BEAVER CREEK, Colo.—Telehealth offers a way to expand outreach and simultaneously improve population health. And for a cardiology enterprise, it might not be as expensive you think, according to the director of telehealth and telecardiology at the Minneapolis Heart Institute.
Outreach always has been a hallmark of the institute, said Marc Newell, MD, a cardiologist and point person for a 41-site telehealth program that launched in May. The telehealth initiative complements the institute’s mission of providing quality care, creating a positive experience for patients and reducing costs. Beyond that, it eases the burden of long commutes for doctors to satellite sites and for patients to the hospital. It also builds relationships with partners who can provide referrals.
“It is a way to supplement and enhance your outreach services,” Newell said, speaking June 19 at the Cardiovascular Service Line Symposium in Beaver Creek, Colo.
The telehealth program hinges on key technologies, particularly the use of EMRs to facilitate communication between healthcare sites and a portable cart and ultrasound device. The ultrasound can be used to examine the lungs, heart and abdominal aorta during a physical conducted at the patient’s local primary care clinic. Images are wirelessly uploaded and linked for review by a specialist at Allina Health hospital system. The cardiologist can access images and consultation reports and then remotely confer with the patient.
“You literally can be in two places at once,” he said.
But the technology is the means, not the end, Newell cautioned. “It is not about the technology,” he said. Instead, it gives the patient and other caregivers increased access to cardiovascular specialists. “The technology is there but it has to be about the relationship.”
A telehealth program needs some upfront resources but equipment cost is reasonable. The telehealth carts and ultrasound used by Minneapolis Heart cost between $10,000 and $15,000, for instance. They also are working on developing a handheld device.
As part of their research developing the program, the Minneapolis team sought advice from colleagues in South Dakota who were telehealth veterans, with a decade or more of experience doing remote cardiology, emergency medicine and pharmacy services. The South Dakota group shared compelling results: a 20 percent increase in visits at sites, a reduction of 5,000 hours annually of physician travel time, a 25 percent reduction in the transfer rate to emergency services, decreased time to treatment and improvement in core quality metrics.
States determine credentialing criteria and billing rules vary state by state. In Minnesota, the remote sites retain the rooming fee and billing for laboratory workups while telehealth cardiologists bill a traditional consult coding with a special modifier.
Chris Bent, senior vice president of the clinical services lines at Allina Health, added that telehealth allows the heathcare system to expand its brand and market share. The program is designed to stretch beyond cardiology to other services as well. “We hope it is a one-stop shop,” she said. “We have the capacity. It is an opportunity from a growth perspective to serve underserved areas.”