Bill Klaproth (Host): Telehealth technology continues to grow in the healthcare industry. It is estimated to have 700 million patient users by 2018 according to an IHS Technology Report, so what are the uses and benefits? Here to tell us more is Dr. David Haseltine, a Chief Medical Informatics Officer at Tidelands Health. Dr. Haseltine, thanks for your time. Right now, how do you utilize Telehealth at Tidelands?

Dr. David Haseltine (Guest): Sure Bill, there are a number of ways that we're using Telehealth within Tidelands both in the inpatient and the outpatient experience. On the inpatient side, we have a strong Telehealth presence both in the Emergency Department, which connects with a psychiatrist and neurologist down at MUSC, the Medical University of South Carolina. That allows people in an emergency situation to both evaluate their psychiatric needs and their neurology needs in places that we don't have subspecialty service on staff. When you have that emergency crisis that requires the psychiatric component, or you're having a stroke, for example, you have the benefit of subspecialty care that's not available in the area, but it is available about an hour and a half away at Charleston. That provides some great benefits there.

On the inpatient floor wards, we also use Telehealth from a pediatric perspective, and we're opening up the neonatal or a children-infant based perspective as well. So, a case scenario and point that we had -- about a year ago I had a young child who had asthma who had some respiratory distress issues, was rapidly worsening on the floor and he really needed a pediatric critical care specialist immediately. That, of course, we don't have in our hospital, but because his respiratory situation was so dire, he was almost to the point of needing an intubation and being put on a ventilator. Fortunately, with the help of Telehealth, we were able to call a critical care pediatric specialist to the bedside who was able to interact with the patient, evaluate them, and provide a much-needed stabilizing measure that ultimately prevented this child from even being intubated. The child did ultimately fly down to Charleston for some added specialty care, but that hospital stay was certainly quite foreshortened as a result of not having to be intubated and on a ventilator. It allows us to provide a lot better subspecialty care in a local environment even when those critical ER specialists aren't available, for example.

In the outpatient arena we are able to incorporate those sub-specialists as well, so for example, psychiatry and neurology, which are two of our areas that we don't have a lot of sub-specialists available, we frequently have people who do outpatient office consultations. They're able to get medication changes, quite commonly things that I'm not able to prescribe from a psychiatric or neurological perspective, so it helps on the outpatient perspective as well.

Bill: So how has this grown over the years at Tidelands?

Dr. Haseltine: Sure, I think we initially started out in a small area in the Emergency Department, and then we rapidly were able to progress to almost every floor now has the capability of having an emergent consultation as needed, so it's not just limited the Emergency Department now. On the outpatient basis, I think we started out with my office, and now we’ve got -- the Medical University of South Carolina probably has about 20 or so offices in the local area, the majority of which are Tidelands owned and operated who are now participating on the outpatient basis as well. It really has, over the course of about three to five years, mushroomed into a quite larger experience that is available to a large number of people in a local area.

Bill: So mainly you use this in the ER right now?

Dr. Haseltine: We do for the inpatient, but for the outpatient, it's quite widespread. I think I’ve got -- nearly every day we have at least one person who's coming in for a consultation with someone down in Charleston on a regular basis, so it's nearly a daily use in the outpatient arena, as well.

Bill: And from the patients' point of view, how do they like it?

Dr. Haseltine: I think patients have really been responding quite positively to this. If you think about it, there are three categories of people who really enjoy and benefit from the use of this. One is our elderly population who find it difficult to drive for long areas. A lot of times there are people who otherwise could have driven down to Charleston in order to make their subspecialty visit. That's a long drive, a tedious drive for some of them, especially when you're over the age of 60. They benefit from just having to drive a short five or ten minutes to their local physician's office now. They don't have to end up driving all that distance.

For those people who don't have reliable transportation, then it's usually much easier to get to your doctor's office than it is to try to find a family member or use a care that's not very reliable to drive that two or three hours down to Charleston with traffic nowadays and then to make that same trip back.

And then the third population that finds it really helpful is working families, so a lot of times these are people who -- a lot of times in order to get down to Charleston and back really would have had to take a half a day or a whole day off of work and in this case we can book them an office visit, which usually lasts them 15 to 20 minutes. There they take maybe an hour or two out of their day instead of a half or whole day instead. For working families, for people who don't have reliable transportation, and for our elderly population we find there's a lot of benefits.

Bill: So are we at the point where people can dial in or utilize Telehealth from their home, yet?

Dr. Haseltine: Not quite yet. Although, there is a project I know that Sarah Allen with Tidelands Health is working on where we will actually be able to contact from your local doctor's office to either your phone or a Skype-like meeting at home so if you’ve got an iPad, a phone, or a home webcam, we may be able to actually call in and see how you're doing at home, as well, from a Tidelands office, as well. That is coming in fairly short order.

Bill: And what about the doctors being able to see patients that they might not have otherwise has got to be exciting for them?

Dr. Haseltine: Sure, I think it’s really helpful, especially for some of the surgeons who are doing follow-up visits; that makes it a lot easier. The patient doesn’t have to come in after surgery; they can just check in on them maybe at home or in brief office visit, so it makes it a lot easier for recovery time if you’re not having to move excessively around.

Bill: And does Telehealth offer data analytics that can improve population well-being?

Dr. Haseltine: We are probably not there, yet. I think that everybody is trying to get to that point where data analytics and population health make an improvement, but the numbers of Telehealth are still fairly small. I don’t think that we’re seeing a lot of good data yet. I have heard that there are some preliminary data out there with David McLean out of MUSC who is a pediatric critical care specialist, that actually reduced both the cost involved in transportation as well as the severity of illness in terms of their – but that’s preliminary data. I’m not sure if he’s published quite yet, but he’s an expert, and I think he’s on his way to doing that and some of those are data from both Tidelands cooperation with MUSC that we’ve done already.

Bill: So it sounds like Telehealth is here to stay. How do you see it growing in the future?

Dr. Haseltine: Sure, I think in the future, we’ll see even more improvement in terms of being able to stay at home or wherever you’re at. I think we’ll see much less involvement of having to go directly to a doctor’s office in order to do routine checkups. Some of those things can save you time, save you expense and energy. People are already trying to use urgent care centers because they find them easier, closer to home, less waiting time. I think a Telehealth actually provides an advantage for a doctor’s office and if you’re trying to compete with an urgent care or retail center in terms of price and convenience, you can certainly provide a better convenience if you can meet the patient where they’re at as opposed to the patient having to go to an urgent care center. We think for physicians who are trying to maintain their competitiveness this obviously will be a great option for them.

Bill: So does Telehealth offer data analytics that can improve population well-being that benefits patients in the long-run?

Dr. Haseltine: I think there are some integration that’s occurring in that area, for example, our vendor who is E-Clinical Works is integrating Telehealth directly into their electronic medical records, so we have the option of intertwining both the official visit and – really you can see if your patient is in a Telehealth visit it shows up on your regular schedule and your electronic medical record as well. That interaction is coming. It’s in the early stages right now.

Bill: And Dr. Haseltine, why should someone choose Tidelands for their healthcare needs?

Dr. Haseltine: Sure, Tidelands is an outstanding organization that I’ve had a great opportunity to work with for about the past 12 to 14 years, so I know there are excellent physicians here who are very caring, very involved in seeing patients’ successful health stories come to fruition. We certainly are caring for people on an individual basis as well as a local community but we certainly how that people will consider Tidelands moving forward.

Bill: Absolutely, and thank you, so much for your time today. Very interesting topic. And for more information about Tidelands Health physicians, services and facilities, visit TidelandsHealth.org, that’s TidelandsHealth.org. This is Better Health Radio. I’m Bill Klaproth, thanks for listening.