The Latest in Remote Presence.

Franklin, North Carolina is a town with just 4,000 residents, located on the historic Appalachian Trail in the southwest corner of the state. The town is famous for its gem mining, including rubies and sapphires. But this community has found something far more valuable: a life-saving connection to the Mission Health telestroke network.

Mission Health reached a major milestone recently when Dr. Alex Schneider, the program director in Asheville, used a remote presence robot dubbed “IC4U” to conduct the network’s 100^th telestroke consultation. The patient was at a facility in Franklin, a 90-minute drive from the hub hospital. Without access to a telestroke network, that patient would have lost 180 million brain cells just getting to Asheville.

The American Stroke Association estimates that only 3 to 5 percent of those who suffer a stroke reach the hospital in time to be candidates for thrombolytic treatment. But the Mission Health program has an astounding 43 percent success rate.

“Treating our 100^th telestroke patient represents a momentous milestone for Mission Health,” says Schneider. “It’s evidence of the strides we are making in bringing timely, expert care to rural neighborhoods throughout western North Carolina.”

In its long history, Franklin, North Carolina has been home to Cherokee Indian councils and colonial era gem miners. But no sapphire discovery can compare to a program that offers Franklin residents an eight-fold greater chance of receiving timely t-PA treatment.

The Mission Health telestroke network serves Franklin, North Carolina, using a remote presence robot with this custom license plate.

Few would argue that the Mayo Clinic is the gold standard in healthcare research. The facility’s main campus in Rochester, Minnesota has been around since the 1890s and employs more than 32,000 people. So when Mayo recently published a study on the cost-effectiveness of telestroke care, hospital CFOs across the country paid close attention.

The study, published last month in Circulation: Cardiovascular Quality and Outcomes, concludes that telestroke programs indeed offer financial benefits, not just societal advantages. 

Using data from both the Mayo Clinic and Georgia Health Sciences University telestroke networks, researchers estimated that a rural hospital would save more than $100,000 annually compared to a hospital without telestroke capabilities.

“The upfront costs associated with setting up the telestroke technology are quickly offset by the financial gains that result from a higher proportion of patients receiving clot-busting drugs and the reduced stroke-related disability and subsequent reduced need for rehabilitation, nursing home care and assistance at home,” says Bart Demaerschalk, M.D., director of the Mayo Clinic Telestroke Program and co-author of the study. 

Most people assume that Mayo operates geographically close to its famous headquarters, but it also has a large footprint in Florida and Arizona. Mayo began using telemedicine technology in 2007 after research revealed that 40 percent of Arizona residents lacked local stroke expertise. Since its inception, the Mayo Telestroke Network has conducted more than 1,500 emergency consultations across the state.

“Previous studies have demonstrated that a hub-and-spoke telestroke network is cost-effective from the societal perspective,” adds Demaerschalk. “For a relatively small amount of money, [it] can save quality years of life – so it’s a bargain really.”

The Mayo study isn’t the first one to document the financial benefits of telestroke technology. But it’s nice when one of the best-known “brands” in American healthcare weighs in with its own convincing evidence.

It’s not often that a new bill introduced in the U.S. House of Representatives has the ATA shouting “Hallelujah!” But that’s the response so far to a recent measure sponsored by Rep. Mike Thompson (D-Calif.). It may be the most sensible and comprehensive telemedicine legislation ever introduced in the halls of that gridlocked chamber.

The Telehealth Promotion Act of 2012 (H.R. 6719) brilliantly addresses the two chief roadblocks in telemedicine: reimbursement and licensure. Plus it goes much further, calling for some long-needed improvements to existing programs. If enacted, Thompson’s bill would extend the benefits of telemedicine to nearly 75 million Americans by increasing access through Medicare, Medicaid, the VA, Children’s Health Insurance Program, and other federal programs.

ATA chief executive Jon Linkous has called the bill “a panacea for federal involvement in telemedicine, eliminating archaic barriers and expanding opportunities for remote healthcare.” Here are some key provisions in the bill:

• Ensuring that no federally covered benefit can be excluded because it’s furnished via telemedicine

• Allowing telemedicine providers in all federal health plans to be licensed solely in the state where they’re physically located and would be free to treat eligible patients anywhere in the nation

• Providing new incentives for hospitals that lower readmissions with telemedicine

• Exempting ACOs from telehealth fee-for-service restrictions

• Creating a Medicaid telemedicine option to handle high-risk pregnancies

We need to do more than applaud Rep. Thompson’s boldness and vision. Now is the time to urge your U.S. representative to join in this common-sense effort to remove the biggest obstacles to telemedicine. Let your elected leaders know that telemedicine has the power to dramatically decrease federal health spending. That’s music to the ears of legislators on both sides of the aisle.

Thompson’s bill is smart and far-reaching. His colleagues can help restore some of the tattered credibility on Capitol Hill by swiftly passing it this year.

The first chapter in telemedicine was about providing care where it was urgently needed, especially in under-served rural communities. But now we’re seeing breakthroughs in how care is delivered, where remote specialists work closely with onsite clinicians as if they were actually present in the room.

Team-based care requires technologies that are seamless and easy to use. And our new RP-VITA remote presence robot is taking ease of use to the next level with its environmental awareness and autonomous capabilities. Simply by tapping a tablet screen, a clinician can select a destination (such as the ICU) and RP-VITA undocks and goes there independently.

Upon arrival, RP-VITA coordinates the care provided by a multidisciplinary team – some local, some remote. Not only does RP-VITA transform collaborative care, but it adds a new layer of clinical value by serving as a force multiplier to existing onsite staff. In short, RP-VITA brings healthcare’s long-sought triple aim into reach: improving healthcare access to entire populations, reducing per-capita costs, and dramatically enhancing the patient experience (both quality and satisfaction).

Here’s an example of how RP-VITA coordinates care in the ICU:

At 7:25 a.m., a clinician taps an iPad screen and RP-VITA automatically undocks and moves on its own to the ICU. The robot displays patient data to the onsite nurse, respiratory therapist and case manager – and makes that same information available to a remote critical care physician and pharmacist. Soon a radiologist joins in the collaborative effort as the team details daily goals. RP-VITA then moves independently to the next patient, and eventually returns to its charging station.

RP-VITA is helping to ensure that technology, people and processes are all “on the same page,” delivering superbly coordinated care that leads to better outcomes and lower costs.

To see a video animation of the RP-VITA coordinating the delivery of multidisciplinary team-based care at a hospital sometime in the near future, click here.