ROCHESTER, NY – Many people associate telemedicine with rural healthcare initiatives, and while that is usually the case, an increasing number of telemedicine projects are in urban or suburban areas.

One such program, a demonstration project called Health-e-Access, has conducted more than 5,000 telemedicine visits for children attending childcare centers, elementary schools and child development programs in the Rochester area since May 2001.

“The motto of our program is ‘healthcare when and where you need it by people you know and trust,’” said Kenneth McConnochie, MD, director of Health-e-Access and professor of pediatrics at the University of Rochester Medical Center. “Our telemedicine model differs from the vast majority of telemedicine programs in that we enable children in urban and suburban environments to connect with their own primary care physicians.”

Initially funded by a grant from the Robert Wood Johnson Foundation, Health-e-Access connects 22 child sites in Rochester – 13 in the city and eight in the suburbs – with clinicians at 10 physician practices. Through late 2006, 42 physicians at the various practices had performed telemedicine visits.

Health-e-Access uses technology developed by Rochester-based Tel-e-Atrics, a company founded in 2003 specifically to support the Health-e-Access project. Tel-e-Atrics has since expanded beyond the western New York region and provides telemedicine technology to more than 50 sites, including projects in Ohio and Wisconsin.

“We created a Web-based telemedicine program that links a provider with remote sites in schools, group homes, geriatric facilities and so forth,” said Don Turrell, president and CEO of Tel-e-Atrics. “Our software connects a healthcare provider’s standard PC to a trained telemedicine assistant who is with the patient end and collects the information the provider needs to make a diagnosis.”

Turrell says that technology at the telemedicine site includes a PC, a high-resolution camera, videoconferencing equipment, and a variety of medical instruments. The telemedicine technician, who is not a nurse, follows a very specific workflow to collect information and inputs it into the system. The physician views the images and collected data, talks with the child, parent and technician if necessary, and makes a diagnosis.

“The real issue is getting physicians comfortable with the technology,” Turrell said. “It amazes me that the capabilities of the Internet have not been applied to the medical profession. This technology has day-to-day applications in urban areas and could save a lot of money and time for parents who won’t have to leave work to take their kids to the doctor’s office.”

The start-up costs for a telemedicine site are at least $25,000 for hardware and training, and Tel-e-Atrics charges a $4,000 to $5,000 annual fee for connectivity and support. The up-front costs have traditionally been supplied by federal, state or foundation grants, McConnochie said.

Regional payers have reimbursed most telemedicine visits in the Rochester program, but McConnochie says broader payer acceptance of telemedicine is crucial to growth of the technology across the nation.

 “For many families, the emergency room is the only medical resource they have, and telemedicine reimbursements are far less expensive than ER visits,” McConnochie said. “It’s a very efficient system.”