When children in rural Georgia need a doctor, there’s a chance they’ll go to the nurse’s office at school, sit near a cart with videoconferencing equipment, and speak to a pediatrician hundreds of miles away.
With few physicians available to see the state’s 1.9 million rural residents in person, telemedicine connects patients with specialists, says Paula Guy, chief executive officer of the Georgia Partnership for TeleHealth, a nonprofit based in Waycross. “The doctor can see in the ear, diagnose an ear infection, call the pharmacy locally, and then the pharmacy delivers the medicine,” says Jeffrey Kesler, TeleHealth’s chief operations officer. “Within basically 30 minutes the child is seen, assessed, diagnosed, and treated, without the child and parents having to take half a day to drive to see the pediatrician.”
The program began in 2005, after John Oxendine, then Georgia’s insurance commissioner, secured an $11.5 million grant from insurer WellPoint to set up the telemedicine system in 40 hospitals and clinics. That agreement ended three years later, but the nonprofit partnership formed to sustain it now has more than 185 doctors providing consultations in 40 different specialties.
Since starting out in primary-care offices and hospitals, the program has spread to schools, nursing homes, and prisons, and may be in churches by the end of the year. Patients interacted with doctors remotely about 40,000 times last year, a number that’s expected to double this year and quadruple in 2013, according to Guy.
Nationally, about 10 million people use telemedicine, though many of them don’t know it, says Jonathan Linkous, CEO of the American Telemedicine Association. “You’re in the hospital, get an MRI done, and your doctor comes around and says ‘the radiologist looked at this, and this is what he thinks,’” Linkous says. “Of course, you don’t know the radiologist happens to be at home, or in a different state, or maybe Singapore.”
Increased broadband availability and lower costs for the technology are helping telemedicine spread, says Thomas Nesbitt, University of California Davis’s associate vice chancellor for strategic technologies and alliances. “Our first [videoconferencing] unit was $100,000” in 1996, Nesbitt says. “Now you can get the same quality for $5,000 to $7,000.”
Insurers have dropped their resistance to reimbursing doctors for interacting with patients through telemedicine, which has boosted use, Nesbitt says. “There are many rural counties in Georgia where the hospital is not staffed with specialty providers,” says TeleHealth’s Kesler. “So telemedicine was a way to bridge that gap.”
One time-critical use is for evaluating stroke patients. A neurologist must determine if someone suffering from a stroke needs medicine within the first four hours of the event to prevent long-term disability. Without telemedicine, many rural patients wouldn’t be able to have the evaluation. “It’s life-changing—you’re looking at a person who could live the rest of their life in a nursing home, or skilled nursing facility, vs. somebody who will live a functional life,” Kesler says.