Telemedicine Case Study

At the 2016 SAWCA Annual Conference, Tearsanne Carlisle Davis from the University of Mississippi Medical Center, Center for Telehealth, discussed how they are using telehealth to enhance care for patients. 

She started by saying they do NOT provide telehealth for workers’ compensation because of the complexities associated with that. 

Telehealth lets doctors examine and treat patients remotely, in real time, using online streaming video technology and interactive tools. Telehealth is important in Mississipppi because 53 of the state’s 82 counties are more than a 40 minute drive from specialty care. Telehealth is useful as it :

• Is designed to provide specialty care that is convenient for patients. 
• Offers vital support to primary care physicians. 
• Helps decrease the cost of care and improves patient outcomes.
• Supports population health in underserved areas.
• Provides interactive distance education for providers to improve quality of care.

The University of Mississippi Medical Center is the only Level One Trauma center in the state, and they were being inundated by patients who were transported there because local physicians lacked the expertise to treat their serious injuries. Using telehealth, the Medical Center is now able to assist local physicians in providing appropriate care which decreases the necessity to transport partients to other facilities. If patients stil need to be transported, the telehealth communications allows local physicians to appropriately stabilize the patients for transportation. 

Telehealth Scope of Services:

• Telemedicine – Live audio visual interaction including scheduled and unscheduled visits. Specialties include primary care, employee and student care, prison care, and ancillary health and wellness.
• Remote patient monitoring – This includes chronic disease management and post a cure monitoring.
• Diagnostic test interpretation – Providing increased expertise to review cardiology, radiology, neurology and other diagnostic testing. 

Since program inception in 2013 they have helped over 800,000 patients. These patients have access to over 200 UMMC physicians. 

Future areas of focus include:

• Population health management – They are providing specialty care to diabetics to assist local physicians in properly managing the disease. Too often patients are only seeing the specialist every 90 days or less and they can suffer significant health consequences during that time if they are not properly managing the diabetes. 
• Patient engagement – Telehealth makes it easier to engage with patients regularly to ensure they are taking medications appropriately.

UMMC has also contracted with certain employers to provide Corporate Telehealth services to their workforce. This provides their employees with access to a healthcare provider when they need one. Employers are seeing significant savings using these telehealth services, and it is decreasing employee absences by addressing illnesses in a timely manner.  The telehealth providers are able to prescribe medications electronically so that the patient can receive them from a local pharmacy in a timely manner. Telehealth is also significantly decreasing the use of emergency rooms. Too often people go to the ER for non-emergency services because it better fits their schedule than trying to schedule a doctors appointment.

The UMMC telehealth services for employers is a flat rate per month for each employee which provides all employees with unlimited access to the telehealth services.  

One thing they do not do with telehealth is prescribe opioids or prescription pain medications. They require the patient to see a physician for those medications.

Telehealth can also be very useful in the mental health area by providing counseling services. This is very useful as there is a significant access to care issue for mental health services as many states have significantly cut funding in this area. 

It is important to note that the quality of care for telehealth is expected to be the same as for in-person care. If the technology cannot replicate the exam a provider would deem necessary during an in-person visit that condition is not appropriate for telehealth. Telehealth is best for routine illness care and follow up appointments. 

One interesting statistic is that they are seeing less antibiotics using telehealth than with traditional clinics. This is because when people come to a clinic and pay a copayment they expect to leave with medications. They will not accept being told to try non pharmacy treatment and coming back if it does not improve the condition.  Under a corporate telehealth contract the patient pays nothing for the visit so they are more accepting of trying alternative treatments and delaying prescription medications.