Telemedicine Technology Solves Healthcare Disparity

Telemedicine program has drastically reduced cost and time spent on patient care

Founded in 1880, Bisbee is located in the rolling hills of the Mule Mountains in southeastern Arizona some 85 miles from Tucson and within three miles of the border with Mexico. The region's rich mineral deposits of copper, gold and silver first attracted miners who hoped to strike it rich. The town that developed around the mines was named for DeWitt Bisbee, a San Francisco Judge and investor in the Copper Queen Mine who, ironically, never set foot in his namesake.

Nearly as old as Bisbee, the Copper Queen Hospital got its start in a mine tunnel as part of the mining community. Now known as the Copper Queen Community Hospital (CQCH), it has served the town for over 125 years. In more recent times, CQCH has become an acute care critical access hospital for the 6,000-plus Bisbee residents and for many of the county's 140,000 residents. The hospital's mission is to maintain and support access to basic primary healthcare throughout southeastern Cochise County and to evolve rural healthcare and provide patients with the highest quality services.

The Challenge

Among the primary challenges of CQCH was how to provide care for patients who needed specialists. For years, emergency department patients with possible cardiac or stroke problems had to be transferred to Tucson and Phoenix hospitals by ambulance, or--in more lifethreatening situations--by helicopter. CQCH patients often discovered after the fact that, although healthcare was warranted, the expense of emergency transfer was not.

"Cardiology disease is the No. 1 killer of people in rural areas," said CQCH CEO James Dickson. "And in Bisbee, we lacked consistent care to treat it. We lacked access to a cardiologist and to the ongoing maintenance care required after initial treatment. We decided we needed a way to solve the physician misdistribution and disease management problems that occur in a rural area like Bisbee."

In 2009, CQCH received a grant to begin a telemedicine cardiology program. Dickson set out to find a system that would essentially bring specialists into Bisbee and CQCH without requiring that they physically be on site. This would eliminate the costly transfer of patients to Tucson and Phoenix. It would also minimize the trauma involved for family members of those being transported far distances. Overall, the implementation of a telemedicine program would shrink the disparity in healthcare experienced by the people of Bisbee by making specialists vastly more within reach without the price tag of on site consultations.

The Solution

Dickson and CQCH worked with telemedicine solutions provider GlobalMedia to build a telecardiology system using GlobalMedia's i8500 Series Mobile Video Cart. The wireless, telemedicine videoconferencing system includes EasyShare videoconferencing technology that uses the public Internet, enabling specialists to visit with patients on a virtual basis. It also includes a large, flat-panel touch screen PC for fast communications, as well as a high quality camera providing remote pan, tilt and optical zoom. Currently in the first phase of its tele-cardiology program, CQCH has connected its system and those of other, small Cochise County hospitals with the larger Tucson medical centers.

From December 2009 to June 2010, 36 patients in the Emergency Department with suspected heart problems required cardiology consultation. Using the Mobile Telemedicine Cart equipped with a digital stethoscope, healthcare providers in Bisbee were able to provide cardiologists in Tucson with the ability to see and speak to the patients in real-time, hear their heart sounds clearly and review their electro-cardiograms via fax at the same time. These consultations confirmed that only nine of the 36 patients needed transport by ambulance or helicopter to another facility. The 27 patients who stayed in Bisbee were discharged from CQCH with prescriptions and/or heart monitors. The cost savings to patients and insurers was approximately $540,000 based on a $10,000 transfer cost and an additional $10,000 hospital stay per patient who instead had their care provided by CQCH and were able to remain in Bisbee.

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