The Doctor Will See You Now (Part I)
Keeping The Doctor Away
While videomedicine is first a means to treat rural patients, it is beginning to fill other gaps between patient and doctor.
Though most Americans are city dwellers, Puskin points out that doesn’t mean they’re particularly close to specialized medical care. When Junior is ill, mom can travel an hour or three to go to the medical center downtown, whether she’s driving a Jaguar from suburban Long Island or taking a municipal bus from the San Fernando Valley.
The distance is being closed in some ingenious ways. The University of Maryland is wiring ambulances so doctors can see and diagnose patients as they speed to the hospital. When a diver with the bends is treated at a hyperbaric chamber on Catalina Island, doctors at the University of Southern California watch to determine how serious the case is.
Consider the University of Texas Medical Branch in Galveston, which for seven years has been building a videomedicine program to treat 115,000 inmates at 92 prisons across the state. UTMB has diversified into treating workers on oil platforms and, most recently, vacationers on cruise ships, says Oscar Boultinghouse, the program’s medical director. And it moves ever closer to home: Last year, the American National Insurance Company started sending its employees to a videoconferencing room down the hall instead of to UTMB for regular doctors’ appointments. American National’s offices are six blocks from the medical center.
Progress Report
While few studies have systematically measured the effects of videomedicine on patient care, the impact appears to be profound. Hospitals that treat by video report that faraway patients are making more appointments and showing up for them — a simple change that often results in earlier treatment, and thus in healthier people, fewer hospital stays and less time away from work and family.
Medicine-by-remote can also improve the quality of care. The University of Virginia, for instance, made a surprising discovery about the prison inmates with HIV/AIDS whom it treats by video. At a congressional hearing about telemedicine last year, Dr. Karen Rheuban of the university noted, "Currently, inmates in our Virginia correctional facilities have access to higher quality specialty care than do many of our other tax paying citizens."
Surveys consistently show that both doctors and patients find teleconsultations just as satisfying as meeting face-to-face. Steve Craig’s diabetes appointment is no exception.
Fifteen minutes into his hour-long appointment, Craig is leaned back in his chair, talking easily with Prescott. He nods attentively as Prescott slaps her palm on the table to emphasize how important it is he keep fruit juices handy in his car.
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