1. Telemedicine- the Cleveland Clinic Experience
Matthew Faiman, MD, MBA
Director Telemedicine Services

2. Lecture Overview Virtual Medical Clinic at Cleveland Clinic.
An historical perspective of telemedicine.
History of telemedicine at Cleveland Clinic.
Current and Future Telemedicine projects at Cleveland Clinic.
Questions.
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3. Virtual Medical Clinic and Telemedicine
What is Telemedicine? It is the transfer of electronic medical data (video, sound, image, EMR) from one place to another or….
“A picture is worth a thousand words…..” (Fred Barnard 1921)
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4. Virtual Medical Clinic
Uses sophisticated, real- time technology to connect Cleveland Clinic physicians with patients requiring specialized consultations, anytime, anywhere
Facilitates physician collaboration and interaction for specialty consultations
Cleveland Clinic physician conducting personalized patient exam utilizing real-time connectivity technology
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5. Location B: Cleveland Clinic
Location A: Exam Room
Patient sees and speaks to Cleveland Clinic physician in real-time through secure technology
Location B: Cleveland Clinic
Physician conducts examination, interacts with patient and nurse, and documents encounter in the MyPractice Electronic Medical Record system
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6. The Virtual Medical Experience Cleveland Clinic Physician
Conducts interaction from Telemedicine studio
Interacts with patient and nurse / technician at remote exam location
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7. The Virtual Medical Experience Cleveland Clinic Physician
Easily navigates real-time views and online medical information (X-Rays, scans, etc.)
Directs nurse / technician through exam, seeing and hearing diagnostic details (heart sounds, etc.)
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8. The Virtual Medical Experience Cleveland Clinic Patient
Sees and hears physician; asks and answers questions
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9. The Virtual Medical Experience Cleveland Clinic Patient
Receives and complies with physician instructions
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10. The Virtual Medical Experience Cleveland Clinic Patient
Nurse / Technician transmits diagnostic equipment data directly to physician for review in real-time
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11. Virtual Medical Clinic
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12. The Virtual Medical Experience Cleveland Clinic Patient
Is examined utilizing all pertinent diagnostic criteria; nurse / technician follows physician direction
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13. The Virtual Medical Experience Cleveland Clinic Physician and Patient
Conclude exam with discussion, final questions, physician instructions, and appropriate future treatment strategy
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14. The Virtual Medical Experience Cleveland Clinic Physician
Fully documents encounter in MyPractice Electronic Medical Record System
Places orders for medications, follow-up tests or other labs into MyPractice Electronic Medical Record System
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15. The Virtual Medical Experience
Cleveland Clinic Physician
Concludes Telemedicine Visit
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16. Telemedicine at Cleveland Clinic
Telemedicine at Cleveland Clinic: began in 2005 with a relationship with University Texas Medical Branch.
Dr. Cosgrove imagined telemedicine as an opportunity for increased access for patients living in hard to reach areas.
Telemedicine felt to be inline with CC/CCHS approach to innovation.
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17. Telemedicine at Cleveland Clinic
In 2006, Virtual Medical visits began from Wooster to main campus in Peds GI and Neuro with Drs. Hsich, Wyllie and later Psychiatry with Dr. Tesar.
In late 2006 a telemedicine council was set up to address the needs of CC/CCHS domestically and internationally.
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18. Virtual Medical Clinic and Telemedicine
On January 23rd,2008 services began with the Parker Virtual Medical Clinic, now at CCAC since early 2011.
This employee-based clinic sees patients for urgent visits and chronic care such as blood pressure.
To date more than 600 patients have been seen.
Patient satisfaction scores are as high or higher than regular brick and mortar visits.
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19. Virtual Medical Clinic and Telemedicine
Other Institutes using Telemedicine:
Orthopedics: since 2008 from Wooster, approx 60 visits and 10 surgeries. In 2009 operations from Canfield (St E’s). Visit yield is 6:1 whereas dept average 10:1!
Bariatrics: first visit from CCC Toronto 6/09.
Transplant Medicine-Discussions began 1/10.
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20. Virtual Medical Clinic and Telemedicine
Other Institutes using Telemedicine:
Cleveland Clinic Canada- Toronto practitioner’s utilization of main campus for 2nd opinions.
Emerging Business: both domestic and international opportunities are being explored including home monitoring and wellness. Tele-stroke service fall 2010 along with EEG. ? Las Vegas.
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21. Virtual Medical Clinic and Telemedicine Final Thoughts
Options are endless.
In the fast-paced world that we live in, telemedicine affords a complementary approach to health care.
Will not substitute but will augment the health care that we have today.
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