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Let’s make telemedicine available to all

If we can keep people from having to make costly and unnecessary trips to the hospital by bringing the care to them, then we must do that.

A mother and baby daughter sit in their house looking at a laptop screen.
Erica Jensen, with her 5-month-old daughter, Charlee Jaques, videoconferenced with Dr. Marie McDonnell from her mother’s home in Wilmington, Mass., on March 15, 2016.
Dina Rudick / The Boston Globe via Getty Images

This is a contributed op-ed by Steven J. Corwin, M.D., president and chief executive officer of NewYork-Presbyterian.

With all of the partisan debate over health-care reform in Washington, D.C., it was easy to overlook an important bipartisan achievement that could benefit millions of patients. As part of the federal budget agreement earlier this year, Congress passed and the president signed a major expansion of telemedicine benefits for many Medicare patients with stroke, kidney disease and other chronic conditions.

We applaud Congress for taking this important step. At NewYork-Presbyterian, one of the nation’s largest health-care delivery systems, we have been at the forefront of delivering care through telemedicine — with the goal of expanding access, addressing costs and improving care for patients. In 2016, we launched NYP OnDemand, a groundbreaking digital health platform that is expected to provide 100,000 annual telemedicine visits by the end of this year. Its services range from digital urgent care to virtual visits for follow-up appointments to peer-to-peer consults between physicians. As we have seen firsthand, telemedicine is expanding access to high-quality care to patients where and when they need it. Rather than make an elderly patient who needs a follow-up visit, or a mother juggling a job and three children — one of whom wakes up with a fever and sore throat — fight their way to us, we want to bring our physicians to them.

When we launched NYP OnDemand, we saw that one key area where the benefits of telemedicine can be quickly realized is stroke care. When it comes to stroke care, rapid diagnosis and treatment are critical to averting lifelong disability or death, which is one reason why the new law holds great promise. Our Telestroke Initiative allows our specialists to respond immediately through live videoconferencing to rapidly evaluate patients and improve door-to-treatment times. Outside the emergency department, NewYork-Presbyterian’s three specially equipped ambulances in Manhattan, Brooklyn and Queens race to patients suspected of having a stroke and digitally relay brain scans taken on board to experts at the hospital. The medical team aboard these Mobile Stroke Treatment Units can then video conference with a neurologist at the hospital for immediate instructions and treatment delivery, saving precious time — and brain cells.

Here are just a few other examples of how we are using telemedicine to provide care to those who need it most:

  • During last winter’s severe flu outbreak, when many patients were too weak to leave their homes, we connected flu patients with our emergency medicine doctors through their smartphones, computers, tablets and even Duane Reade drugstore kiosks through a new collaboration with Walgreens.
  • Our tele-ophthalmology mobile unit equipped with state-of-the art imaging devices, the nation’s first, travels to New York City’s underserved neighborhoods. Inside, medical staff offer free screenings for eye diseases that cause blindness and share test results digitally and in real time with an ophthalmologist who then consults with patients on a giant video screen.
  • We’ve dramatically reduced the time it takes for many of our patients to get care. Through Express Care, available at some of our hospitals’ emergency departments, patients with non-life-threatening conditions can choose to hold a video consultation with a physician after they arrive, reducing visit times from two to three hours to about 35 to 40 minutes. This is also freeing up emergency rooms and doctors for patients with serious emergencies.

Because we have seen the promise of telemedicine firsthand, we know that more can be done to make telemedicine mainstream to reach all who need it. The recent changes to Medicare are an important step. Working together, we can explore other ways to improve coverage, whether through pilot programs for specific populations (such as remote patient monitoring of diabetes care, obstetrics or behavioral health visits that do not require in-person medication administration) or through reducing regulatory barriers that limit where the patient must be located to access telemedicine. Accelerating infrastructure improvements to expand broadband access to underserved communities is also key so that residents can receive remote medical services at home, school or their community organization, regardless of where they live.

While telemedicine will never negate the need for in-person visits with doctors, it does have the potential to dramatically increase access to the highest quality of care and to improve health outcomes for all Americans. Our mission is to provide the highest quality and most compassionate care to everyone who needs it. And if we can keep people from having to make costly and unnecessary trips to the hospital by bringing the care to them, then we must do that, as well.

There has been promising attention to telemedicine recently in Washington, D.C., and in many states, including New York, where the recent state budget broadened telemedicine access to patients who receive Medicaid, an important move for underserved populations. Now we must propel the issue to the top of the public health agenda so care can reach more people outside the physical walls of health-care facilities.

Telemedicine is no longer “next-generation” health care. It is here today and rapidly growing — revolutionizing — the way we deliver care. Everyone deserves to benefit. Let’s work together to make this happen.

Steven J. Corwin, M.D., is president and chief executive officer of NewYork-Presbyterian, one of the nation’s largest, most comprehensive health-care delivery systems. Under his leadership, NewYork-Presbyterian has nearly doubled in size, comprising more than 46,000 employees dedicated to providing world-class care to nearly 3.6 million patients each year at 10 hospitals. Corwin has launched a number of groundbreaking initiatives, including NYP OnDemand, a suite of digital health services, a suite of digital health services that increases access to NewYork-Presbyterian’s world-class care, and the East Coast’s first Mobile Stroke Treatment Unit, which provides fast, specialized care to patients who may be having a stroke with additional units now in Brooklyn and Queens. Corwin is chairman of the Healthcare Association of New York State and the chair of the Health Care Systems Council of the American Hospital Association. Reach him @nyphospital.

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