Telemedicine extending the reach of health care

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Lisa Miller, a home health nurse with Centura, uses high-tech equipment to reach patients via the Web.

Specialized audio and video equipment can reduce hospital and emergency room charges by 73 percent and Internet consultations can lower hospital costs and patient wait time.
Both are part of a fledgling aspect of health care: telemedicine.
Colorado is positioned to be the first state to reimburse for telehealth expenditures, leading the way to create more distance opportunities for residents in remote areas.
A bill being considered by the state legislature would allow Medicaid to reimburse for the equipment and staffing charges for telehealth programs. Many home health agencies use video and audio monitoring equipment for their homebound patients.
“Telemedicine is a great thing, but what’s holding it back is that there is no revenue source,” said Erin Denholm, CEO of Centura Health at Home and a proponent of telemedicine. “This bill will allow payors to come up with a model that allows for reimbursement. It’s an important step in this form of medicine becoming widely used.”
Hospitals are using technology to lower health care costs and to decrease response time. Bill Braithwhite, the executive director of eHealth Initiatives, said telemedicine is an idea whose time has come.
Braithwhite became interested in telemedicine 30 years ago, as a medical student. He felt that the demands on doctors could be alleviated through technology – and he’s spent his career trying to make it happen. Now, technology has made it possible to do more than he imagined.
“It just wasn’t practical,” he said. “Even sending photos was time-consuming. Now, with faster connections, you can move photos and x-rays quickly. A dermatologist can consult on a case via the Web.”
Braithwhite’s organization lobbies Congress for e-health initiatives and promotes the use of telemedicine.
“We’re right at the ground floor,” he said. “But the idea has been around for at least 20 years. In the old days, before e-mail, telemedicine was meant to get high resolution pictures such as x-rays from one place to another. A lot of people laughed at the idea; saying it was just another way to get expensive toys to play with.”
But those expensive toys can save time, money and lives.
Centura Health started a project two years ago in Colorado Springs that gives patients recovering from congestive heart failure a Web camera, specialized stethoscope and other high-tech equipment. The program has yielded amazing results, Denholm said.
“The program really helped lower costs and was a real benefit to the patient,” she said. “If a patient’s signs started heading in a downward spiral, we were able to change that, to get them back on the right track very quickly.”
Patients using telehealth equipment entered the hospital 90 percent fewer times than patients who did not use the monitoring equipment. Costs at the hospital were reduced by 95 percent and emergency room visits were eliminated.
The audio and video monitoring system was manufactured by American Telecare, and uses a Web cam to interact with patients. The equipment can transfer heart and lung sounds, weight, temperature, blood pressure and pulse readings to nurses by telephone.
“It’s just a great strategy for the rural areas,” Denholm said. “People will get excellent clinical support, and distance doesn’t matter, as long as they have a phone line. The telehealth liaison can immediately call a physician if they see something aberrant. It’s a very quick turnaround.”
Centura is not the only hospital experimenting with telemedicine.
At Memorial Hospital, the radiology department has been trading x-rays with an Australian hospital for about 18 months. The department also can read x-rays from towns throughout Colorado – easing staffing shortages on the western slope.
“We can read images from multiple locations, in real time, by using virtual private networks, over high speed lines,” said director of radiology Dr. Warren Goldstein. “The technology is there. We’re planning to get a new system in the fourth quarter of this year that will make it even better, even faster.”
Radiology is uniquely suited to telemedicine, Goldstein said, but that the programs could expand to other areas, such as fetal monitoring, EKG, cardiology.
“We’re definitely going to be seeing more of it,” he said. “As technology gets more sophisticated with digital imaging, we’ll be able to offer more services to other areas. It’s great for all of us.”