California, Blue Cross to implement telemedicine

Ontario telehealth reaps IP benefits

About 90,000 members of the California Public Employees' Retirement System (CalPERS) who live in rural areas will soon be able to receive medical advice from specialists via a telemedicine network operated by Blue Cross.

When the network starts Jan. 1, 2006, CalPERS will be the first employer health care purchaser in California to offer telemedicine as a specific rural benefit.

CalPERS members will be able to access specialists in dermatology, psychiatry, endocrinology, cardiology and pediatric neurology at the University of California at Davis, Cedars-Sinai Medical Center and other institutions via videoconference and data links at more than 50 sites nationwide.

The network is based on individual point-to-point links using the best phone line speeds available, said Bridget Hogan Cole, manager of the telemedicine program at Blue Cross, which administers the CalPERS preferred provider organizations. Those links usually are ISDN rates, she said, although sometimes fractional T1 connections are available.

"That doesn't allow us to do such things as radiology in real time since the bandwidth is too small," she said. Those images can be sent in a time-delayed fashion using a store-and-forward system.

However, Blue Cross will also try to upgrade the various links, including connecting to the several high-speed backbone networks that run through the state.

CalPERS and Blue Cross will be spending the next year evaluating whether telemedicine is a cost-effective way to improve health care for the system's rural members, Hogan Cole said. They will use three criteria: overall use of the system, satisfaction with the process and a review of the medical claims history to gauge how the encounters with telemedicine actually impacted CalPERS members.

"People outside of the state usually don't realize that California is 80 percent rural," Hogan Cole said. "Telemedicine might be the only way for many people in rural areas to get this kind of timely help without having to drive seven or eight hours."

Blue Cross operates other telemedicine networks around the country, one of the biggest of which is in Georgia, which launched in April 2005.