As the summer wound down, AmeriChoice by UnitedHealthcare of Tennessee kept the focus on the future of telemedicine by announcing more than $300,000 in grants to better serve rural patients and debuting an 18-wheel mobile health clinic during a statewide sweep.

 

On July 29, AmeriChoice unveiled a newly minted strategic agreement with the Community Health Network (CHN) and Tennessee Primary Care Association (TCPA) to expand telehealth services across the state. The initiative was based on months of planning with state officials in support of Gov. Bredesen's eHealth initiative.

 

AmeriChoice of Tennessee President Eric Paul said, "Tennessee is fortunate to have a governor who is healthcare savvy, understands the challenges of today's healthcare environment and is committed to overcoming those challenges through partnerships like this." He added he was proud his company, a managed care organization providing services to TennCare members across the state, was to be part of a collaborative to put Tennessee in the forefront of employing telehealth to improve access and quality and to achieve greater efficiencies in the delivery of care.

 

Two separate grants were given. A smaller, $40,000 grant was awarded to TCPA to assist with virtual Continuing Medical Education training for providers using CHN's telehealth network. A larger grant of approximately $290,000 went to CHN to support telehealth staffing and to improve and expand infrastructure around the state. In addition to purchasing specialized telehealth equipment, the grant also allows for adding new specialties to the network, including collaborating with TCPA to more fully integrate behavioral health services into primary care.

 

The underlying goal is to expand the number of TennCare members and others in rural areas that can access telehealth technology to receive care from a medical or behavioral specialist ­–– often located in larger, urban areas –– from the convenience of their local community health center.

 

During the same time period, AmeriChoice's parent company, UnitedHealth Group, was traversing the state in an 18-wheel, rolling health clinic to promote Connected Care, a national telehealth network initiative utilizing Cisco's HealthPresence videoconferencing, plus other eHealth technologies. Stops in Knoxville, Nashville and Memphis showcased the tricked out truck that featured a check-in area, patient education kiosk, "activation stations" where forms are filled out and online screens conducted, and a private exam room.

 

The only difference from most physician offices is that when the patient is told, "The doctor will see you now," the provider is on a flat screen monitor. A nurse, physician assistant or paramedic is onsite in the exam room to upload patient data for the remote physician and facilitate the office visit. A high definition camera allows the doctor to see and interact with the patient in real time. Using some of the same communications technology as NASA space shuttles, the voice and video data from the mobile clinic travels 22,300 miles between Earth and a satellite in about a quarter-second.

 

Andrew Felrice, program director for UnitedHealthcare who is traveling with the coach on its national tour, said convenience is a huge factor with the mobile clinic.

 

"The technology can be deployed at community centers, schools and even company locations. You're making it easier to access care," he said, adding accessibility incentivizes people to take better care of themselves. Felrice noted the clinic also has the ability to feature streaming video that can be tailored to match a patient's needs. "We can engage them with content that is very personalized to them."

 

Felrice said a pilot clinic would be launched in the final quarter of 2009 but declined to give particulars on location. He did say there are designs to build a second truck to work with Project Hope in New Mexico in an effort to reach migrant workers. He also noted the mobile clinic concept was scalable, and future clinics in the fleet could be smaller than the 80-foot coach showcased in Tennessee.

 

In addition to its regular patient care uses, the mobile clinic with its powerful generator is anticipated to be useful in cases of national emergency … particularly when health facilities have been damaged and normal communications have been interrupted. Mike McCabe, CIO of AmeriChoice Southeast Region, said, "It's got a satellite so you're completely self sufficient."

 

For day-to-day use, McCabe said the technology increases efficiency in the delivery system for both specialists and patients. "It saves travel time. They (physicians) can visit with technology." For patients, he continued, "You're getting fast, rapid assessment."

 

He added this type of service is meant to supplement what is already in place. CHN already operates a telehealth network in Tennessee with approximately 80 locations across the state.