A dose of telemedicine: can use of broadband control health care costs?

Rising health care is no longer an annoying item on the expense line; it is now a basic threat to overall company performance. Some companies try to avoid the obligation through the use of temporary employees or simply moving more of the costs to the employee through increased co-payments and contributions to health care plans. These are only short-term tactics. In the long run, we need to find more permanent solutions. In fact, some suggest that these spiraling health care costs are so great that they offset the normal growth produced by an otherwise healthy company.

In 1996, I had the opportunity to serve on a task force led by the former Surgeon General of the U.S., Dr. C. Everett Koop. Our objective was to look at ways that technology could help address some of the health care challenges we faced at the time. We reviewed a number of telemedicine applications, many of which were pioneered by the U.S. military as they attempted to provide care to military personnel around the globe. Our task force urged that policy changes were necessary in order to fully take advantage of those systems.

For example, state-by-state physician licensing did not allow for practice across state lines using telemedicine systems, and federal reimbursement policies would not pay for consultations done using telemedicine systems. Progress has been made in some of those areas, but many are still barriers to the effective use of these systems. Efficacy was never a question, and it was clearly recognized that providing patients with easier access to health care produced better long-term results, both from financial and quality of life perspectives.

So, what does this mean to business leaders? One of the reasons that the U.S. military pioneered many telemedicine applications was that they were ultimately responsible for the care of military personnel and their families, so they were simply looking at the most efficient and effective way to provide that care. Reimbursement policies and other issues weren't relevant in their case.

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In many ways, business leaders are now in the same situation. Companies are often responsible either directly or indirectly for the cost of providing health care to their employees and family members, and the current system providing that care isn't structured to look at efficiency and effectiveness over the long term. It's time that business leaders consider a different approach.

BellSouth is launching an initial trial of a system that is designed to help diabetic employees and/or family members improve the management of their disease. The system utilizes a connection to the employee's home (typically broadband), as well as an application for monitoring the employee's compliance with their diabetes management protocol. It includes the capability to alert medical professionals and family members if the protocol is not followed or if blood sugar levels are out of range.

BellSouth data suggests that the average annual health care cost for a diabetic employee is several times higher than a nondiabetic employee. We estimate that improved compliance could reduce those costs by about one-third, which more than pays for the cost of the system. Furthermore, improved compliance will add years to the employees' lives and improve the quality of life. We believe that there are many other similar opportunities to improve compliance and reduce costs using broadband capabilities to the home.

Let's utilize the same technologies that improve productivity, effectiveness and customer service to deal with these problems. We could try waiting for a government-led solution but frankly, we don't have the time.

Bill Smith ([e-mail]) is chief technology officer at BellSouth.