Docs, states look to telehealth to deliver medical care

Can't get in to see a doctor? Or live hundreds of miles from a specialist? Try Skyping in to their office.

That may be the wave of the future. And it's gotten the attention of the Legislature, which is being asked to pass legislation to certify and impose standards on a growing practice.

More and more doctors and hospitals are using desktop video conferencing technology to help treat patients, particularly if those who live far away from a needed specialist.

Burdick, a dermatologist, treated eight children throughout South Florida Tuesday morning through multipoint video conferencing."The benefits of telemedicine? It allows clinical care to be delivered where and when it's needed," said Dr. Anne Burdick, associate dean for telehealth and clinical outreach at the University of Miami Miller School of Medicine.

The university has a pediatric mobile unit, essentially a high-tech bus, that travels around the region with a doctor on board to take basic patient information and history. Then, that doctor helps connect the child to a specialist – in this case, Burdick – who can help diagnose specific problems.

Tuesday, her cases included scabies and eczema.

The University of Miami founded the country's first telemedicine program in 1973, and as technology has improved, the program has grown and is being delivered in a variety of ways, including the mobile unit. It's only a small percentage of the medical center's work, but it's growing.

The program connects low-income children in Broward, Palm Beach, Martin and Miami-Dade counties who are covered by Medicaid to specialists at the university. It also provides dermatological care for the staff of the Royal Caribbean and Carnival Cruise lines. It helped monitor the general health of Brazilian athletes during the London Olympics, with the option to connect them to any specialist should a major injury occur. The doctors are now working on a program that will be available to all Olympic athletes at the 2016 Brazil games.

Further north in Orlando, Orlando Health is piloting a new "hospital at home" program to help reduce readmissions; it targets patients treated for blood clots, skin infections or pneumonia. Sent home with cloud-based video conferencing equipment and technology to monitor their vitals, the patients are checked every few hours by a nurse via teleconference. A nurse also makes a daily visit.

Representatives from Orlando Health could not be reached for comment.

Internet-connected medicine is not entirely new; many hospitals and clinics employ out-of-town radiologists to review x-rays and scans. And often, doctors consult colleagues in other states or sometimes countries on complicated cases. Now, improved technology is allowing direct interaction between physicians and patients.

But it's hard to gauge just how widely teleconferencing is used in Florida. Most insurers don't pay for a virtual doctor's visit, so the technology is most often used on a contract basis or for patients covered by Medicaid, the state-federal program that does pay for it. Medicare also sometimes approves payments for patients in rural areas.

"We have not tracked this information in the past, but there may be some efforts to do so in the future," said Shelisha Coleman, a spokeswoman for the Florida Agency for Health Care Administration, which regulates health care in the state.

Burdick thinks telemedicine will only grow and improve.

"It is trending upward," she said. "We are looking to increase to other specialties. I think patients are hearing the word 'telemedicine' and are understanding more what it's about, and I think there's going to be more of a demand to be cared for by specialists when there's such a dearth of specialists in non-urban areas."

But there are some issues that may require lawmaker intervention.

Currently, most states allow for teletreatment for certain Medicaid patients, but only 19 require private health plans to pay for it. Florida isn't one of them.

Now, Sen. Arthenia Joyner, D-Tampa, has filed legislation that would require private plans to pay for telemedicine and also directs the state to research how best to implement a telemedical system and regulate it. A similar bill filed last year went nowhere.

Joyner was out of state Tuesday and could not be reached for comment.

Doctors around the state and the medical lobby are watching closely. Not only do they want to make sure that licensed and trained physicians are the only ones using the technology, they also want to ensure that doctors can be paid.

"Telemedicine offers tremendous potential to not only increase patients' access to physician services, but also to make follow-up visits and consultations more convenient for patients," said Timothy Stapleton, executive vice president for the Florida Medical Association, which lobbies on behalf of the state's doctors.

"The FMA understands that telemedicine is a trend that is here to stay, and we look forward to working with lawmakers to make Florida a national leader in the use of innovative health care technology."

Article Source: Docs, states look to telehealth to deliver medical care