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LOS ANGELES -- James Kyle, M.D., chief medical officer of the hospital at the most populous Indian reservation in the country, came to the American Telemedicine Association (ATA) annual meeting and trade show here to learn new ways he can deliver telemedicine services.
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At the Tuba City Regional Health Care Corporation, Kyle oversees healthcare for some 70,000 Navajo Indians -- most of whom live far from traditional healthcare facilities -- scattered across a vast Arizona reservation the size of Vermont.
Videoconferencing makes telemedicine work
Kyle turns to secure videoconferencing -- a staple of telemedicine services -- so his patients can sometimes see psychiatrists, neurologists and other specialists in Phoenix or Flagstaff.
"I came here because I want to learn about other people's mistakes and success stories with telemedicine," Kyle said just before Monday's main keynote address by medical innovator Patrick Soon-Shiong, M.D.
Treat patients like astronauts
Soon-Shiong, the South African-born businessman, researcher, professor and founder and CEO of biomedicine firm NantHealth, urged the audience of about two thousand to think of patients as astronauts to be cared for from afar.
Using tools such as telemedicine, the Internet of Things, and molecular medicine, healthcare providers can now routinely monitor patients remotely and envision a more successful war on cancer, Soon-Shiong said.
ATA leaders optimistic
The annual conference, the ATA's 20th, drew more than 3,000 attendees and was accompanied by an optimistic buzz as half a dozen states recently approved legislation making government reimbursement for telemedicine on parity with face-to-face doctors' visits.
This brings the number of telemedicine-friendly states to 25, according to ATA leaders.
"The energy here is really high," Reed Tuckson, M.D., the ATA's president-elect, said. "Telehealth is now in the healthcare mainstream."
Telemedicine's urban campaign
Meanwhile, the frontiers of telemedicine, long focused on tending to patients in remote rural areas, are expanding to urban zones. The ATA has pinpointed some of its congressional lobbying on bringing parity for telemedicine services practiced in cities, and many vendors here are showing off products and services destined for urban healthcare settings.
David Ramirez, M.D., chief quality officer for CareMore, a Cerrito, Cal.-based insurer-provider network managing population health in mostly urban areas located in four states, described his pilot project with telemedicine analytics vendor Sentrian, which had a booth at the show.
Reed Tuckson, M.D., ATA president-elect
CareMore has recently started to use Sentrian's Remote Patient Intelligence system to isolate about 1,000 of the most intractable cases of chronic pulmonary obstructive disease from a larger pool numbering nearly 10,000. CareMore teams will then use remote sensors from another ATA show exhibitor, Ideal Life Inc., to personalize the care of those 1,000 patients while trying to keep them out of the hospital.
"Sentrian tells us which patients we should be watching," Ramirez said.
Another show vendor, Avizia Inc., a spinoff of IT communications giant Cisco Systems, had a big booth showcasing its turnkey hospital video carts, which are fitted with connected medical devices the company markets to big city hospitals and academic medical centers.
Avizia CEO Mike Baird said his company's products can help big healthcare systems use their physicians more efficiently; for example, by making specialists available to emergency room staff and patients remotely 24 hours a day.
Rural areas still need attention
But the present and future of telemedicine is still tied to providing healthcare to patients in rural areas; not only because of patients' needs, but also because of the growing shortage of primary care physicians willing to work there, many at the conference said.
One conference panel examined how the University of Mississippi Medical Center (UMMC) worked with a community health center, Intel-GE Care Innovations, and a local wireless company to use telemedicine to care for 200 chronic diabetes patients in the rural Mississippi Delta. With the nearest big hospital a 90-minute drive away in Jackson, patients would otherwise not have easy access to diabetes specialists.
Patients in the pilot project have tablets they bring with them to regular tele-checkups at the North Sunflower Medical Center. A care team at the medical center uses those same tablets to monitor and educate the patients daily.
After about a year, most of the patients have shown marked improvement and have stayed out of the hospital, said the project's director, Kristi Henderson, M.D., chief telehealth and innovation officer at UMMC.
"The rural Mississippi Delta is not Los Angeles or San Francisco," Henderson said from the podium. "It's a very challenging environment."
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