Virtual doctors treat real patients at remote digital clinics

Telemedicine is improving the quality of health care coverage at remote medical clinics throughout the U.S., like the one at Jones Wheat Elementary in Bainbridge, Ga.

These kinds of clinics are regularly staffed by one, overworked, overstressed, nurse, who is charged with the care of hundreds, or sometimes, thousands, of school children. But advances in Bluetooth wireless technology, including a ”virtual stethoscope,” and video teleconferencing, are allowing physicians from all over to provide online consultations with these patients.

This new technology allows a sniffling patient to sit down in the clinic and, with wireless cameras, and monitors, be seen by an out-of-town physician online.

A nurse wields the medical equipment, in place of the doctor, and the digital data from the diagnostic tools streams over the Internet. A so-called Horus scope allows the nurse to show any problem area on the patient’s body to the doctor, and also enables the physician to hear the patient’s heartbeat, or other bodily sounds.

“When you connect your stethoscope to your computer, the physician on the other end is doing the same thing,” says Loren Nix, liaison for the Georgia Partnership for Telehealth, which is funding the $30,000 project at Bainbridge, along with the Georgia State Office of Rural Health.  “So, as she is listening to the patient's heart sound here, the physician hears the same thing on his end, just as if he were in the room with the patient.”

All registered nurses in the Decatur County School District, south of Atlanta, near the Florida border, were recently trained on the new equipment, developed by Avizia. "We're excited because our goal is to help our kids and to keep them healthy so that they stay in school," said Cindy Harrell, the director of school health care for the school district. "If we have a parent that can’t get their child to the doctor as conveniently because of work or location, we can use this technology."

Though there are some concerns about physicians being properly paid for the services rendered, most interestingly, from a public health perspective, health care providers are actively pursuing these telemedicine advancements, according to a recent survey released by health care law firm Foley & Lardner. “There are many viable options for getting compensated for practicing telemedicine,” said Larry Vernaglia, chair of Foley’s Health Care Practice. “The smartest thing organizations can do now is to continue developing programs, and be ready for the law to catch up -- because it will.”

The poll asked senior executives of for-profit and non-profit health care providers about the future of telemedicine and how their organizations are navigating regulatory and reimbursement hurdles, as well as other barriers to widespread adoption of telemedicine. Key findings in the 2014 Telemedicine Survey Report include:

  • Nine out of 10 report their organizations have already begun developing or implementing a telemedicine program
  • And 84% say that offering meaningful telemedicine services will be central to the success of their organizations in the future. 

The majority of respondents currently offer remote patient monitoring services (64%), store and forward technology (54%) and real-time interaction capabilities (52%).

“Telemedicine offers new ways for providers to manage this new level of risk and keep their patients healthy, happy and out of the hospital,” Nathaniel Lacktman, a partner and health care lawyer at Foley, told

Interestingly, at this point, some health care providers report, up to 40% of telemedicine consults are not paid for, or reimbursed, by the insurer, usually Medicare or Medicaid. However, with Obamacare, this is expected to change, so the doctors continue to provide the services.

Urban initiatives

Rural health care isn’t the only system benefiting from the technology. Urban health care providers, and patients, are as well. Based in Cleveland, University Hospitals Rainbow Babies  & Children's Hospital  (UH Rainbow) teamed up last fall with HealthSpot, an Internet technology provider, to offer patients access to board-certified pediatricians after hours and close to home.

The technology being used in the Cleveland “UH Stations” is a cutting-edge telehealth system developed by HealthSpot that connects patients to UH Rainbow pediatric experts seven days a week through a private, walk-in kiosk with high-definition videoconferencing and interactive digital medical devices. “HealthSpot stations are an innovative step in providing better care for children,” said Dr. Andrew Hertz, medical director for UH Rainbow Care Connection. “Our goal with UH Rainbow HealthSpot stations is to improve the quality of outpatient care for children, and decrease unnecessary emergency visits and hospitalizations.”  The state and federal government are providing funding for the project, as the patients are primarily from families, who receive government-subsidized health insurance, and these patients often head to local hospital emergency rooms with less-than life-threatening emergencies, due to the convenience of them being located in their home neighborhoods.

Even university medical clinics are implementing this kind of virtual medical visit technology. Though university towns are often urban, they also service patients in the surrounding exurban or rural areas.  At the University of Virginia health care system, physicians last year conducted 40,000 consults via telemedicine in 40 specialty and subspecialty areas. “UVA has been able to extend its services into hard-to-reach areas, improve the quality of patient care and reduce costs for both patients and the UVA,” David Cattell-Gordon, director of the UVA Office of telemedicine, told