Location, Location, Location (in health care delivery)

This post contributed by Health for All's Urmila Srinivas.

A six-month waiting list for patients is never comforting for a doctor, much less for the patient. Such was the case with residents of New Mexico waiting to see Dr. Sanjeev Arora, a physician at the University of New Mexico hospital and one of the few hepatitis specialists in the area.

If patients near the hospital have to wait six months to see a specialist, what about the needs of other residents that have no means of physically getting to Arora or another type of specialist? Can the problem of location be solved? Will anything motivate specialists and physicians to pick up their established lives in hospitals, clinics, and private practices and move to rural, more remote areas?

Dr. Arora, an Ashoka Fellow, understood that having the ability to communicate is an essential element of healthcare delivery and arguably sets the foundation for healthcare delivery.  If you’re lucky, your specialist lives close by and you are a subway, bus, or car ride away from an appointment, diagnosis, or treatment. The problem arises when rural and underserved populations are unable to travel and communicate with specialists who are dispersed across a state, often times much farther than a day’s worth of travel.

Teaming up with Polycom , Dr. Arora devised a method to essentially bring the doctor to the patient using telemedicine and the creation of “teleECHO” clinics. Project ECHO is designed to treat chronic diseases in rural and underserved areas of New Mexico and monitor the outcomes of this treatment. Instead of having the patient physically go to see a specialist, Dr. Arora instructs and teaches primary care providers by using visual communication methods and gives them the means to treat patients and develop a treatment plan within their community. No transportation, no car mileage, no gas- just a simple video conferencing call is made and a treatment plan is devised and recommended for the patient. The provider gives the specialist updates, notifies them of problems or issues, and stays in constant contact with them throughout the entire process.

Taking a step to eliminate location as a problem for individuals inflicted with chronic, complex diseases and living in remote areas, Dr. Arora has set the momentum for telemedicine to be a fantastic and effective solution to this seemingly difficult problem.

Focusing initially only on Hepatitis C, the program has expanded “TeleECHO clinics” to the following areas:
-    Child and Adolescent Psychiatry
-    Child Adolescent Family and Community Psychiatry
-    Chronic Pain and Headache
-    Diabetes and Cardiovascular Risk Reduction
-    Hepatitis C Corrections
-    High Risk Preganancy
-    HIV/AIDS
-    Integrated Addiction and Psychiatry
-    Medical Ethics
-    Occupational Medicine
-    Pediatric Obesity
-    Psychotherapy Community Clinic
-    Psychotherapy Residents Clinic
-    Asthma and Pulmonary
-    Rheumatology

To date, Dr. Arora has enrolled more than 3,000 patients in his Hepatitis C disease management program. ECHO is currently expanding to Washington State and Dr. Arora hopes to spread the program internationally.
   
For more information on these areas visit TeleECHO Clinics.

Picture credit: University of Texas Medical School