TELEMEDICINE
The lab results are back, and the prognosis is good for real-time telemedicine. Kaiser Permanente, the largest HMO in the US, recently finished 12- to 18-month clinical trials of the remote delivery of medical care. The California trial, one of over 150 private and public telemedical initiatives active in the US according to the Association of Telemedicine Service Providers, found that remote treatment maintained the overall quality of care while reducing costs.
One hundred clinicians and 400 home-care, dermatology, kidney-dialysis, and psychiatry patients participated. They connected using a mix of POTS, microwave, and videoconferencing via leased ISDN. Patients consulted with nurses and exchanged pulse, blood pressure, and stethoscope readings. "In terms of the clinical quality of care, it was the same as it is for in-person visits," says Kaiser senior project manager Jill Deuser. "There was no deterioration, and that was our goal."
On the cost side, Kaiser would not disclose specific savings, but the HMO found that distance consultation retained patients who might otherwise have gone outside its network, and it enabled physicians to intervene sooner when psychiatric patients took a turn for the worse.
Deuser says Kaiser plans a larger trial next year, contingent on funding (Kaiser finished 1997 $280 million in the red), and will use the Web to provide nonemergency advice to its entire national membership.
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