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Bringing telemedicine to the workplace

04/01/2013

Telemedicine – using video, audio and the Internet to provide clinical health care services when the doctor and patient are separated by distance – is a proven use of technology. But Tufts Medical Center Physician-in-Chief Deeb Salem, MD found a new twist when he began to explore using telemedicine to bring cutting-edge clinical care from Tufts Medical Center to the patients’ workplace.

Telemedicine consults on the job save patients work time missed to receive preventive care and funds spent on travel. As a result, workers are happy, healthy and productive, and self-insured employers save substantial amounts of money on employee health care.

“This is yet another step forward in furthering our Distributed Academic Medical Center™ model,” said Salem. “The introduction of telemedicine to the workplace, particularly the rural workplace, will improve patient access to medical specialists, while reducing corporate health care costs. It will keep patients healthier, out of the hospital and on the job, which benefits both the employee and the employer.”

To turn his idea into a reality, Salem teamed up with Patient Advocates, a Maine-based company that manages health plans for self-insured businesses. Patient Advocates wanted to bring telemedicine diabetes consultations to its clients in rural parts of Maine, where it’s harder to find endocrinologists and diabetes specialists.

The first Tufts Medical Center telemedicine “house call”

After securing a license to practice medicine in Maine and reviewing the patients’ medical records in advance, Endocrinologist and Co-Director of the Diabetes Center Richard Siegel, MD held the first Tufts Medical Center telemedicine “house call” on October 11. Siegel spent 20 to 30 minutes each with seven diabetic employees of manufacturing company Hardwood Products & Puritan Medical Products Company in rural Guilford, Maine. The patients all wanted physician oversight for their diabetes, but none of them had easy access to diabetes specialists nor could afford expensive deductibles for specialized care.

The consultations took place online using video conference technology, and were held in a private room at the manufacturing plant. Dr. Siegel answered the patients’ questions and helped them create an effective care plan that minimized their costs whenever possible. Siegel then sent medical records, comments and recommendations for follow-up care to each patient’s primary care physician (PCP).

“I will continue to maintain close communication with the PCPs and work together with them to develop an ideal treatment plan for each patient, including arranging for physical examinations, if needed,” said Siegel. “I think our first telemedicine session was extremely successful. The patients seemed to feel very comfortable and came away satisfied with the care they received. It’s definitely easier for people to stay local and limit their trips to Boston for care, especially if they live in areas where the resources for consultation are not available.”

The future of telemedicine at Tufts Medical Center

The next Tufts Medical Center telemedicine session is already planned for January. As the program grows, Siegel may eventually hold two consults per month, with five-to-seven patients per session. Soon he hopes to be joined by additional members of a telemedicine diabetes team, including a local diabetes educator, pharmacist and exercise consultant, to help keep patients healthy.

Salem also hopes to soon begin offering telemedicine house calls in other medical areas with oncology (Jack Erban) and bariatric surgery (Julie Kim) as the next two likely clinical specialties. According to President of Patient Advocates Jim Ward, JD, a number of companies already have expressed interest in starting telemedicine programs with Tufts MC at their workplaces.

“Tufts Medical Center has brought tremendous value to our patients and their employers,” said Ward. “[Your] physicians’ skill and dedication really reflect [your] culture, which is why we are always thrilled to refer our patients to Tufts Medical Center and look forward to expanding our telemedicine relationship in the future.”