Mature and Advanced Telemedicine Program: An Interview with Morgan L. Waller, RN
What is a Mature or Advanced Telemedicine Program?
A mature or advanced telemedicine program is characterized by a pervasive network of modern, audio-visual technology, which delivers healthcare remotely. It ensures the standard of care is maintained and improves efficiency. An advanced telemedicine program offers an alternative to in-person communication and assessment for nearly all traditional patient-provider encounters.
Accomplishments of a Mature Telemedicine Program
In fiscal year 2024, Children’s Mercy Kansas City had 4,689 RN-facilitated, digital device-enabled, level 2-5 encounters hosted at five regional outreach multi-specialty telemedicine clinics. They also had 49,992 direct-to-patient home appointments and 54,681 total telemedicine visits, accounting for approximately 16% of total outpatient visits.
What is Missing in a Mature Telemedicine Program?
Our telemedicine program does not yet offer an audio-visual telemedicine presence in the emergency rooms, in our ambulatory clinic exam rooms, nor our critical care units. Although we do asynchronous retinopathy of prematurity interpretations, I would like to see us do more. We do not yet have asynchronous telepathology, nor asynchronous dermatology. We have had in the past real-time tele-surgical collaboration; we do not currently.
Why Do Healthcare Systems Struggle with Telemedicine Implementation?
A collection of issues that have hindered our national healthcare for decades are getting worse, not better. What makes it difficult for health systems to implement and maintain telemedicine is the struggle between fee-for-service and managed care, the healthcare delivery to reimbursement labyrinth grows daily, insufficient numbers of providers, CMS and private insurance dictating who provides care, and consumer understanding of telemedicine and empowerment to ask/demand for the services is in the toddler phase.
Advice for Peers Looking to Grow a Mature or Advanced Telemedicine Program
I would offer the following advice:
- Hire a natural leader – someone with experience, not so much to have become cynical, but someone with energy who believes anything is possible. Give them access to the resources they need, time, people, a well-funded budget. Remove barriers and tell them they "won’t be the first, but they will be the best" (borrowing a quote from Steve Jobs), and then let them build the telemedicine program.
- Financial investment is required to create a mature telemedicine program.
Conclusion
In conclusion, a mature or advanced telemedicine program is characterized by a pervasive network of modern, audio-visual technology, which delivers healthcare remotely. While there are still areas that need improvement, such as asynchronous telepathology and dermatology, the telemedicine program at Children’s Mercy Kansas City has made significant strides in providing access to highly sought-after medical professionals via virtual care technology. With the right leadership and financial investment, healthcare systems can create a mature and advanced telemedicine program.
FAQs
Q: What is the most important piece of advice you would offer your peers at other hospitals and health systems looking to grow a mature or advanced telemedicine program?
A: I would offer the advice to hire a natural leader and provide them with access to the resources they need, time, people, and a well-funded budget.
Q: What are the challenges that health systems face when implementing and maintaining telemedicine?
A: The challenges include the struggle between fee-for-service and managed care, the healthcare delivery to reimbursement labyrinth grows daily, insufficient numbers of providers, CMS and private insurance dictating who provides care, and consumer understanding of telemedicine and empowerment to ask/demand for the services is in the toddler phase.
