January 15, 2009

Telemedicine in Hawaii: A Model for the Developing World?

Today, January 15th, the Hawaii Medical Service Association (HMSA), an independent licensee of the Blue Cross and Blue Shield Association, launched its Online Care health care system that allows Hawaii residents to talk with a local physician or specialist from HMSA’s PPO network through the web or telephone for a session lasting ten minutes (see "Hawaii tries out online health care"). HMSA is licensing the online system from American Well, a Boston-based company that creates and delivers innovative health care communication services to organizations across the country. (Photo courtesy of New Wave Marketing)

Except for brief maintenance work scheduled during low-usage periods, the system is available seven days a week, 24 hours a day. In The New York Times article published on January 5, 2009, "Doctors Will Make Web Calls in Hawaii," "The Hawaiian health plan’s 700,000 members pay $10 to use the service. The insurer also offers the service to uninsured patients for $45. Health plans pay American Well a license fee per member and a transaction fee of about $2 each time a patient sees a doctor."

The physician and HMSA members will have real-time access to the patient's electronic health records, provided that prior access has been granted to the physician. In addition, anyone who uses Microsoft HealthVault to collect, store and manage their personal health information can make that information available to the consulting physician.

In explaining why HMSA is offering this system, the company says they understand "that one of the most important benefits of the system is improved access to care, especially for residents in rural or isolated areas of the state. Using a computer or phone, access to the system is nearly immediate." While they also understand "that online health care is not a replacement for face-to-face visits with your physician...it is another way for you to access care when you need it. HMSA sees the system’s vast possibilities and benefits for HMSA members, providers and the community."

Can this telemedicine model serve as an example of expanding the reach of providing medical services and health care education to the developing world? Yes. The need to have Internet access with adequate bandwidth to run the software is essential. I recommend continuing collaboration between governments, civil society, and the private sector to expand capacity building, and designing and implementing systems similar the one created by American Well.

A viable telemedicine system should serve as a vehicle to that will diagnose and treat patients, monitor patients with chronic illnesses or diseases, and provide essential nutritional and preventive health care information. In other words, it is important to develop a program using the latest technological platforms, but an effective system should focus on providing quality and relevant content. A successful program should focus on empower and educate individuals, whether they reside in industrialized or developing markets. on preventing illnesses and making informed health care decisions.

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