Devices slice time, distance for patients via telemedicine

08/16/2014 2:58 PM

08/16/2014 2:58 PM

Concerned about a growth on his face, Mt. Lebanon, Pa., resident Robert Johnston could have made an appointment with the dermatologist already treating him for other reasons.

Instead, he snapped photos of himself and the affected area, uploaded them to the doctor’s website and waited.

“I got feedback from him the same day. It was probably within three, four hours,” said Johnston, 52, who required follow-up care at the doctor’s office.

Such is the promise of telemedicine, the use of technology to connect patients and health care providers who may be miles or even half a world apart. The growing trend is touted as a way to increase access to medical care, especially among patients in remote areas, and to bring efficiency to an overburdened health care system.

It is, said Robert McCaughan, vice president for pre-hospital care services at Allegheny Health Network, one more way to improve care. It already is being used in dozens of specialties and, at least in the Pittsburgh area, on the front lines of emergency medicine.

McCaughan this year helped to establish what the network is billing as the state’s first pre-hospital telemedicine initiative.

When paramedics answered a June 30 diabetic emergency call in Leechburg, Pa., they brought a doctor with them. So to speak.

After assessing 59-year-old Barbara Verdu’s condition, paramedics used an iPad to set up an on-the-spot video consultation with an emergency department physician at Allegheny Valley Hospital, in Natrona Heights, Pa. In the end, patient and caregivers agreed that Verdu had no need for a hospital visit, a decision that saved her time and money, put the paramedics back in service for other calls and helped to prevent overcrowding in the hospital emergency department.

It was an interesting experience, said Verdu, who had called 911 after waking up with low blood sugar. “I was just so nervous because it wasn’t going up,” she said.

The number of telemedicine services is increasing around the country, and research supporting the initiatives is growing, too. In July, for example, the journal General Hospital Psychiatry published a University of Pittsburgh School of Medicine study showing that telephone follow-up helped patients manage symptoms of depression – and reduce medical costs – following coronary artery bypass graft surgery.

The telemedicine market includes not only services provided by health care organizations such as Allegheny Health Network and UPMC but those offered by out-of-state, investor-backed networks, such as 12-year-old Texas-based Teladoc and six-year-old Florida-based MDLIVE.

While the concept may sound new to patients, telemedicine originated with doctor-to-doctor telephone consultations and has been evolving for at least 25 years, said Natasa Sokolovich, executive director of telemedicine for UPMC.

“It’s been around for longer than I think most people realize,” Sokolovich said. A shortage of psychiatrists helped give telemedicine a boost in the early 2000s, she said.

Technological advances – some that have improved diagnostics and others that have ensured the confidentiality of patient communication – also have fueled the surge.

But insurance hasn’t yet caught up with the technology. In some cases, patients have to pay out of pocket for telemedicine, though the fees may be no more than the co-pay for an office visit.

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