Evaluation of the Telecommunications and Information Infrastructure Assistance Program: Tele-Network for Remote Pain Management

Laurie Somers
Virginia Mason Medical Center (VMMC) in Seattle, WA, established a teleconsultation system for its Pain Management Program, which allowed patients to “see” a specialist at VMMC from their local clinic and in the presence of the local provider and family, in some cases. Local providers and consulting physicians were able to work together to provide a continuity of care not previously possible. Prior to the project, chronic pain patients had to travel several hours to Seattle for a relatively short consultation without their primary caregiver. The project linked three clinics and one hospital on the rural Olympic Peninsula, two of which were tribal clinics, through a hybrid T-1/ISDN connection. Project staff reported positive health outcomes, as well as saved time and money, for the 25 patients who used the system. The project had planned to serve more patients, but because of delays in setting up the system, largely due to vendor delays and the limitations of the rural infrastructure, they were not able to start early enough. Unsupported administrative responsibilities placed on rural clinics contributed to limited buy-in on the part of the clinics, and this also may have resulted in the project treating fewer patients than intended. VMMC staff and rural providers also built stronger working relationships with each other and with state and private insurers. The biggest hurdle now facing the project is working with the insurers to detail reimbursement policies for telemedicine. One rural clinic has recently received a large grant to expand the telecommunications infrastructure in the area, due in part to their experience with VMMC and the TIIAP grant.
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