overall operations.

  2. Wanda Kjar-Hunt says:

    Thanks Dale this is nice information to have. Evan posted that reimbursement is still an issue. In Nebraska most consults are being reimbursed by insurance companies, Medicare & Medicaid.

  3. Chiquinho says:

    An applicant runs the risk of being deined coverage due to current medical status or a pre-existing condition. A person would not be excluded from a government- or employer-sponsored plans for those reasons.