Two years after its launch, LSU telemedicine is slashing the time it takes for patients in rural Louisiana to get subspecialty care while saving them hours of travel time.
Prior to the telemedicine program, LSU Lallie Kemp Regional Medical Center in Independence would refer a patient who needed to see a rheumatologist to a clinic in New Orleans, said Dr. Kathleen Willis, Lallie Kemp medical director.
“Those clinics are very backed up there so it may be three or four months, maybe even longer before we can get an appointment down there,” Willis said.
It can take up to a year to see some specialists, such as neurosurgeons, because of the shortage of physicians in that field, Willis said. Once a patient got an appointment, he or she would have to travel to New Orleans for a face-to-face visit.
“With our current process, we simply schedule them into our telemedicine slots, and we can usually get them seen within two weeks,” Willis said.
Patients see a significant cost savings, she said. The savings include the cost of gasoline, a meal, and losing a day of work.
“A 30-minute clinic visit turns into a five- or six-hour trek,” Willis said.
Lallie Kemp has four telemedicine cameras – three in outpatient clinics and one in the Emergency Room.
From July 1, 2010, to June 30, 2011, patients in the Lallie Kemp Heart Failure Clinic had 413 telemedicine appointments with LSU cardiologists in New Orleans, according to LSU. Patients in the Lallie Kemp Mental Health Clinic had 159 telemed appointments with JSA Health Telepsychiatry in Houston.
The first telemedicine subspecialty for Lallie Kemp was cardiology. Since November, Lallie Kemp and the Interim LSU Public Hospital have added telemed services for rheumatology, hepatitis C, endocrinology, neurology, dermatology, nephrology, physical medicine, rehabilitation and psychiatry.
From November to May, Lallie Kemp had 473 telemedicine appointments in those subspecialties.
Willis said Lallie Kemp’s telemedicine appointments are growing rapidly, and the hospital could see 700 telemed visits during the current fiscal year.
Dr. Juzar Ali, medical director of the Interim LSU Public Hospital in New Orleans, said LSU has more than 30 specialty clinics, but it’s difficult for those facilities to add more face-to-face patient visits.
LSU thought it could help more people using telemedicine, Ali said. LSU put together the telemedicine infrastructure and a grid so that clinics could cooperate on providing care.
The idea for the grid was to match the services available with the needs of the outlying areas, Ali said. LSU couldn’t do that entirely, but the health system has been able to make eight to 10 specialties available through telemedicine.
Ten LSU physicians in New Orleans at the interim hospital provide most of the telemed services. The physicians offer 36 hours of clinic time each week for Lallie Kemp. There are also 14 additional LSU doctors available.
Ali said different specialties are offered on different days.
For example, psychiatry appointments might be scheduled for Friday, while rheumatology visits are held on a Tuesday, he said.
“This is a project that has really taken off, but at the moment is still in its evolution stage,” Ali said. “Intuitively and conceptually it seems to be a right approach, and I think nobody can really argue with that.”
LSU is also offering telemed services at LB Landry High School, ILH Community Clinic in Algiers, and some of the health system’s other hospitals, such as LSU W.O. Moss Regional Medical Center in Lake Charles and LSU Bogalusa Medical Center, Ali said.
Ali said LSU could have initial quality data from Lallie Kemp in six months or so.
The first measures will include whether telemedicine provided faster, earlier care to patients; how frequently telemedicine allowed patients to forgo face-to-face visits; and whether telemed visits are increasing, Ali said.
Willis said Lallie Kemp tells patients about the telemedicine option when making a referral to a specialist.
The hospital asks if the patient is OK with seeing his or her specialist over a camera and makes sure patients are comfortable with that idea.
“We tell them how it’s going to be and what it’s like. I don’t think we’ve had anybody decline a visit,” Willis said.
Willis said in addition to saving patients time and money, telemedicine has also improved compliance.
Patients who are referred for telemedicine appointments typically keep them, she said. Telemedicine is new, it’s interesting and innovative.
Patients want to be a part of it, she said. When patients are sent down to New Orleans it’s a whole other story.
“Telemedicine is definitely the wave of the future. It is definitely a growth market in the rural and underserved areas where we can provide better care for our patients by allowing them to see a subspecialist when needed,” Willis said.