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Texas companies, agencies and researchers take the lead when it comes to telehealth

From where Craig Walker sits, telehealth's time has arrived.

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Of course, as the vice president of public policy for HealthCare Vision Inc. in Austin — a company that offers telehealth technology — it's Walker's job to convince others that things such as videoconferenced patient consultations and online pharmacies are ripe for the taking. And there's logic lies behind the marketing pitch. "The cost of the technology is coming down, the infrastructure needed is becoming ubiquitous and homeland security is catapulting telehealth into the spotlight," Walker says. The time for Austin's spotlight in telehealth may also have arrived.

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The area's tendency toward technology and the fact that it is the heart of the state in many respects — geographically, politically and otherwise — lead many experts to believe telehealth will be a blessing to the local health care industry, and a boon for a variety of Austin businesses from consulting firms to tech startups. Last year, for example, Forgent Corp., an Austin-based videoconferencing and software company, profited from a deal with the Physicians Telehealth Network Inc. to launch a telehealth pilot program in Ohio this year.

Locally, telehealth or telemedicine initiatives have already taken off to some extent. Rural hospitals in surrounding Central Texas communities such as Rockdale, Taylor and Gatesville were recently linked to health care giant Scott & White in Temple through the Central Texas Telehealth Network. The network also involves four of Scott & White's satellite clinics. Dr. Gregory Hobbs, Scott & White's director of telemedicine, has been working on the project for almost four years. He is just now seeing how video, Internet connections and computer technology can bring patients instant access to potentially life saving information and immediate second opinions from specialists without leaving their hometowns. From their Temple office, Scott & White medical consultants can "see" patients via standard desktop computers. The network gives rural doctors and patients quick and convenient access to specialists in emergency medicine, endocrinology, nephrology, cardiology, plastic surgery, pediatric neurology, orthopedics and mental health. And there's another testament to the growing acceptance of telehealth — a telemedicine training program is being established in Central Texas through a $117,000 grant from the Texas Telecommunications Infrastructure Board.

The Austin Medical Education Programs Family Practice Residency is working on the project with Llano Memorial Hospital, the Hoerster Clinic in Llano, Pecan Valley Area Health Education Center in East Texas and the University of Texas Medical Branch's Center for Telehealth and Distance Education in Galveston. The grant will establish a telemedicine program allowing for expansion of training for rural primary care physicians and improvement of health care delivery in the Llano area between Austin and San Antonio. "The goal of this project is to deploy advanced telecommunications technology in a collaborative effort so that resident education, physician continuing education and patient care can be emphasized," says Russell Thomas, program director at Austin Medical Education. The AME program provides medical services for training of resident physicians. It is affiliated with Austin's Seton Healthcare Network, which provides health care services at 20 locations in Central Texas. The University of Texas Medical Branch in Galveston, or UTMB, is establishing a one-of-a-kind telehealth research center thanks, in part, to a recent $1 million donation from the SBC Foundation, part of SBC Communications Inc. "We are entering a new era in technology, and the result of this research is going to have a global impact on the medical industry and the insurance companies," says Barry Beasley, director of external affairs for SBC Communications.

"A lot of people have talked about it, but no one has ever performed the rigorous research that will be done here to quantify the effectiveness of telemedicine," Beasley says. It's because of telehealth's growing acceptance and use by doctors that the facility is being established, according to UTMB Vice President Dr. Ben Raimer. The research center is scheduled to be operational in April. Raimer says research at the center will be a way to validate the effectiveness of telehealth in diagnosing and treating people who live in remote locations across Texas, the United States and around the world. In addition to providing research data for physicians and patients, information gathered at the center will also help insurance providers establish reimbursement policies for health care professionals who use telemedicine.

Walker was one of a handful of telehealth experts invited to Washington, D.C. recently to give the federal government input and guidance on telehealth issues. He says aside from some infrastructure inadequacies, the primary barrier to telehealth is insurance reimbursement policies, which don't always recognize telehealth services. "But on the bright side, Texas [laws] are better than most states," he says about insurance reimbursements for telehealth care. UTMB says it has already performed more than 53,000 live video consultations, with a current pace of about 1,800 a month. The university predicts the number of consultations will double by the end of the year.

While most of the consultations are in Texas, the technology has allowed UTMB physicians to consult with patients as far away as the South Pole. UTMB has telemedicine contracts with five Texas school districts and a pilot project linking geriatric specialists with four rural community clinics and a county hospital. The technology is also being used to provide health care for workers on offshore oil rigs and passengers on cruise ships. Austin-based Carpe eDatum Inc. provides much of the technology that makes it possible for cruise ship doctors to seek advice from land-locked medical specialists. Carpe eDatum and the University of Texas Medical Branch at Galveston extended their relationship last month to enhance UTMB's telemedicine program even further. Carpe eDatum CEO Gary Mermelstein says the university will provide the medical guidance, and his company will supply the necessary technology. Supply and consulting contracts are tangible ways businesses can cash in on telehealth, but it promises to help employers of all types, regardless of whether they are directly tied to the emerging industry.

Raimer, for example, sees virtual office visits as a way to help lower the expense of health care for employers. He says in certain cases it's much more cost effective to use telemedicine in place of time-consuming office visits for workers. At test sites UTMB has set up in area workplaces, researchers have determined that the average employee is away from a work station for approximately two hours while visiting a doctor. Researchers say if an employee were able to dial in from a workplace computer to see a doctor, loss of productivity could be greatly reduced. Those involved see few limits for the future for telehealth. Taking it to remote or rural areas is just the beginning. "Telehealth isn't just valuable to remote areas," Walker says. "Inner city needs are just as prevalent as in rural areas."

Email COLIN POPE at (cpope@bizjournals.com).