Expanding Reach with Telemedicine

The concept of telemedicine is catching on — not just as a way for patients in rural areas to connect with physicians, but as a means for physicians to grow their practices by expanding their reach.

If you’re not familiar with the names of telemedicine vendors like Teledoc and Ring-A-Doc, chances are you will be in the not-too-distant future. They help physicians create platforms to better communicate with their patients.

Mario Quintanilla, MD — board certified in emergency medicine and family medicine — is a telemedicine expert who has gone a different route. He recently set up a free-standing emergency department in Houston, which is also fully equipped and staffed for telemedicine. He says telemedicine is his pet project.

“We have poor access in health care, and it’s too expensive,” Quintanilla says. “Not everyone needs to be sitting in an emergency room paying a $250 copay. And they may not be able to wait a week for a doctor’s appointment. We can’t paint every health care event with the same brush. We have to be able to use different brushes and different colors for different presentations. And I believe there is an audience of patients that can be serviced by this type of health care delivery system.”

No better place

When Quintanilla built his fully functional licensed emergency department in Houston, called Bellaire ER, he did so with telemedicine in mind. The facility, which has been open for about two months, has a CAT scan, an X-ray department, a full pharmacy and a full lab, and is licensed by the state of Texas. Within the emergency department is Quintanilla’s telemedicine hub.

“Whenever you do telemedicine you need a hub,” he explains. “You need qualified personnel to be available and receive calls. And I thought the best place to do this would be a place where people are available all the time, which is clearly an emergency room, where you have highly skilled personnel available 24 hours a day, seven days a week. Who else is best at triaging these emergency patients?”

Quintanilla is well aware of telemedicine’s critics who question how it’s possible to treat patients by viewing them through a camera. He points out that VirtualER is not looking to treat every patient. More so, the goal is to treat that segment of the patient population that can be managed through a computerized monitoring device. Sometimes, those patients don’t even need full medical treatment.

“There are people who just need information, who just need to talk, who need consultation, who feel good when you tell them what they need to hear,” Quintanilla explains. “And there’s the group that need triage; they just don’t know what to do with their pathology, with their illness. They need information. So a lot of what we’re going to do is triage, and simply give information to people who want to know, what should I do with this? People need information, and they sleep better and feel better.”

All for $49

The patient charge for phoning in to Quintanilla’s VirtualER is $49, and the doctor admits that he’s been told by many of his friends that he’s undercutting himself. That those same patients that walk into the emergency room and are charged a $250 copay will no longer walk in when they can phone in for a much lower price. But Quintanilla has a different perspective.

“I want to be fair with people,” he explains. “I have always had this passion to do something like this, and I think it can contribute not just to my community, but this can be nationwide. I really believe that. We need this to evolve, this ability to service people. It will serve many people, and lessen their pocketbooks, and help the economy. There are lots of reasons to do this, and greed is not one of them.”

Quintanilla admits that he has only done some preliminary math, and with the highly skilled, highly trained health care professionals he has recruited for the facility, charging patients $49 should allow VirtualER to at least break even. But what’s more important, he says, is the bigger picture. The scenario that by opening the door to patients, maybe new patients, maybe patients who might have gone elsewhere, word of mouth could lead to a greater potential economic benefit.

“I believe that if we’re fair with individuals, and they recognize that we’re not just trying to burn them, that we’re trying to be fair and offer a cheaper option, they’ll come to us when they really need an emergency room X-ray and such,” Quintanilla says.

The belief is that when individuals call in who need to be seen in person, that those patients will actually go to the emergency room like recommended.

“I believe that we’re going to be nationwide, and maybe some day international. I feel we have no boundaries with this,” he says.

Ed Rabinowitz recently wrote One More Dance, a book about one family's courageous battle against time and glioblastoma brain cancer. Read more about the book here.