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HU MEENA — Now Streaming: The digitization of U.S. health care



Today’s society will be remembered as the first wave of instant access culture. Need proof? There are ghosts of companies wandering the corporate graveyard, howling at the moon because they couldn’t keep up with our thirst for immediacy. “I went to Blockbuster” is now a primitive expression, akin to “Hand me the phonebook,” or “Me, Tarzan. You, Jane.” Disruptive services like Netflix, Amazon Prime, online banking, and Uber, are all examples of industries adjusting to our expectation of instant access, and they’re thriving for the sake of their business. Anyone who has taken a $20 Uber ride over a $65 taxi cab from the airport knows that this ultimately benefits the consumer.

So, what happens when healthcare, one of our most important and complex industries, dips its toe into the modern era of instant access? It’s called telemedicine. It’s taken them a while to dive in, but the health-care industry is slowly beginning to modernize. And this recalibrating to our instant access standard will not just add convenience and save money. It will save lives.

healow-TeleVisits-and-Trackers-Infographic-4-6-15 infographicBy definition, telemedicine is any form of clinical health care provided at a distance by way of telecommunications. This could be a video-conference with a diabetes specialist, a phone call with your family doctor, even the transmission of CT scans and X-rays is considered telemedicine. Remote monitoring is an important sector of telemedicine that uses sensors and direct patient-to-doctor communication to help patients with chronic conditions avoid the emergency room. This is crucial in a state like Mississippi where physicians are relatively scarce and rural areas are commonplace.

Yes, telemedicine holds the promise of uber-convenience: no more sacrificing a half-day of work for an obvious antibiotic prescription—just Skype your doctor on your lunch break and you’re good to go. But the real impact of telemedicine is how it affects the low-income populations in our state and country that are literally dying for access to health care.

It’s no secret that Mississippi has some of the highest rates of obesity, diabetes, and heart disease in the nation. You know where the clusters of these sick people are? The rural areas of our state where physicians are scarce or non-existent.

That’s where telemedicine has stepped in, and Mississippi is leading the country in the movement. Just last month Healthcare IT News, the national authority on health-technology, encouraged other states to use Mississippi as “a model of telemedicine implementation.” The Center for Telehealth at the University of Mississippi Medical Center is the reason Mississippi was one of only seven states to receive an A rating from the American Telemedicine Association in 2014. Earlier this month, FCC commissioner Mignon Clyburn paid UMMC’s program a visit, extolling the importance of telemedicine in our country. Our state has achieved national attention because of measurable success: improved patient outcomes and decreased spending.

Telehealth coverage and reimbursement policies across US graphicThe savings that telemedicine promises is no paltry sum. There’s still a lot to be uncovered regarding the economic impact of telehealth, but we’re seeing very clear and positive signs of its potential benefit. In 2014, C Spire partnered with UMMC Telehealth for an 18-month remote-monitoring initiative to improve the health of diabetics in Ruleville, Mississippi. Aside from the virtually impeccable patient outcomes (not a single patient ended up in the ER), that nationally recognized pilot program illuminated a staggering statistic: if only 20 percent of diabetics in Mississippi participate in this type of telehealth initiative, our state would save $189 million every year. Nearly 67 percent of the entire federal budget is spent on entitlement programs like Social Security, Medicare, Medicaid, welfare and other benefit programs. Furthermore, CMS reports that 93 percent of this spending is on patients with one or more chronic conditions. In a state like Mississippi where our biggest issues are poverty, chronic medical conditions and limited access to medical care, there is clearly a massive opportunity to improve efficiency—medical and fiscal—through telehealth.

do patients trust telemedicine infographicAnd yet, of the federal government’s $634 billion annual Medicare budget, only $17.6 million was paid for telemedicine services in 2015—a tiny morsel of total spending roughly equivalent to a rounding error.

This is one of the big barriers to more widespread adoption of telemedicine. With so few Medicare dollars going to telehealth-related reimbursements, most physicians simply can’t participate, thus making it financially unfeasible for patients. Some doctors have taken the leap of faith, hoping their results will in turn coax some more support from federal and state reimbursement entities. Our own Mississippi State Legislature has championed this approach. Mississippi is one of only three states where Medicaid reimburses for live video, store-and-forward, and remote patient monitoring—the three pillars of telehealth.

Governmental skeptics of telemedicine cite fears that it will actually increase spending. This is based on hypothetical scenarios of patients billing Medicare for something like a live video consultation and then going in for an office visit anyway, resulting in one encounter for the price of two. But this is tedious, unsubstantiated quibble. And it’s one we can’t afford, if the potential savings are true.

I grew up in Clarksdale. With the increasing restrictions on health-care provider networks, most of the elderly population in my hometown has to drive two and a half hours multiple times a month to see a specialist. This is not the best we can do for the “greatest” generation, especially one that raised us. Technology and the elderly are not mutually exclusive terms: the 60+ age bracket is the fastest growing demographic to use social media, according to Forbes Magazine.  Just ask any mortified teenager who’s friended “Mimi” on Facebook. Telehealth is a viable solution for an elderly population that is steadily growing.

But telehealth does not exist just to be techsavvy. It utilizes the latest technology already at our disposal to solve real-world challenges and problems. It can help the entire health-care ecosystem, from doctors to hospitals to older patients who live in rural areas and to the chronically ill.  According to the Centers for Disease Control and Prevention, there were 136 million ER visits in 2011. Telemedicine bridges the health-care gap from a $2,000 ER bill to a $50 live-video consultation.

If we’re honest with ourselves, there is no practical solution to our country’s healthcare predicament that doesn’t involve telehealth and telemedicine. The Mississippi Legislature has led the way and our state’s congressional delegation is working hard to make changes on the national level that will pave the way for more widespread adoption of telemedicine.  Hopefully, doctors who are reticent about telemedicine because patients have more ready access to care will see the broader benefits of a healthier society and the federal government will see the opportunity staring them in the face. For the sake of our economy and our people.

Telemedicine offers great promise for our region and the nation.  It feels good to live in a state where we’re leading the country in a field that literally means the difference between life and death. So, be on the lookout for medicine’s fashionably late arrival to the instant-access culture of today. Yes, it’s been a bumpy ride for the first few miles, but the digitization of health care is gaining momentum.  When Netflix first added instant streaming content, we all remember how lackluster the selection was – pixelization, buffering, latency and poor picture quality were just a few of the challenges.   Few of us dreamed of its potential. Now it’s a living room staple.

If you’re interested and would like to learn more about the opportunities and challenges for telemedicine in the U.S. healthcare industry, check out our most recent C Spire “Let’s Talk Tech” podcast.  Every month, this program explores the latest emerging technologies, the people behind them and how these trends affect the way we live, work and play.

» Hu Meena is president and CEO of C Spire, a Mississippi-based diversified telecommunications and technology services company


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