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Telemedicine Tackles Diabetes Epidemic

Harvard's Joslin Diabetes Center partners with American Well to streamline diabetes referrals, improve health data sharing, and get people healthier.

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A partnership between a telehealth service provider and a leading diabetes research institution could accelerate health information interoperability and boost national efforts to improve people's health, according to executives from the partner organizations.

Joslin Diabetes Center, an affiliate of Harvard Medical School, recently announced that it would begin offering telehealth services nationwide--and potentially internationally--on a communications platform developed by Boston-based American Well. Joslin is looking to share its expertise in treating this rampant chronic disease with a wider audience for whom regular in-person visits are not convenient.

Dr. Ido Schoenberg, chairman and CEO of American Well, said that the collaboration is a taste of "medicine of the future," where care does not necessarily revolve around a hospital. "It's moving away from location-centric to person-centric," Schoenberg told InformationWeek Healthcare. "There are limitations to what you can do online, but you can do quite a lot online."

[ Learn about a similar project in New York. See Telemonitoring Pilot Attacks Diabetes. ]

Joslin and American Well were not forthcoming with many details, despite the fact Schoenberg said the two parties had been in discussions for more than a year before announcing the deal, but American Well's CEO said that the institution will look to serve as an adjunct to primary care physicians caring for patients with diabetes.

With financial risk starting to shift from insurers to providers, primary care doctors will have more of an incentive to move patients to specialists for consultation as quickly as possible, he said.

American Well serves as what Schoenberg called a "brokerage network" that connects two or more people in distant locations, and that is exactly what the company will be doing with Joslin and far-flung patients.

Last fall, American Well won a U.S. Department of Veterans Affairs competition to provide online behavioral health services to patients in Minnesota and remote oncology consultations to patients in Nebraska. The company has numerous other partnerships with providers and payers, including one with health insurance giant WellPoint.

American Well will be looking to integrate its Online Care telehealth technology with the NextGen Healthcare Information Systems electronic health record that Joslin has had since 2004, and with primary care physicians who refer patients to Joslin over the Online Care network. "We can inject the specialists into the primary care workflow," Schoenberg said.

He added that he believes that the traditional process of referring patients generally is "terrible," particularly when primary care physicians have to follow the HMO "gatekeeper" model. But Schoenberg also said patients should not have to wait weeks to see a specialist after getting a referral from a primary care doctor.

The Boston diabetes care institution will be offering its virtual consultations nationally, even though many states require physicians to be licensed in the state where the patient is physically located. "Joslin will ensure that providers delivering care through telehealth are appropriately licensed in the states where patients may access their services--in full compliance with the relevant regulations and requirements," Joslin Diabetes Center president and CEO John L. Brooks III said in an e-mail. "We will also explore opportunities to work with the states to show the benefits of telehealth, and to see if the regulations can be adopted to enable this very effective means of providing care."

Plans to take the program to other countries are still in the early stages. "Joslin is currently mapping out how our strategy needs to be aligned with the significant needs that exist internationally, as we see the diabetes pandemic explode across the globe. We are assessing the best ways to engage practitioners in each international area, as we recognize that each country or locale needs a tailored solution that works for their constituents and is consistent with our mission," Brooks explained.

Healthcare providers must collect all sorts of performance data to meet emerging standards. The new Pay For Performance issue of InformationWeek Healthcare delves into the huge task ahead. Also in this issue: Why personal health records have flopped. (Free registration required.)

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