The Virtual Doctor Will See You Now
Cisco's medical director talks about how the Connected Care initiative will help transform national healthcare, based on her experience using HealthPresence to improve employee health at Cisco.
July 15, 2009
Cisco and UnitedHealth Group are launching the Connected Care telehealth initiative to make medical care more accessible throughout the United States, especially in under-served areas. This initiative draws in part on Cisco's experience using its HealthPresence technology to improve employee healthcare.
As Corporate Medical Director at Cisco, Dr. Pamela Hymel oversees healthcare for Cisco employees around the world, and has been closely involved in the company's internal HealthPresence initiatives. Board-certified in internal and occupational medicine, she is on the front lines of corporate healthcare and its role in the national healthcare debate. She talks with News@Cisco about Connected Care and the future of telehealth.
Q: As Corporate Medical Director at Cisco, what's top of mind right now for you?
Dr. Hymel: Overall, the same thing that's top of mind for any corporate medical director: ensuring the good health of our employees and their families. I'm part of Human Resources, charged with designing health enhancement programs for employees globally. This has involved a number of initiatives, including the HealthConnections program, emergency response issues for employees and work with our partners in Cisco's Internet Business Solutions Group on technology solutions.
We recently opened the LifeConnections health center on our San Jose campus, which takes a lot of my time, of course. It combines a first-class healthcare facility with technologies such as the Cisco Medical Grade Network, a paperless environment with electronic medical records, on-line scheduling and HealthPresence to deliver convenient preventive and integrative primary care to more than 45,000 employees and their families.
A good deal of our focus is on telehealth; specifically, extending the reach of our LifeConnections center using Cisco HealthPresence. We want to bring the holistic approach to integrated healthcare that we offer at the center to employees in remote locations through the virtual face-to-face capabilities of HealthPresence, which uses Cisco TelePresence plus networked medical devices and other technologies to create an experience similar to an in-person office visit.
We piloted healthcare delivery from physicians in Los Angeles to patients at the LifeConnections center to test care quality as well as patient and doctor acceptance of a virtual consultation using HealthPresence. This is in cooperation with UnitedHealth Group and HealthCare Partners, with the goal of giving LifeConnections patients access to a wider pool of physicians.
The results were quite favorable. More than 90 percent of patients would recommend the service to others. Similar pilots have taken place in Scotland and New Zealand, and we're also piloting healthcare delivery from physicians in our LifeConnections center to patients in another building in San Jose. [See related feature.]
At the top of my list right now is the Connected Care telehealth initiative we're announcing in Washington, D.C., with UnitedHealth Group (UHG). This is a logical extension of the work we've been doing at Cisco with HealthPresence, and will enable UHG to deliver similar benefits nationwide.
Q: How will the Connected Care initiative use technology to improve national healthcare?
Dr. Hymel: The joint Cisco-UnitedHealth Group Connected Care initiative is a national telehealth program that combines UHG's extensive national healthcare resources with Cisco's HealthPresence and other technologies to greatly expand the reach of doctors. It will comprise a mix of mobile and fixed HealthPresence pods or installations with the goal of reaching five million patients in the first three years.
These HealthPresence units may be put in pharmacies or other retail settings, in the workplace or installed in mobile units that can travel to locations more convenient for patients, and can link patients to doctors using call-center technology. An attendant can use networked medical equipment, like blood pressure cuffs, pulse oximeters and just about anything else needed for a basic physical exam to relay vital signs to the remote physician. The virtual face-to-face experience furnished by HealthPresence gives the exam the feeling of a personal visit.
"The Connected Care initiative is a national telehealth program that combines United Healthcare Group's extensive national healthcare resources with Cisco's HealthPresence and other technologies to greatly expand the reach of doctors."
That's what we're demonstrating in front of the Capitol building: the Connected Care mobile, an 18-wheel trailer that provides visitors with a close up and personal look at telemedicine in action with a preventive health screening. It will be on tour around the country, demonstrating the wider access to medical care this initiative is designed to deliver.
Where Connected Care will initially make the most difference is exactly where we've been using HealthPresence at Cisco: easier access to physicians. The Association of American Medical Colleges has estimated a potential shortage of 159,000 primary care physicians by 2025, due to factors like population growth and aging. Patients in under-served areas will be among the hardest hit.
The Project Hope partnership we're also announcing illustrates how Connected Care can help overcome this shortfall. It will use a Connected Care mobile unit to offer health screenings and management of chronic conditions like diabetes for residents of remote counties in New Mexico
Q: Given your experience at Cisco, how do you see initiatives like Connected Care changing employee health, and healthcare in general?
Dr. Hymel: As the healthcare initiatives being debated in Washington demonstrate, the two are inextricably bound together in the United States. Millions of people get healthcare via employer-provided plans, necessitating a close partnership between health care companies and corporations. In our work with UnitedHealth Group, I feel we're right on the leading edge of healthcare reform, working through all the same issues.
From the standpoint of employee health specifically, a lot of employers are trying to control medical costs with on-site health centers. Telehealth integrates easily into this healthcare model, which is naturally outsourced.
For instance, LifeConnections is run by Cerner Corporation, which handles administrative functions and manages the center for the contracting medical group that supplies physicians. Cerner is also a Cisco technology partner and is piloting HealthPresence in its facilities. With HealthPresence, companies like Cerner can offer quite extensive medical care to smaller businesses that ordinarily wouldn't be able to afford a healthcare center.
Looking at the wider stage, initiatives like Connected Care can also be used to expand the reach of specialists. We're already looking into that at the LifeConnections center. Right now, specialist referrals must be in person, but with HealthPresence Pods in specialist offices, we could offer employees instant access to specialists such dermatologists, cardiologists and behavioral health experts. The same will be possible nationally, bringing specialized care within the reach of millions more Americans.
What Connected Care really comes down to is increasing the efficiency of healthcare by removing distance, and to some extent time from the equation. Physicians will be able to serve more patients, and patients will have quicker access to a wider range of medical expertise. Initiatives like this will be one of the key levers of healthcare reform, and a major factor in reducing the cost of healthcare for individuals, corporations, government and society in general.
Q: What does the Connected Care initiative say about the changing role of IT in healthcare delivery?
Dr. Hymel: It emphasizes the integral and strategic role of IT in healthcare. IT's role is so big, in fact, that it can be difficult to see. One of the most exciting things about the Connected Care mobile unit is that it gives people a concrete, personal-scale example of IT's power, and helps us talk about the fact that improved healthcare is a matter of integrating a whole lot of technologies, not just the ones everyone tends to talk about like electronic medical records.
Rather than concentrating on technology, a good way to think and talk about IT's role in healthcare is in terms of how it can accelerate the transformation of the doctor-patient relationship into a partnership. One of the primary themes of the healthcare debate is how to empower patients to take responsibility for their own health, rather than asking healthcare professionals to shoulder the entire burden, an approach that we as a country can't afford anymore.
Connected Care will be an important part of this transformation, making healthcare more accessible and affordable and helping people become more comfortable with IT in healthcare. We fully expect to see telehealth eventually reach into the home, so that many medical consultations won't involve any travel at all. The result will be a healthier society where people have more time for productive and life-enhancing activities.
