About once every hour during the work week, someone in rural Georgia visits a specialist physician without going far from home, thanks to one of the largest integrated telemedicine programs in the country.
The program began 18 months ago with an $11.5 million grant from WellPoint, owner of Blue Cross Blue Shield of Georgia. Now in 39 rural counties, patients and their doctors can visit a local presentation center and meet remotely with one of 75 specialists in areas such as dermatology, cardiology and pediatric medicine.
The specialists practice at 11 urban sites, including the state’s major hospitals. They get paid for their services as if the visit were in person, according to a new Georgia law, state Insurance Commissioner John Oxendine said.
Oxendine got WellPoint to contribute about $126.5 million to improve rural health care in Georgia when the company was seeking his approval for its merger with Anthem, another large insurer.
Oxendine said rural Georgia lacks specialist physicians. Local primary care doctors can refer patients to specialists in the cities, but that may require the patient to drive an hour or more and lose time from work. “If you’re really sick, you have to have a relative or someone drive you” to the doctor, he said, and productivity losses quickly add up.
Patients tend to postpone making appointments with distant specialists, and their conditions can worsen. The telemedicine program aims to put a presentation center within 30 miles of every rural resident who lacks access to specialty health care. Primary care doctors get extra reimbursements for using the centers and working with the remote specialists, said Sunil Joshi, director of the program at WellPoint.
Patient satisfaction with the program is high, Joshi said. “WellPoint feels strongly that telemedicine is one solution” to the country’s health care problems, he said, and it has programs under way in other states.
In California, Joshi said, an analysis suggests there has been some reduction in the insurer’s per-patient cost of care as a result of telemedicine programs, but the figures are based on a small quantity of data, and further study is needed.
John Monahan, president of WellPoint’s State Sponsored Business unit, said the biggest obstacle to wider use of telemedicine is cultural. “This is the message that really needs to get out: that telemedicine is an acceptable way to practice medicine,” Monahan said.
The WellPoint contribution in Georgia is also being used to make loans to rural hospitals and clinics for modern equipment, and for a teleradiology network that is now being implemented. It will have 15 centers statewide that capture and send images to radiologists in Atlanta for analysis.
From the battlefield to the home front: Managing medical data
Government Health IT presents Col. Claude Hines Jr., program manager for the Defense Health Information Management System, in this recent InSight eSeminar. Col. Hines discusses the health information technology and tactical challenges faced by the military medical community in Iraq, Afghanistan and other areas of conflict. In doing so, he describes the current information technology solutions for transferring clinical data between battlefield care givers to health care personnel at military treatment facilities worldwide.
