Growth In ‘Telemedicine’ Creates Opportunities, Challenges For Health Care System

When most people see a doctor, they’re usually in the same room. But that’s changing as more patients get medical treatment through video teleconferencing. Advances in computer technology is changing medicine, and states like Wisconsin are looking at policies to both accommodate and regulate this practice.

One of the first and perhaps most-recognizable examples of a doctor practicing high-tech medicine was Leonard “Bones” McCoy from the 1960s sci-fi TV series, “Star Trek.” The character, played by actor DeForest Kelley, was often seen using a hand-held device called a medical tricorder to monitor a patient’s vitals.

Of course that wasn’t real, nor was “beaming” the show’s characters from one distant location to another. But now, thanks to new technology, doctors can and do practice medicine when the patient is far away. Maybe not the next galaxy, but now miles away.

The practice is called telemedicine, and it helped Michael Harrigan when he was having a stroke.

“It was a miracle for me, I tell you,” Harrigan said, “I’m convinced that having had that experience (with the stroke) where I had it, it made all the difference for me.”

In 2009, Harrigan was driving on Interstate 94 near Johnson Creek in Jefferson County when he reached for water and couldn’t hold it. He said his face felt strange and he decided to call an ambulance. He was taken to Watertown Hospital, which recently had paired up with neurologists at the University of Wisconsin Hospital who are using high-speed broadband to quickly treat patients to limit brain damage.

In this video, UW neurologist Marcus Chacon tests the strength of an emergency room patient who is 42 miles away. They see and hear each other on a computer screen.

“Hold up that left leg for 5 seconds. One, two,” Chacon said, in the video.

Telemedicine is practiced across the state in different ways. The Marshfield Clinic uses this virtual care to do everything from monitoring high-risk pregnancies to checking infant hearing.

Telehealth director Nina Antoniotti said the practice is efficient in rural areas where, she jokes, there might be more “cows than people.”

“If we can make it easier for patients to get the care they need, the outcomes are improved and costs go down,” she said.

Antoniotti was part of recent forum in Madison on telemedicine organized by the Evidence-Based Health Policy Project. It explored several issues surrounding virtual medicine, like reimbursement.

“You can do ‘telehealth’ anywhere,” she said. “The question is: Do you want to get paid for it? And do our public policies support that? There’s absolutely no reason we can’t see patients in the home. The reason we don’t is we don’t have public policy that allows for reimbursement in the home. There’s really no reason we can’t see kids in school health offices rather than making them leave school and their parents leave work.”

Some insurers are offering “e-visits” for certain common conditions. Brian Collien, with Unity Health Insurance in southern Wisconsin, said

“It really began as a retail experience for a set of nine conditions (such as) cough, diarrhea, headache,” he said.

Collien said these conditions didn’t require the doctor to see a patient face to face. Instead, they communicate with the patient through a secure online medical chart.

Collien said satisfaction for e-visits has been high in the pilot program.

And perhaps, telemedicine’s biggest fan is stroke victim Harrigan.

“I won’t say I’m 100 percent, but I would say pretty much 99 (percent),” he said.