Lubbock, TX, Hospitals Embrace Telemedicine

June 16--An increase in patient volume from rural areas is driving up a demand for medical services in Lubbock, TX.

Local health officials say they believe a solution that would sustain costs and provide more access lies within reach through telehealth.

"The goal of telemedicine is to bring care closer to home and provide better access," said Carson Scott. "So with that, there's technology."

Scott is the director of telemedicine and TexLa Telehealth Resource Center through the Texas Tech University Health Sciences Center F. Marie Hall Institute for Rural and Community Health.

The center was established through funding provided three years ago, he said. Its focus is to provide health facilities with the information and tools necessary to incorporate telehealth with patient care, he said. In January, Scott and a team moved into an office location in West Lubbock.

The Need

Telehealth provides a way for rural patients to receive access to care by eliminating travel time, Scott said.

Since West Texas is home to only 12 percent of the state's population, this is an optimal location for telehealth services, said Jodey Arrington, president of Scott Labs Inc., the holding company for Grace Health System.

Through telehealth, smaller clinics within the rural communities could offer services such as dermatology, urology or mental healthcare -- the services in highest demand through telemedicine, Scott said. Patients wouldn't have to drive to the nearest hospital or to the Metroplex to seek that type of more specialized care, he said.

Scott said a hospital that chooses to incorporate telehealth and make use of a rural location wouldn't spend much more than the initial cost of equipment.

The cost can vary based on the type of services a health institution wants to offer, he said. A few of the services in greatest demand in Texas are dermatology, urology and mental health.

"It crosses many disciplines," Scott said.

Resistance

Telehealth services face resistance, especially in Texas, Scott said.

Arrington said Texas has one of the tightest restrictions on telemedical care.

In an ongoing lawsuit between the Texas Medical Board and Teledoc, a Dallas-based telehealth company, a federal judge postponed the implementation of a rule put forth by TMB that would prevent physicians from treating patients without making initial face-to-face contact, according to a story published by the Texas Tribune.

On Friday, a spokesperson for the Texas Medical Board sent a statement to A-J Media concerning the use of telemedicine.

One of the organization's greatest concerns is lack of face-to-face contact between patients and doctors.

"The Texas Medical Board has always held that a physician-patient relationship must be established prior to a physician prescribing. A telephone medicine scenario that allows a physician to prescribe remotely that does not verify who the patient is, relies solely on question and answer provided by the patient without any objective diagnostic data, and with no ability to follow up with the patient, does not meet the standard of care.

"The adopted amendments to the TMB's telemedicine rules reaffirm this, and, in fact, would expand the telemedicine opportunities previously allowed in Texas. The only telemedicine scenario that is prohibited in Texas is a situation in which a physician would make an initial diagnosis to a new patient without either a prior face-to-face consultation or in-person evaluation."

Embracing Telehealth

Scott said several Lubbock hospitals are embracing telehealth practices including Grace, Covenant and UMC.

"There is so much technology available today and things that can be done," said Steve Beck, senior vice president for Covenant Health. "We're currently using it quite a bit."

The telemedicine equipment aids officials in doing tasks such as reading X-rays, he said.

Arrington said Grace currently has a telehealth program that allows monitoring of vitals while the patient is at home.

The health system is currently serving 88 patients with the program throughout the Lubbock region -- and plans to add more as early as this week -- through a remote patient monitoring device connected to a LifeStream program, Arrington said.

It gives real time feedback to health officials electronically monitoring patient progress while the patient is at home, he said.

When vital levels get too high, one member of the team of about 14 telehealth monitors reaches out to the patient and helps them get their levels back to normal.

The practice illustrates a cost-efficient side of telemedicine by decreasing unnecessary patient visits, Arrington said.

But that's not the only program in the hospital's future, he said.

Arrington said the health system has been looking into incorporating mental health services, too.

Beck added: "It's got a great future and there's a great need. It will certainly benefit many rural communities and outlying areas. The question is getting everything lined up to go with it."

Most health facilities are practicing telehealth at different stages, he said.

He and Arrington said the future of health and the need for efficiency will yield more telemedicine opportunities.

"What that allows is basically a visit to take place with a patient closer to their community and then a physician that's here. It just removes the distance; that's the simplest way to say it," Scott said.

ellysa.gonzalez@lubbockonline.com

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