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Showcasing mobile telehealth technology on Capitol Hill

Simulating in-person doctor's visits, sometimes called 'virtual visits', has become fairly trendy says the Wall Street Journal. Isn't it great that United Health Group and Cisco are 'unveiling' a new telehealth network and parking the demo on Capital Hill. And United Health Group is committing tens of millions of dollars to the effort. Mobile Connected Care, no doubt something that could employ Cisco's costly telepresence equipment (averaging $300,000 per Forrester report in 2007), launched last year, and benefiting from a very applied use as enterprise IT budgets have flattened and shrunk. Mobile telehealth -- good PR, but a work in progress.  In an example of well-timed advance PR, Cisco's VP for its Internet Business Solutions Group Healthcare Practice, Dr. Kaveh Safavi, was quoted recently in the San Jose Mercury News as advocating for bringing back the house call -- virtually. And here it is. But in terms of Cisco and United Health Group's offering, a bit of perspective may be in order here:

Great press, not much happening yet. Just as with GE and Intel's telehealth alliance, it's great press, beautifully timed and presented in Washington to concide with Congressional discussion of health care cost savings. The first service is planned for rural areas of New Mexico and ProjectHOPE, an international humanitarian effort to bring healthcare to more rural areas. No other deployment plans were indicated. And while there are Medicare codes available today for telehealth, most care delivery is still in the context of doctors' offices and clinics.

See VA for proven telehealth cost savings. The Veterans Health Administration (VHA) introduced home telehealth through their Care Coordination/Home Telehealth (CCHT) program between July 2003 and December 2007, reducing hospital bed days of care by 25%, hospital admissions by 19% and boosting patient satisfaction by 86% at a cost of $1600/patient per year.

And think about virtual doctors visits -- via the telephone or e-mail.  Doctors want to be doctors and the provider location-centric system is putting them under enormous pressure that could be alleviated if they were paid the same for virtual visits. Telephone-based (and e-mail) access to doctors is a growing business. TelaDoc, with a $35/visit price point per encounter, has grown from 300,000 to 2 million members over the past 18 months. eDocAmerica (e-mail with 1 million members), ConsultADoctor (e-mail, telephone, several hundred thousand members) have all joined the phone/e-mail services for accessing a doctor for advice, diagnosis, and prescription.

The traveling doctor.  Getting a Medicare-certified doctor to come to the house (or assisted living facility) is not as difficult as it might have been. Iin California, 1-800-Call Doc sends a doctor out on a house call, including in-home X-Rays.  House Call Medical Care does the same in the NY area. 

Telehealth and mobility -- where the citizen is. ConsultADoctor's website notes that '70% of doctor visits are informational' and could be provided by phone or e-mail at a fraction of the cost of today's visit-centered care delivery system. This includes, no doubt, the triggering of a referral to a specialist, which for the 65+ population may actually be multiple specialists, consuming more visit time than that of the primary care physician. 

Cisco and United Health Group -- a beginning. To quote Jane Sarasohn-Kahn, author of the Health Populi blog notes: "health care should be delivered where the citizen is."  The predominant health care delivery based on in-person visits is inefficient, draining costs and energy out of the 'citizens' and threatening the incomes of providers. Caution about too much hype in DC: the Cisco/United initiative is just a limited tip of the care mobility (and transformation) iceberg to come.


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