Health IT

Here’s an approach that anyone developing an e-visit program for remote patients needs to consider

Telemedicine, and the concept of meeting patients where they are, is gaining ground rapidly.

As consumer technologies like Skype have taken off, televisits are now possible between doctors and patients who may be at far-flung locations. At the Mayo Clinic, too, doctors are meeting with patients virtually, and since 2009, doctors at its flagship Rochester location have conducted more than 2,000 televisits with patients.

But when one of Mayo’s Center For Innovation’s design researchers started visiting patients  in Iowa, Wisconsin and Minnesota, he encountered a theme that may well be counterintuitive when trying to set up a telemedicine program. Matthew Gardner, the lead designer for the Connected Care platform, described those insights at Mayo Clinic’s recently concluded Transform conference.

The Connected Care Platform within the Center For Innovation has a single aim: to develop sustainable models to extend the scope of specialty care from where it is currently available (hospitals and clinics) to other settings.


“We are trying to get specialty knowledge out beyond the walls of the clinic,” Gardner said in an interview Thursday. “This has basically morphed into meeting the patients where they are.”

In that effort Gardner has been working with specialists who are using video-based telemedicine to interact with patients. This is more convenient for both the physician, who otherwise would have to make the trip to the local clinic, and the patient, who would have to travel to Mayo instead. Through this program the patient is able to use the local clinic’s communication system that uses CISCO equipment as opposed to using Skype from home, Gardner said.

To be able to fully understand the patient experience, Gardner traveled to Decorah, Iowa; La Crosse, Wisconsin; Albert Lea and Austin in Minnesota to talk with a handful of patients. His list of questions included one that asked whether there was ever any time where a video consultation would be inappropriate.

And surprisingly a theme emerged. Several patients, one of whom lived alone, responded that if the doctor had bad news to deliver, then it would be much better to have that conversation in person.

“The response hit me with a stark reality. The patient was saying “I don’t want to face this alone. I want a more proximate touch,'” Gardner said.

Gardner said Mayo physicians already take into account a patient’s emotional make-up as well as technological savvy (Can they find to judge whether they are candidates for interacting with physicians through televisits. But this response from patients is something to pay close attention to.

“I think it’s an insight that becomes much more weighty when [televisits] become the norm of communication,” Gardner said.


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