At a Glance
- Patients save time and money
- Practitioner support
Healthcare Center Extends RealPresence Medical Safety Net to Remote California North Coast Patients
Open Door Community Health Centers provides a medical safety net to remote northern California Patients with an extensive telehealth network.
In its quest to provide healthcare and education to underserved patients, Open Door Community Health Centers (ODCHC) is making the kind of headway some organizations only dream about. Ten ODCHC clinics serve two counties in the northernmost areas of California, where patients are treated locally by primary care personnel and a handful of specialists. But for patients in towns with no local access to psychiatrists, cardiologists, or experts in other fields, seeing a specialist means missing a day of work and a long and costly drive to a larger town—enough of a burden for some patients to skip treatment. To offer an affordable and convenient way to get that kind of care, ODCHC turned to a high-definition (HD) telepresence network from Polycom and Solution Conferencing.
Through its telehealth network, ODCHC puts patients face-to-face with an array of specialists, from pediatricians and allergists to gynecologists and behavioral health clinicians. In addition to remote consultations, the service offers a cost-effective way to educate patients and providers, and has been shown to lead to better outcomes for patients trying to manage diabetes and other chronic conditions. Behind the telehealth network is a Polycom UC Intelligent Core infrastructure that connects Polycom enabled healthcare carts and Polycom desktop and room-based video conferencing systems. Solutionz designed and deployed the Polycom environment, and provides ODCHC staff with training, grant assistance, and 24x7 technical support.
Delivering Care Remotely along California’s Rugged North Coast
Throughout the United States, physicians in all fields are migrating to centers of excellence in large cities. For people who live in remote or hard-to-reach places, are financially strapped, or are blocked by language or cultural barriers, the lack of local specialists makes it difficult to access proper medical care. The residents of California’s rugged North Coast once knew this story well. The region’s ridges and valleys have long separated poor, working class and uninsured families in Humboldt and Del Norte counties from comprehensive healthcare.
So in 2006, ODCHC answered that need by opening its Telehealth & Visiting Specialist Center (TVSC) in Arcata. A Federally Qualified Health Center, ODCHC relies on Polycom telepresence to remotely deliver the expertise of specialists in multiple fields. “These doctors come in four to eight hours a week to see safety net patients,” explains Frank Anderson, RN, ODCHC’s director of telehealth development. “For our clients, driving 50 to 100 miles to the doctor is a big deal. Now they can see a specialist without leaving their hometown.”
Creating a Patient-Centered Medical Home
Regular, face-to-face contact has proven crucial to a successful patient-centered medical home, especially for clients with chronic conditions such as diabetes or HIV. And it works: In 2009, ODCHC tracked glycated hemoglobin (A1C) levels in 42 participants in the center’s diabetes self-management counseling program via telepresence. Before entering the program, only 17 clients had A1C levels of less than 7%. Six months into the counseling program, 28 patients had these preferred (lower) A1C levels. And the number of patients with A1C levels of greater than 9% was nearly cut in half, from 11 to six. “With our Polycom telehealth network, the entire healthcare team is in a much stronger position to keep each patient well,” says Anderson. “It helps us promote long-term wellness and deliver better, more accountable care.”
Every clinic site has at least one Polycom endpoint, and TVSC has one in every examination room. So it’s easy to collaborate not just across the ODCHC network, but beyond it to consult with other experts on tough cases, or to fulfill Continuing Medical Education (CME) requirements. For instance, ODCHC staffers participate in Kaiser Permanente’s live, interactive CME programs. ODCHC also hosts “lunch and learn” sessions featuring cultural competency presentations, interpreter training, EHR implementation, and more.
Every year, ODCHC conducts 1,100 to 1,200 appointments over video. While 70 percent involve physician consults, other sessions often involve ODCHC staff presenting symptoms of current patients to specialists who aren’t part of the ODCHC practice. “Our cardiologist might recommend a sub-specialist in San Francisco,” says Anderson. “They usually require two visits—a preliminary exam and then the procedure itself. Because we now can do that first visit over video, we’re saving the patient 12 hours of driving and potentially hundreds of dollars if they have to stay overnight.”
Using a Reliable, Secure Network
And in a new teledentistry project with UC San Francisco, local dentists will use intraoral cameras to present to UCSF oral surgeons, who then offer a diagnosis. Joe Lewis, ODCHC’s IT director, says Polycom’s HD video quality and its commitment to open standards contribute to successful consults. “Our superior video infrastructure makes other institutions happy to work with us,” says Lewis, who manages the center’s Polycom UC Intelligent Core infrastructure. “By collaborating with Solutionz and Polycom, we have a telehealth environment that’s reliable and secure, and that interoperates with just about everything.”
But for ODCHC, this is just the beginning. Anderson is anxious for state and federal policies surrounding reimbursement for services delivered across state lines, and credentialing for telehealth services, to catch up to the technology that powers them. “We’re proving the benefits of telehealth every day by delivering low-cost, quality care to people who need it most,” he says. “Once we resolve these policy issues, we’ll be able to help even more.”