For hospitals, cost also is a major factor. In addition to physicians, physician assistants and advanced practice registered nurses, the long list of covered caregivers includes psychologists and psychoanalysts; clinical mental health counselors; social workers; and alcohol and drug abuse counselors. And at the University of Vermont Health Network, "there has been a lot of work done on telemedicine" over the years, said Barbara Paganelli, a project manager for the network. Caregivers also talk about making health care easier to access, especially in rural areas where isolation and transportation are potential barriers for patients. Nor is the basic technology that enables it — generally, a secure broadband connection and a webcam or other video setup.
Tieman said the hospital association supports the bill, and it's also welcome news to the hospitals that are looking to expand their telemedicine offerings. At the Brattleboro Retreat, administrators are planning to set up remote psychiatry consults. Brattleboro Memorial has a neurologist on staff. Grace Cottage is working directly with pilot program patients to get them set up and make sure they're comfortable with the system. And soon, a group of patients suffering from diabetes and hypertension will be chatting with Grace Cottage Hospital staffers by webcam from the comfort of their own homes. And they previously looked into home monitoring programs, but limited insurer reimbursements were an obstacle. But the hospital recently announced a partnership with Dartmouth-Hitchcock Connected Care that will bring the New Hampshire hospital's neurology experts into Brattleboro's emergency room via video conference. A bill approved Friday by the state Senate, S. Josephson also is hoping for better outcomes due to quick telepsychiatry interventions. Grace Cottage administrators said they had not been able to afford Dartmouth-Hitchcock's telemedicine service. In Brattleboro, the Dartmouth-Hitchcock collaboration is expected to improve safety and shorten response times - a major factor when attempting to limit stroke damage. It says all insurance plans including Medicaid should cover telemedicine services "to the same extent that the services would be covered if they were provided through in-person consultation. And at the University of Vermont Health Network, "there has been a lot of work done on telemedicine" over the years, said Barbara Paganelli, a project manager for the network. Health care providers are investing in new forms of telemedicine or "telehealth," terms used for the practice of linking doctors, nurses and patients who aren't in the same physical space. Rutland Regional Medical Center has been using telemedicine to support gynecology, oncology and neurology treatment. He's also advising patients about the best way to use the system so that their medical privacy is preserved. For hospitals in Windham County, those possibilities are manifesting in different ways. In addition to physicians, physician assistants and advanced practice registered nurses, the long list of covered caregivers includes psychologists and psychoanalysts; clinical mental health counselors; social workers; and alcohol and drug abuse counselors. There are several pilot projects in the works, with administrators assessing new technology — including medical instruments tailored to telemedicine — and examining the interactions between physicians and patients. Nor is the basic technology that enables it — generally, a secure broadband connection and a webcam or other video setup. There are no other such programs in Brattleboro at the moment, but a spokeswoman said the hospital is "actively exploring other telemedicine options for needed services. Josephson cited a chronic shortage of psychiatrists as a big driver behind telepsychiatry. Having received a grant from the Vermont Community Foundation's Crosby-Gannett Fund, the hospital is starting a pilot project to see how care providers can connect with diabetes and hypertension patients in their homes. The idea is that doctors who are off-site could consult at the Retreat, and the Retreat's psychiatrists also could treat patients who are located elsewhere. But hospital administrators say the roughly nine-month trial will give them an idea of how well patients can connect to and use the new resource.
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