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California Program Uses Telemedicine to Reach Medically Underserved

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Doctor-patient interaction is the key to a new telemedicine pilot program with community centers in California.

Under the California Telemedicine Pilot Project, more than 15 sites will be equipped to deliver telemedicine primary and specialty services using the networking system known as Cisco HealthPresence.

The "care-at-a-distance" plan will allow patients to visit a center with high-definition cameras and electronic scopes linked to physicians who may be a long distance away. While a physician assistant stands next to the patient and uses the necessary medical instruments, the physician can see or hear what's necessary in the examination, such as a patient's heartbeat. In turn, patients will be able to see and listen the same way as clinicians.

Indeed, potentially multiple members of a care team, including a primary care provider, specialist, case manager, and family members can meet in "real time"—at a distance.

"We're always looking for ways to reach the Medicare and Medi-Cal populations. A lot of patients, such as the disabled and blind population have mobility issues," says Rafael Amaro, MD, a medical director at Molina Health Care Inc.

Molina Health Care Inc. is a multi-state managed care organization that arranges for the delivery of healthcare services for Medicaid and Medicare beneficiaries and other government sponsored programs for low-income families and individuals. Molina Healthcare's licensed health plan subsidiaries serve about 1.4 million members.

Besides Molina Healthcare, other centers taking part include Mountain Health & Community Service and LaMaestra Community Health Centers, both in San Diego; and the University of California-Davis. The programs are expected to be operating within the next six months. Amaro says he is unsure how many patients may be served in the telemedicine pilot project.

The networking equipment company, Cisco Systems Inc., is contributing $10 million in products and services to support the project.

Telemedicine is considered a fast growing area for healthcare delivery options. In fact, Congress has earmarked billions of dollars for broadband infrastructure that can support telemedicine, according to Cisco officials.

Although the Cisco system, known as HealthPresence, has been in clinical settings for two years, company officials say the new pilot demonstrates the scale in which telemedicine can work, as well as new dimensions to the program.

Cisco officials said the state-of-the-art medical diagnostic equipment will provide healthcare professionals with excellent evaluation capabilities that is more "participatory and immersive" than in-person visits or telemedicine programs of the past.

"The technology has been around for a while, but this product is very high definition and capable with different instruments measuring the patient's needs," says Amaro. "We have stethoscopes you put on a chest and listen. You can use an otoscope and check the ears. You can look inside a throat."

In a statement, Gov. Arnold Schwarzenegger said: "We have been laying the groundwork for years with our Broadband Task Force and Telehealth Network and we are beginning to see fantastic results, including greater access to quality medical care throughout the state."

"What Cisco is doing here with the latest in high-tech approaches and communication is the future of medicine," Schwarzenegger said.

The Association of American Medical Colleges has estimated that the country is facing a potential shortage of 159,000 primary care physicians by 2025 because of population growth, aging, and other factors, according to Cisco. Telemedicine technologies are expected to help scarce healthcare professionals reach the widest possible population in the most efficient manner, according to Cisco.

"Healthcare is in the midst of a major market transition—and technology can make a tremendous impact," says John Chambers, chairman and chief executive officer of Cisco.