From a high-tech command center at Miami Children's Hospital, doctors can diagnose and treat patients in a small Peruvian village, a mall in the Ukraine or a cruise ship sailing the Atlantic, among many distant and diverse locations.
"The only thing our physicians can't do today is touch the patient," says Ed Martinez, the hospital's CIO.
Martinez, a 2012 CHIME Innovator of the Year Award winner, offered a virtual tour of the hospital's telehealth center during last week's HIMSS 14 Conference and Exhibition in Orlando. His tour outlined the potential of telehealth to deliver care whenever and wherever needed, empowering local physicians with collaborative care and avoiding thousands – if not millions – of dollars in transportation and other critical care costs.
And while the distant locations may seem exotic, it's worth noting that MCH boasts a staff of some 650 clinicians, many of them specialists. That makes the telehealth center just as important to the hospital's home state, where some children live 200 to 300 miles from the nearest specialist.
With officials from a Colorado children's hospital and the U.S. Department of Health and Human Services in attendance, Martinez led a tour of the center and its MCH Anywhere program via iPad, communicating with Bill Manzie, the center's director. The center, equipped with glass walls that can be rendered opaque within seconds, features several "pods," or workstations equipped with three video monitors, a headset and a digital stethoscope. One monitor allows for communication with a doctor on-site, while the second enables consults with others and the third provides access to the electronic medical record.
At its busiest times, the center can care for hundreds of patients a day, Martinez pointed out. In the case of a natural disaster or government emergency (the center recently held a tour for a number of 4- and 5-star generals), the room can be shut off from the rest of the hospital and serve as a self-contained emergency command center.
"We don't need a lot of space to take care of a lot of patients," Martinez said.
To facilitate the telehealth connection, MCH deploys a portable workstation that includes a high-definition video camera with two-way conferencing and several devices, including an otoscope, stethoscope, dermascope, ultrasound and lab units. MCH is also partnering with HealthSpot to integrate with HealthSpot Station kiosks in remote sections of Florida and across the Caribbean. And the hospital is working to establish a second command center in Costa Rica as part of a hub-and-spoke model.
Recognizing that not all emergencies can be solved via telehealth, the 650-staff hospital also owns two trauma helicopters and a pair of Lear jets. 'Part of the benefit (of telehealth) is we're trying to avoid" using those aircraft, Martinez said.
Martinez said the program's value can be seen in many ways. MCH recently helped diagnose and treat a child in Peru, saving the cost of a flight to Miami, and has treated cruise ship passengers at sea, where a change in course and re-routing to the nearest hospital could cost upwards of $1 million. The hospital also boasts one of the top two pediatric spine surgeons in the country, who can consult with partner providers around the globe.
While cross-state licensing legislation is still a slow process and only 22 states currently reimburse for Medicare- and Medicaid-based telemedicine treatments, Martinez said MCH sets itself up with the on-site healthcare provider, offering a specialist consult or a second opinion. That's how the encounter is billed. He expects that formula to change as more and more states recognize telehealth as an acceptable – and reimbursable – method of care.
Meanwhile, he said, the telehealth center earns its keep with lucrative international and private-payer contracts.
"We don't want to own the patient," Martinez pointed out. "We want to help the patient recover wherever he or she is" and through the care of the local provider.
Aside from the United States, Peru, the Ukraine, Costa Rica and the cruise ship industry, MCH also offers its services to the Vatican Children's Hospital, France, Guatemala and Barbados and is actively seeking partnerships with more providers across the globe. A wall-sized map in the telehealth center points out just how far the hospital can reach, and show's how a doctor in one part of the world can affect a life far away.
"We're really taking this to another level really, really quick," he said.
