ORLANDO, Fla. — Jon Yeitrakis used to drive almost an hour each way to see his psychiatrist at the Veterans Affairs hospital in Orlando, Fla.
Now, the Kissimmee, Fla., resident and former Marine medic drives eight minutes to a local VA clinic.
The doctor is still in Orlando. Yeitrakis is still in Kissimmee. But now Yeitrakis attends his 50-minute “tele-psychiatry” appointments over a two-way video system.
Although the technology has been around for decades, only within the past few years has it been available to patients such as Yeitrakis. And the VA plans to expand those telemedicine services during the next year.
“The advantage of telemedicine is that it allows the veteran, or civilian for that matter, to access care in their location,” said Nick Ross, assistant director of outpatient clinics and planning at the VA of North Florida and South Georgia.
In some respects, telemedicine represents the death of distance.
Patients with chronic diseases such as diabetes can now use a device to send medical data to the doctor’s office from their homes. Then doctors can provide targeted advice over the telephone when necessary.
No more drives to the doctor’s office or long waits in the waiting room.
“What we’re seeing is just the beginning of a huge use of technology that is going to have a significant impact,” said Ken Peach, executive director of the Health Council of East Central Florida.
But telemedicine is not a cure-all. Many of these technologies require a basic Internet connection and often a high-speed, broadband Internet connection.
Doctors still have to spend the same amount of time with a patient on a video screen as they would during a face-to-face visit.
Patients in underserved, rural communities can save time, but telemedicine doesn’t directly address the underlying shortage of doctors in some medical specialties and in primary care.
“I still only have limited hours to work,” said Dr. Kenneth Goldberg, chief of staff at the Orlando VA. “If there just aren’t enough doctors in Florida, that doesn’t solve the doctor-hours problem.”
For patients, telemedicine can enable them to have more control over their care.
At Florida Hospital’s new inpatient unit in Celebration, patients can request specific foods or housekeeping services through an interactive television. They can change the lighting too.
“You can create night,” said Dr. Stephen Knych, division chief for patient safety and clinical excellence at Florida Hospital Celebration Health.
Doctors can monitor patients remotely to detect changes in their vital signs and send messages to patients through the interactive television sets.
They also can prescribe an educational health video to a patient. After the patient takes the quiz on the TV, results are sent to the hospital staff who can then tailor their in-person visit to what the patient needs to know.
“They know what you don’t know,” Knych said.
At the obvious health extremes, patients know to rush to the hospital or stay at home.
But does that persistent, irritating rash warrant a visit to the doctor?
To answer that question, consumers can turn to websites that ask them a series of questions to determine what kind of care is most appropriate for their symptoms.
The website’s professional database uses algorithms that track consumers’ answers and recommend a place of treatment: the emergency room, physician’s office, urgent-care center or a physician e-visit by telephone or email.
Services like that could save both the consumer and the health system time and money by reducing unnecessary physician visits, Peach said.
“That’s an avoided visit and therefore an avoided expense,” he said.
Avoiding unnecessary visits could alleviate shortages of physicians in some specialties.
That shortage is what caused Yeitrakis to try telemedicine in the first place.
“I thought, well, I’ll try anything so I can sleep at night,” he said.
The 64-year-old veteran said being in a different room than the doctor has helped him speak candidly about disturbing memories.
“I used to have to patch the guys up when they got shot and get them in the helicopter immediately, and it was a lot of things you want to forget,” he said. “This new videoconferencing, it’s a way to release ... it’s a person, but you don’t have to worry about being in the same room with them. It’s a lot easier to say what you want to say.”