Tuesday, January 27, 2015

Missouri doctor: Telemedicine could be boon for Kansas

KHI News Service

KANSAS CITY, KAN. ---- A doctor from southwest Missouri told legislators Monday that the state could see Medicaid savings if it helped rural physicians connect with national experts through online videoconferencing.

Roger Cady, who specializes in headache treatment and primary care in Joplin, told the Vision 2020 Committee that by using telemedicine to improve treatment of just one prevalent health condition, the state could save thousands per physician.

“It’s pretty significant when you think about that and choose the right areas of intervention,” he said.

As an example, Cady cited chronic obstructive pulmonary disease (COPD), a long-term lung ailment that afflicts many current and former smokers.

He said a physician who has unsuccessfully tried many treatments for a COPD sufferer might use telemedicine to consult with a national expert on the disease for the next appointment with the patient.

During a videoconference, the expert could help form a plan of care that would give the physician new ideas on what questions to ask COPD patients and give the patient fresh insights into his or her ailment.

“What happens that’s unique here is the education is being given to everyone,” Cady said.

The collaborative process makes it more likely that the patient will adhere to his or her new plan of care, he said. Over time, that should decrease hospitalizations and thereby decrease costs.

“The idea is it reduces health care costs, it improves health care delivery and it is designed to optimize patient outcomes,” Cady said.

If the state were to incorporate telemedicine in Medicaid, he said, it should be done in four steps:
  • Establish priorities, focusing on chronic conditions that carry high costs.
  • Identify physicians interested in using telemedicine to treat those conditions and recruit national experts to participate.
  • Make sure participating physicians have proper equipment, including a computer with a camera, videoconferencing software and reliable broadband internet.
  • Start setting up appointments among the physicians, experts, patients and, when necessary, patients’ caregivers.
While Cady said he thinks the costs ultimately would be offset by savings from improved care, he acknowledged there would be some expenses to establish the telemedicine program.

“The million-dollar question is, ‘What about funding?’” he said. “I don’t have an answer.”

Cady suggested the state could set up a fund to help providers purchase the service themselves, explore billing Medicaid for the physician and the expert who participate in the teleconference, partner with the KanCare managed care companies under the assumption that the program will save those companies money or seek grant funding.

Cady was promoting eMentorU, a conceptual software program that he envisions rural physicians using to connect with national experts.

The committee also heard another presentation on telemedicine from a University of Kansas Medical Center research director.

After the presentations, Rep. Barbara Bollier, a Republican from Mission Hills and committee member who is a retired physician, said she had a lot of questions about the practicality of telemedicine given the current national health care reimbursement model.

She said insurance companies may not be willing to pay for both physicians involved in a telemedicine call.

Bollier also said some areas of Kansas still do not have broadband service that is reliable enough to support the videoconferencing necessary for telemedicine.