Telemedicine: Extending the Delivery of Health Care

Telemedicine has moved well beyond novelty status. The American Telemedicine Association describes telemedicine as, “a significant and rapidly growing component of health care in the United States,” with more than 200 telemedicine networks and 3,500 service sites in the country. Over half of U.S. hospitals now use some form of telemedicine.

The Children’s Mercy Telemedicine program has participated in this growth, both in terms of services delivered and as a recognized industry leader.

“In fewer than six years, Children’s Mercy has grown from one telemedicine patient to over 2,300 virtual patient encounters in the recently ended fiscal year 2018,” said Morgan Waller, MBA, BAPsych, BSN, RN, Director of Telemedicine Business & Operations.

Morgan also cited several other areas of Telemedicine growth at Children's Mercy, which includes:

• Expanding from one to four Outreach Centers: St. Joseph; Joplin; Wichita; and Junction City, plus KidCare Anywhere, a direct-to-consumer virtual health service that offers access to providers via smartphone, tablet or computer.
• Providers from 31 specialties offer services via Telemedicine, and the program aspires to include all 40-plus Children's Mercy specialties.
• Language services may be accessed through telemedicine technology to support in-person or virtual encounters.
• The Heart Center’s highly successful remote patient monitoring application, CHAMP.
• Advances in technology. “It’s better, faster and easier to use,” Morgan said. “The technology is developing so rapidly that we hardly ever have connectivity issues. We’re now able to deliver services to patients in their homes on their cell phones. That was just a dream five years ago.”
• Divisions are exploring advanced employment flexibility, recruitment and retention efforts by supporting part-time providers who practice exclusively via telemedicine.
• In Fiscal Year 2018, asynchronous telemedicine experienced record numbers, with Radiology interpreting just short of 6,000 outside hospital (OH) images, 1,500 OH EKGs and 325 OH ECHOs.

This growth and success were made possible by the most important of reasons: the quality the program delivers (which Morgan attributes to all members of the Telemedicine Team); and the adoption by providers, patients and families. Feedback from satisfaction surveys is more than 98 percent positive. Here are some examples:

• “It was very easy and still comprehensive. The technology was great. [The provider] was able to listen to her breath sounds and heartbeat via stethoscope and zoom in on her PICC line.”
• “Feels personal even though it’s through a screen; very convenient.”
• “With this new technology it really feels like you’re there with the doctor.”
• “Same great care that she would receive as if we were in person.”
• “We live three hours away from the doctor and this saves us in gas.”
• “This was rad!” 

From the provider perspective, Alvin Singh, MD, Pulmonology, and Lindsey Malloy-Walton, DO, MPH, Heart Center Pediatric Electrophysiologist, cited these advantages of telemedicine:

“In this area of the country, it is vital to provide comprehensive care without burdening the family,” said Dr. Singh, who recently was recognized by InTouch Health for the largest number of pediatric specialty visits. “Telemedicine provides the opportunity to help in the best way we can. The technology is very reliable. I can provide the same type of care compared to if the patient and their family were face-to-face with me in clinic.”

Dr. Malloy-Walton said, “Telemedicine is a great way to make care more convenient for our patients, getting rid of extra time and distance spent traveling. Telemedicine has advanced so much over the years and the technology is amazing. It’s the wave of the future for medicine in pediatrics.”

Success story

One of telemedicine’s best success stories involved KidCare Anywhere (KCA), Children's Mercy direct-to-patient telemedicine platform used by Children's Mercy Integrated Care Solutions for our managed-care population. (The service is available from 5 p.m. to 10 p.m., 365 days a year for minor medical needs.)

Recently, a KCA provider was caring for a patient in the patient’s home when the parents had questions about the schedule and doses of medication the child takes routinely. The child, who also is followed by Endocrine, takes the medicine for a chronic specialty condition. The medication is out of KCA’s minor medical scope, but because of our providers’ support of new and better processes, the KCA physician paged the on-call Endocrinologist for direction. The Endocrinologist was familiar with the condition, both providers had access to the patient’s medical history via the electronic health record, and the parents’ questions regarding how to proceed with their child’s medication were answered. The entire interaction required less than 20 minutes of the parents’ and provider’s time, and no time was lost to a commute.

“This is an ideal example of the quality and efficiencies a health care organization can achieve when it embraces telemedicine to connect care for patients and families at the right time and right location,” Morgan said.

“Telemedicine is fast becoming part of how health care is delivered. It is no longer considered novel,” she added, “Telemedicine is an important strategic initiative for our hospital because it improves access to our services; enhances outreach efficiency and quality; and is more convenient for patients, families and providers.”

Learn more about Telemedicine Services we offer at Children's Mercy.