Reengineering health care delivery using telemedicine

Traditionally, the practice of medicine has been based on interaction of the patient and health care resource in the same place and at the same time. In a region with numerous remote areas, that meant the patient traveled up to 300 miles and lost one or two days of work-time in order to obtain specialty care. This remoteness of duty stations also translates into professional isolation for primary care providers (PCP). Interactive telemedicine has changed this paradigm by re-engineering the delivery of healthcare for both the patient and the PCP. Telemedicine programs can empower the providers with access to web-based medical databases and tele-videoconferencing consultation with specialists. As a result of this telementoring, patients are often cared for at their duty station when they might otherwise have traveled for care. The telemedicine program in use throughout Region Nine (southern California) has delivered multispecialty care to over 170 patients. The program has demonstrated an increase in appropriateness of consultation request, improved access to care, enhanced provider education, and higher customer satisfaction.