How a Pacific Northwest hospital extends its reach into remote areas

From the mHealthNews archive
By Eric Wicklund

With patients in such distant locales as Alaska and Montana and the likes of Swedish Medical Center and Providence Health in the neighborhood, Seattle's UW Medicine sometimes has to scramble to stay at the top of its game.

The four-hospital University of Washington-based health system has had a telehealth program for more than 40 years, serving patients in Washington, Wyoming, Alaska, Montana and Idaho with services that include telepsychiatry, teledermatology, telestroke, teleradiology and education programs. The natural extension of that program would be in primary care, but officials were looking at a project of roughly two years and $2 million to make that happen.

John Scott, medical director of UW's telehealth program, pointed to former CMS chief Don Berwick's oft-referenced comment that 70 percent of all outpatient visits will be handled virtually within five years. And that comment was made a few years ago.

"There's going to be a huge demand" for easier access to outpatient services, he told mHealth News. "We have to keep up with the demand and try to find ways of meeting it. With (a telehealth platform), it allows us to be more efficient with our clinical services."

[See also: Virtual clinics step toward Telehealth 2.0]

The UW chose Carena's hosted model, which offers 24/7 "Virtual Clinic" coverage for the health system, with phone or video visits lasting roughly 20 minutes and costing $40. The service is designed not only to pull people out of the hospitals and clinics who would best be served by an online consult, but also to give consumers an easier option for quick one-and-done healthcare needs, like treatment for colds, the flu, rashes and infections.

With a $300 million increase in funding for care services outside traditional clinic and hospital settings in 2014  a 315 percent increase over the previous year – there's ample proof that telemedicine is taking hold. 

The Seattle-based Carena, in fact, has seen its business surge this year. It has already signed partnerships with four large health systems in 2015 – in addition to UW Medicine, INTEGRIS Health in Oklahoma City, Froedtert & The Medical College of Wisconsin in Milwaukee and the Hospital Sisters Health System in Springfield, Ill., adding 6.3 million consumers to the company's partner base, for a total of 13 million people served by Carena clinics.

Carena CEO Ralph Derrickson said in a prepared statement that the new “partnerships demonstrate how our Virtual Clinic technology can create consumer-friendly options for receiving medical care that lowers costs and increases access to high quality care.”

Scott said that having Carena set up and staff the service enables UW physicians to gradually adapt to the use of telemedicine for primary care, a critical component as the health system moves toward an accountable care platform in coming years. "It's a learning process for all of us," he said.

UW's Virtual Clinic is seeing a 95 percent satisfaction rate, he said, with roughly three-quarters of all cases handled online and the remaining quarter referred to a primary care physician or urgent care clinic for in-person care. That referral process is sometimes lost on patients who think – or worry – that they can't get appropriate care over a telephone or online feed.

"A good portion of the public doesn't know you can do this," Scott said. "And Carena really puts up the guardrails as to what they can and cannot manage."

What they can offer, above all else, is access to healthcare services for patients in remote areas, which is a natural fit with UW's patient base. When you're dealing with a five-state region of the Pacific Northwest, it's not always easy to find a doctor's office nearby.

"This really is the only way that some of these people are going to get real, quality healthcare," Scott said.

Related Video:

See also: 

Do doctors have the right 'bedside manner' for telehealth?

Interstate telehealth licensing compact set to become reality