In 2003, Kaiser Permanente developed a vision called Blue Sky—by 2015, home would be the hub of care, said Naomi Fried, PhD, director of innovation and advanced technology for Kaiser. That paves the way for telemedicine. Kaiser currently has more than 12 telemedicine programs and is working on scaling them up. “There is an opportunity to implement telemedicine programs throughout the organization,” she said.
Pharmacists are highly trained but underutilized, said Marie Smith, PharmD, department head and clinical professor, department of pharmacy practice, School of Pharmacy, University of Connecticut. With telemedicine, they can provide services such as remote telemonitoring and reinforcing care plans, she said. In recent years, CPT codes have become available for pharmacists to provide cognitive services, such as medication management which has become an important component in chronic care.
There is a shortage of real evidence in how telemedicine is affecting healthcare, said Mitch Mitchell, vice president of RelayHealth, McKesson Consumer Solutions Group. But, “there are some exciting projects underway to measure both patient and physician satisfaction with the level of care being delivered.”
Giving patients the ability to connect to their health information, he said, in one study, showed a savings of $1.30 per member per month. Another review showed a provider productivity boost of 10 percent, which translates into the capability to see one or two more patients a day. And once adopted, electronic systems “can begin to create opportunities to maximize performance,” Mitchell said.
Kaiser has established a teledermatology program where patients go to a central site and have their history and pictures taken. The next day, they get an evaluation. Before, patients were waiting two or three months for a dermatology appointment, so the program is saving them time. Another program for chronic heart failure (CHF) patient management uses home monitoring devices for newly diagnosed patients. Working with a nurse and email has reduced ED visits in this patient group by 40 percent. eCare for Moods is for patients with depression or bipolar disorder. Web surveys and other tools helps clinicians anticipate when patients are trending to an area of concern.