Health care in a box arrives at Talbert House: Kiosk gives patients access to doctors 24/7

CINCINNATI - The revolution of medical technology has landed at Parkway Center, the hulking former Days Inn that serves as the main refuge run by Talbert House.

A large white box stands in an upstairs room reserved for medical personnel. That box is a portal to 24-hour telemedicine for the residents, with access to a physician who can read symptoms, provide advice and ship a prescription to a local pharmacy.

Provided by Anthem Blue Cross Blue Shield in Mason and manufactured by American Well of Boston, the telemedicine kiosk is the first to be placed in a Ohio facility such as Parkway Center, which provides transitional housing for homeless men and veterans with substance abuse and mental-health issues.

“So far, the response has been just great,” said Teri Nau, Talbert House’s community relations director. “This is a population that has a particularly difficult time obtaining health care, so to have this option available now provides a safety net.”

Pushing the boundaries of health care

Telemedicine is the logical next step in the blending of technology and medical care. Americans have been slow to embrace the concept, loving as they do that in-person connection with a physician. But as the Internet has changed other relationships, it’s pushing medicine, too.

For about thirty years, the federal government has been driving the development and installation of telemedicine devices, particularly in rural areas with few medical providers. The 2009 stimulus law enacted after the Great Recession spurred growth with billions of taxpayer investment into pushing medicine to adapt more quickly to the changing technological environment.

Cincinnati is a national leader in the development of telemedicine. In March, the University of Cincinnati College of Nursing held a national conference with a keynote address from UC Professor Charles Doarn, who is editor-in-chief of the Telemedicine & e-Health Journal. UC doctors in obstetrics and gynecology can use telemedicine to read, in real time, ultrasounds conducted at other locations.

Health care in a box, on the go

At Parkway Center, the telemedicine kiosk dominates its space; with its clean lines and white surface, it could be a display in an Apple store. The kiosk, about the size of a ping pong table, runs on a regular electrical outlet and an ethernet connection. In separate cubbyholes rest all the usual implements of a doctor’s office: stethescope, blood-pressure cuff, automatic thermometer, blood-oxygen reader, otoscope, weight scale. A large flat touch screen offers prompts to a patient.

Nau said that since about half of Parkway Center’s residents are veterans, they use the VA hospital system, but the other half have access to the telemedicine kiosk. A resident can come into the room, sit at the kiosk, slide a driver’s license into a card reader and begin.

While showing off the kiosk at Parkway Center, Marcus Taylor, Anthem’s regional vice president for southern Ohio, whipped out his iPhone to demonstrate Anthem’s telemedicine system.

“When you make health care convenient, it’s better for everyone,” Taylor said. “People will use it, when you have the right care at the right point of access.”

The basic fee for an Anthem telemedicine consultation is $49. Taylor said Anthem donated the $100,000 kiosk and the fees for 500 visits to Talbert House.

“This is a complement to the health-care system,” Taylor said. “It’s a great supplement to primary care.”

The doctor is... in?

About 1,000 doctors around the country are available for telemedicine visits. But if a patient develops a relationship with a particular doctor, the patient can ask to see just that doctor in future telemedicine calls.

If a doctor writes a prescription, the kiosk can send the orders to either a local pharmacy or a dispenser of the patient’s choosing.

A test drive with the kiosk rings up physician Nicole Boxer of Battle Creek, Mich. The sound quality on the kiosk wasn’t crystal clear. Taylor said if that happens on a real telemedicine call, the patient can hang up and try again for the same doctor. The kiosk provides information about the doctor at the press of a button on the touch screen.

Boxer said said she’s communicated with about 1,000 patients via telemedicine, although no one yet from the Parkway Center location. As a practice, Boxer said she finds telemedicine efficient.

“I like it a lot. It’s very different from traditional medicine, but the fact that people can have access to medicine this way is very gratifying,” she said. “I find that you can get a lot done doing medicine this way.”

What's the prognosis?

Chris Topher Weinland, operations manager at Parkway Center, said the partnership among Talbert House, Anthem and American Well with the kiosk is an experiment that will help everyone participating.

“This is the kind of thing that shows how we can work together. We try this out, we find the lessons learned, and a population that is often neglected when it comes to medicine now has really great access. We’re excited about it.”

Weinland said the Parkway Center residents at first were wary of the kiosk, but at least one resident has reported a good outcome.

“One guy used the kiosk, and the doctor he consulted decided that the guy was taking too much metformin,” a diabetes drug. “The doctor cut the dosage in half, and the guy felt better the next day. That news gets around fast.”

Connect with Anne Saker on Twitter: @apsaker.

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