Video streaming for consultation with doctors expands and becomes more popular; 2 Ky. insurers use it and another plans to

In the past, people had to go to the emergency room to receive medical attention if they required it outside the usual hours for doctors. Now telemedicine programs such as KentuckyOne Health's "Anywhere Care" and Anthem BlueCross BlueShield's "LiveHealth Online," Kentuckians can access a doctor 24/7 through a computer or mobile device.

Photo from The Lane Report

"Patients like telemedicine because it's fast and easy to use and cheaper because it's a low-overhead service," Esther Zunker writes for The Lane Report, a Lexington-based business magazine.

UnitedHealthCare, a Minnesota-based health benefits provider for many people in Kentucky, plans to cover Skype-based doctor visits through "NowClinic," "Doctor on Demand" and "American Well." Anywhere Care and Live Health Online give clients a list of certified doctors they can chat with through video on a computer or a mobile device. The doctors can provide diagnosis and treatment and even write a prescription. They can direct patients to an emergency department if necessary.

It's affordable, too. A LiveHealth Online appointment costs the same as an office visit for eligible members. LiveHealth doctors usually charge $49 per online "visit." Anywhere Care costs $35 per visit, even if patients don't have insurance.

"As we know, care can be limited and is based on being able to get someplace when [a doctor] has an opening," said John Jesser, Anthem's vice president of provider engagement strategy. "They only have certain hours, and that doesn't always work for when people don't feel well. [Telemedicine] expands access to care for the consumers, making it much more friendly to their schedule and lifestyles."

Telemedicine is also convenient for doctors. It saves money for hospitals and allows one doctor in one location to help patients in a variety of locations. Patients can receive help with chronic conditions over periods of time without having to travel to the doctor's office.

"We've had amazingly positive feedback from patients who have tried this service," said Kathy Love, director of strategy and business development for KentuckyOne Health's Central East Kentucky Market. "People have told me they've used it multiple times when they've needed it . . . either late at night or over the weekend."

She also said people who use telemedicine still need a primary-care physician: "It's something you can access 24 hours a day with a very minimal wait and very professional providers, but it shouldn't replace your very important relationship with your primary-care doctor." (Read more)

Collaboration, telemedicine save lives in rural Kentucky

Many rural women in Appalachia can now have their babies closer to home thanks to a partnership between Appalachian Regional HealthCare and UK HealthCare.

UK HealthCare women's health providers are now based at permanent community clinics in Morehead, Georgetown and Hazard, says a University of Kentucky news release. Prenatal emergencies are still transferred by air ambulance to the UK Chandler Hospital, but full-time obstetricians, telehealth and a partnership with ARH is allowing most women to deliver closer to home.

A Breathitt County mom, Elma Thorpe, shared her story about how Dr. James Dawson, one of two doctors based at the UK HealthCare Women's Clinic in Hazard saved her life and her newborn son's life in November 2012.

At 36 weeks pregnant, Thorpe had stomach pains and thought she was going into labor. She went immediately to the hospital and was admitted to the emergency department at Appalachian Regional HealthCare Medical Center in Hazard. Her regular doctor was on vacation, so the on-call obstetrician Dr. James Dawson, one of two doctors based at the women's clinic, stepped in to deliver Thorpe's baby.

While waiting to be taken to the labor and delivery department, Thorpe developed a placental abruption, which occurs when the placenta prematurely breaks away from the wall of the uterus and was causing bleeding from the womb. That cut off the baby's oxygen supply, and Dawson feared that the baby would die inside the womb before he was able to deliver. He also knew Thorpe was in danger from losing a high volume of blood.

"With some emergencies, you have several minutes or an hour, but this was one where we had only a few minutes," Dawson said. He and the ARH medical team performed an emergency Cesarean section to deliver baby Nicholas and then successfully worked to stop Thorpe's bleeding.

UK HealthCare's Women's Health in Hazard employs two full-time obstetricians with the intent to keep women closer to their home for prenatal care and delivery, even when emergencies arise, UKNow reports.

Dawson and colleague Dr. Misty Thompson live and work in the Appalachian community they serve. A partnership between UK and ARH allows them to be on-call for deliveries and emergencies, and provide women's health services at health departments in surrounding counties.

Obstetricians in Hazard also have access to the latest ultrasound technology and consultations with UK specialists in Lexington through telemedicine if they partner with UKHealthCare.

Dr. Wendy Hansen, chair of UK's Department of Obstetrics and Gynecology, said these collaborative resources and support "will improve the level of care for women in every part of Kentucky" and will also "help recruit doctors to an historically underserved area that struggles to attract providers."

Telemedicine helps reduce waits for mental-health patients in ER and provides better health-care access in schools

Health professionals have used telemedicine to help delay Alzheimer's disease and reduce hearing loss in Appalachia, especially among children. Now the new approach is helping students access health care, and mental-health patients to get faster medical attention in emergency rooms.

AMD Global Telemedicine has been establishing telemedicine systems in schools, which allow "providers to care for students on-site with few clinicians to support it," Katie Wike writes for Health IT Outcomes. So far "the Center for Rural Health Innovation in western North Carolina used the technology to support 14 school-based programs and provide care to 4,000 students.

The health-care provider can ask the questions during the exam, and "it doesn't assume the presenter knows the questions to ask," said CRHI Executive Director Amanda Martin. This approach allows one nurse practitioner to provide care to thousands of children. Some Kentucky schools are already using the telemedicine platform, Wike reports.

Sometimes when patients seek mental-health care in emergency rooms, no psychiatric services are available. In this case, hospitals often contact and wait for a provider to arrive or send written evaluations for review, Karla Paris writes for Health IT Outcomes. Now KentuckyOne Health has a telemedicine program that gives faster response times for those requesting mental-health care. For example, patients who visit Louisville's Ss. Mary & Elizabeth Hospital for mental-health care will be able to videoconference with professionals from Our Lady of Peace Hospital. "Patients can then be referred for admission at Our Lady of Peace, another outpatient program or care center," Paris reports.