No longer science-fiction, virtual health care has hit South Florida with a gigabyte bang.
Like something out of TV's "The Jetsons," telemedicine is helping patients see their doctor, have their vital signs checked and get their records updated — without leaving the house.
But the idea of an Internet-connected, doctor-patient relationship may remain stuck in its infancy in the Sunshine State, physicians fear, because most insurance companies only reimburse in-person visits. Some area hospitals have been able to launch telemedicine programs without passing the costs on to patients, but most individual practitioners can't afford that option.
This spring, lawmakers in both legislative chambers are considering at least two measures that would require insurers to cover "advanced communications technology" — beyond emails, phone calls and faxes — in their health plans. At least 19 other states have passed similar laws.
"There's a question about the extent to which physicians can engage in telemedicine, what the requirements are. There's a lot of uncertainty," said Jeff Scott, general counsel for the Florida Medical Association, which is lobbying for telemedicine legislation on behalf of the state's doctors. "So what we're trying to do is provide the appropriate framework so people know what they can and cannot do."
With momentum building, Scott thinks the bills' chances for passage are "pretty good," and some in the South Florida health-care industry agree the measures could usher in a new era.
"Telemedicine is very cost-effective," said John Santangelo, IT director at Cleveland Clinic Florida in Weston. "If insurance companies start to recognize that [and include telemedicine in their plans], it fuels innovation and helps it to greatly expand."
Along the way, the medical community hopes telemedicine offers an affordable answer to delivering quality care amid an impending doctor shortage, while saving the patient valuable time and driving down medical costs. The technology already is making a difference for patients at the few local hospitals that have launched virtual health initiatives in the past year.
"It's fantastic. You don't know what it does for your confidence," said retired pipefitter Ralph DeLuca, 72, who is able to convalesce at his Hollywood home a month after heart surgery, thanks to a computer tablet provided by Memorial Regional Hospital's Home Health Services program.
Every day at 9 a.m., the tablet turns on automatically, ready to read and transmit data from the weight scale and blood pressure and oxygen monitors connected to it. The information streams in real time to DeLuca's nurses and doctors at Memorial, allowing them to track his progress between weekly home visits — and sounding an alert if abnormalities arise.
The data also is instantly added to his electronic medical record, giving doctors a comprehensive picture of his health over time, at no extra cost to him.
Recently, when DeLuca's blood pressure plunged, he got a call from the hospital, he said, and a nurse arrived at his home within an hour.
"Where are you going to get that kind of service?" he said. "The object is to keep me out of [the emergency room]."
And it's working, said Sheila Schubert, administrator for Memorial Regional's Home Health Services. In the past year, since offering its "telehealth" program to heart failure patients recovering at home, Memorial has seen its 30-day hospital readmission rate among that population drop to less than 2 percent — far lower than the 22.8 percent national average and Memorial's overall 19.9 percent readmission rate, she said.
In all, Memorial Regional's home health program has 51 computer-connected monitors. Some, like DeLuca's, just transmit data, but others with Skype-like technology allow patients to consult with their providers by video. Within the next few months, the hospital plans to begin expanding the service to patients with certain lung diseases.
"It will never take the place of nurses," Schubert said. "But we will be able to have more interaction with patients in between nurse visits."
Broward Health Coral Springs' ER doctors confer with off-site neurologists via Skype-like technology when deciding whether a stroke victim is a good candidate for anti-clot medication.
"It's really the ideal," said Dr. James Roach, emergency medical director at the Coral Spring facility. "It expedites what we're already doing and makes it better. It's a win-win for everybody."
And at Cleveland Clinic Florida, "smart" devices are speeding up efficiencies in the hospital, where patients awaiting discharge can connect with an off-site pharmacist on an iPad to discuss questions about medications. Because patients don't have to wait for the doctor to visit their room, they can get out the door faster, Santangelo said.
Cleveland Clinic patients also are using virtual health gadgets at home, like the glucose monitor, worn on a belt clip, that feeds data to the doctor.