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Virtual Doctor Visits Expand in Rochester

Thursday, February 10, 2005

By integrating primary care doctors into the Health-e-Access network, and having it available where children spend the majority of their time, such as schools and child care centers, we have the potential to reshape the way our nation’s pediatric offices provide care for very common childhood illnesses, the type that account for nearly 75 percent of all pediatric office visits for illness.

Health-e-Access, the University of Rochester Medical Center telemedicine program that uses the Internet to connect pediatricians with sick children at inner city child care centers, is undergoing a significant expansion in the Rochester area.  Beginning in March, Health-e-Access will begin a year-long roll-out that will double the number of participating child care centers, begin service to 10 city and suburban elementary schools, and link area pediatricians into the network. 

The addition of nine local pediatric offices to the network is significant, because it allows children to be treated by their own pediatrician without ever leaving the child care center or school.  Likewise, parents also can remain where they are, whether it’s at work or at home, if they chose. This Health-e-Access expansion is believed to be the first of its kind in the nation, where a large group of children at different types of locations have the ability to be treated by their own pediatrician.

Kenneth McConnochie, M.D., a pediatrician and founder of the Health-e-Access program, says this expansion could revolutionize the way pediatric offices nationwide diagnose and treat children suffering from common illnesses.

“Our experience with more than 2,200 telemedicine visits indicates that telemedicine can effectively treat almost all problems that arise in child care settings,” says McConnochie.  “It is a highly efficient way to diagnose and manage the common childhood illnesses that many children get in child care centers or schools, with the added benefit of allowing working parents to stay on the job if they choose.

“Now, by integrating primary care doctors into the Health-e-Access network, and having it available where children spend the majority of their time, such as schools and child care centers, we have the potential to reshape the way our nation’s pediatric offices provide care for very common childhood illnesses, the type that account for nearly 75 percent of all pediatric office visits for illness,” McConnochie added.

In another first, local insurers, including Blue Choice, Monroe Plan, Preferred Care and Aetna, have agreed to reimburse physicians for sick visits completed via the Health-e-Access network until September 2007.  At that point, each company will evaluate the value of the pilot program, and make a decision if it plans to continue coverage.  Families will be expected to make their standard physician co-pays for the visit.

Historically, telemedicine’s impact on the health care field has been limited to linking rural populations with specialty medical services, benefiting a relatively small number of people, McConnochie noted.  But with the upcoming Health-e-Access expansion, the ability to help large numbers of people in varying stages of life will undoubtedly yield a number of social benefits.

“The costs of these common childhood illnesses are substantially reduced, for example, when we can treat them during the day, and reduce after-hours emergency room visits,” McConnochie said.  “From our experience, Health-e-Access allows everyone – children, parents, and child care employees – to spend more of their time doing what they’re supposed to be doing.”

Eye-opening Effectiveness

In May 2001, pediatricians from the University of Rochester Medical Center’s Golisano Children’s Hospital launched Health-e-Access. Specially designed computer equipment was installed at seven child care sites in Rochester, allowing a trained child care provider to send live video and audio across town to pediatricians at Golisano Children’s Hospital.

Two-way video teleconferencing establishes real-time communication so that doctors and children can interact with each other. The high-speed connection allows information to be transmitted from a specialized camera that provides diagnostic-quality images of the inner ear, throat, eyes, and skin – areas most affected by common childhood illnesses. In addition, an electronic stethoscope captures high quality lung and heart sounds. Doctors at the remote location then make a diagnosis, prescribe treatments, and provide a treatment report to the child’s pediatrician when applicable.  Prescriptions can be delivered directly to the center that same day so that treatment can begin even before a parent picks up a child. 

Since its launch, Health-e-Access has produced astounding results during more than 2,200 long-distance visits. For example, child absences due to illness plummeted by more than 50% at participating child care centers.  In surveys, almost all parents said that Health-e-Access helped avoid making a visit to the primary care physician or emergency room, and allowed them to stay at work.  In fact, most parents indicated that they would choose a child care center with telemedicine over one without the service.

“The benefits of Health-e-Access go beyond providing sound and timely medical care to a sick child,” says Neil Herendeen, M.D., medical director of Health-e-Access, citing research that shows parents and employers benefit, too. “Research shows that among parents with preschool children nationwide, 40% of parental absences from work are due to child illnesses. We know from our experience that telemedicine significantly reduces parents’ work absences. While the parent experiences less stress and can remain present on the job, employers are getting their money’s worth from an employee who can remain focused on the task at hand.”

Health-e Expansion

Funding for the planned expansion comes from $2 million in grants from two federal entities, the Agency for Healthcare Research and Quality and the Maternal and Child Health Bureau.

In March, Health-e-Access will begin its year-long rollout, expanding from serving seven sites to 22, including suburban child care centers, and city and suburban elementary schools.  Total potential enrollment in the expanded network based on school and childcare enrollment is about 8,500 children. 

School #22 will be the first of five city schools and five suburban schools to be added to the Health-e-Access network, with service scheduled to begin sometime in March. At the end of the year, Health-e-Access estimates about 7,000 elementary age children will be eligible to participate in the program. Five suburban child care centers will be added to the network beginning in July, bringing the total number of participating child care centers to 12, and adding 475 children to the program. In all cases, enrollment in the program is voluntary, and participating children will have the option to be seen by their own pediatrician if available, or by doctors at Golisano Children’s Hospital.

The nine pediatric practices joining this Health-e-Access program expansion were selected based on their marketshare/geography to give children participating in this Health-e-Access expansion the greatest likelihood to be seen by their own pediatrician. Researchers believe that participating city pediatric offices provide care to about 75 percent of children attending the participating child care and schools, while the participating suburban offices care for about 60 percent of children attending one of the participating child care centers and schools. 

Specific names and locations of all participating child care centers, schools and pediatric offices is available by emailing

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