Ideas In Action: Innovations in Healthcare

Limited health care resources combined with an increased demand for quality care in Florida has led to essential innovations in our current health care delivery system. Telemedicine is one such innovation that Tallahassee Memorial HealthCare has implemented to expand access to care and extend the reach and impact of health care providers.

The Tallahassee Memorial Telemedicine Program uses secure videoconferencing to allow physicians, nurses, and other healthcare professionals to connect with patients remotely, rather than face-to-face. These visual connections combined with the use of peripherals such as high definition cameras and Bluetooth stethoscopes, allow for providers to effectively examine patients from a remote location. The Tallahassee Memorial Telemedicine Network currently consists of over 100 providers from across the region and includes primary care providers, specialists, and rural health partners. With the push of a button these contacts can have instant visual connection to facilitate effective, efficient service delivery.

The use of Telemedicine does not comprise quality of care provided, or change the way patients are cared for. What it does is change the communication method. The remote connections are particularly important for rural communities in the Big Bend Region and to patients with limited resources who cannot get to the care that they need. Telemedicine alleviates many of the transportation and geographic challenges by allowing patients to receive the care they need close to home.  

Tallahassee Memorial is in its third year of implementation of the Telemedicine program and has already experienced significant benefits to all stakeholders including patients and their families, health care providers, and insurance carriers. 

PATIENT BENEFITS

For patients, the most critical benefit is the ability to receive the right care at the right time. The use of Telemedicine technology removes geographic, transportation, and resource barriers. Patients can access care closer to home, in partnership with their primary care physician, with less time missed from work, school, or other commitments. Telemedicine allows patients to receive preventative care, rather than waiting for a health episode that may result in hospitalization. Thanks to a small grant from the Department of Health, TMH is currently providing Telepsychiatry services to Doctors Memorial in Perry and Weems East Clinic in Apalachicola through telemedicine.  Patients can receive needed emergency or outpatient psychiatric services through telemedicine without traveling to Tallahassee. 

HEALTH CARE PROVIDER BENEFITS

The use of Telemedicine allows providers to be efficient and effective with their time, while also expanding their reach to a much broader patient population. The ability to coordinate care more closely with primary care providers, allows for specialists to increase patient outcomes and quality of care. TMH residency program faculty are using telemedicine to facilitate instant patient consults rather than waiting on a consulting physician to have to physically be where the patient is. 

INSURANCE CARRIERS

If fully implemented with the opportunity for reimbursement, private insurance companies, as well as Medicaid and Medicare would benefit from the cost efficiencies and timeliness of care provided through Telemedicine. Treating patients earlier reduces costs by eliminating emergency room visits and hospitalizations. The ability to connect providers with patients remotely also decreases costs associated with patient transfers. Telemedicine allows increased preventative care which reduces health costs associated with health episodes requiring a higher level of care and treatment. The challenge in Florida right now is there is no mandated reimbursement, so entities like TMH are reliant on grants for telemedicine funding. Through Low Income Pool Grant funding, TMH is operates a pilot program which includes telemonitoring of high risk patients at home by medical personnel through equipment that reports vitals such as weight, blood pressure, blood sugars, etc. so that interventions can be provided in a timely manner and so that patients are supported in proactively managing their own health. This monitoring reduces readmissions to the hospital and visits to the Emergency Department which saves time and money and improves outcomes for patients. A group of 25 high-risk TMH patients were monitored for 60 days and their hospital use decreased by 83%.

FUTURE OF TELEMEDICINE

There are pilot projects across Florida that are using Telemedicine in a limited capacity, but there is not yet a fully integrated component of the State’s healthcare system primarily because there is no comprehensive Telemedicine legislation that defines Telemedicine or related requirements such as state licensure for providers, liability, and reimbursement.  Telemedicine legislation was introduced during the past three legislative sessions, but it did not pass. The promise of improved patient care and reduced cost are too important to wait another session.