The Mayo Clinic is experimenting with an intriguing new way ofdelivering health care to employees — via a kiosk that connects thepatient to a physician by video conference, over a secure, onlinelink.

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The Mayo Clinic Health System's clinic in Austin, Minnesota, ispiloting the new program, called Health Connection. The kioskswere developed by HealthSpot, a health technology company based inDublin, Ohio.

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“This concept of a kiosk is fairly new,” says Gary Capistrant,senior director of public policy for the American TelemedicineAssociation. “The advantage of telehealth is the convenience.An advantage to an employer is reduced absenteeism forworkers.”

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“Step into the kiosk.”

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The walk-in kiosks can take blood pressure readings, record thepatient's height and weight, and feature a stethoscope, along witha device to look inside a patient's ears, nose, throat andeyes.

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Officials say the system allows employees to see a providerquickly and conveniently, without an appointment. During the visit,the patient will talk with a Mayo Clinic Health System primary careprovider, such as a physician, a nurse practitioner, or a physicianassistant.

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Read: Consumers optimistic about telehealth

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The provider can discuss the employee's symptoms and make adiagnosis and treatment plan, which is then integrated into thepatient's medical record. Conditions that can be seen at the kiosksinclude earaches, sore throats, sinus infections, or skinconditions.

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According to Steve Cashman, CEO of HealthSpot, MayoClinic is one of a handful of employers that are experimenting withthe kiosk system. Others include the Kaiser Permanente healthsystem in San Diego, and the Cuyahoga County Justice center inCleveland, Ohio. The company is developing provider relationshipswith health systems across the country, including Mayo Clinic,Kaiser Permanente, Miami Children's Hospital and ClevelandClinic.

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Cashman says the kiosk technology expands the reach of providerswhile managing resources effectively, allowing health care toremain affordable.

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“Employers are looking to low-cost alternatives for emergencyroom or physician office visits for nonemergency health issues thattheir employees may have,” he says. “Employees can find superiorpatient experiences right in their place of work, where they spendmost of their day. This decreases absenteeism, lowers costs andincreases wellness.”

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Capistrant agrees that businesses will benefit from havingemployees who are able to access health care without leaving work.“This greatly reduces the amount of time the employee has to beaway, and it's convenient — the employees love it,” he says. “Thenotion of getting the right care at the right time can end upreducing cost.”

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Matt Bernard, MD, chair of Family Medicine at Mayo Clinic, saysthe kiosks could be the next step after retail clinic-type sites,which many employers use to give employees convenient careoptions.

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“This is taking that same idea but putting in the technology andencompassing the visits in a different way,” he says. “This is anexciting step for us — it gets us further down the road in tryingto identify ways to care for patients in a less costly, butultimately higher-quality way.”

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Hands-off care?

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A number of physicians have questioned whether a remotephysician can deliver the best quality of care, but Bernard saysthat despite skepticism, physicians will eventually adapt, becausepatients are embracing new technological solutions.

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“We were all trained to practice medicine a certain way,” hesays. “But we are in some ways failing to provide the type ofservices our patients need when they need it and where they needit. I look at it as listening to the voice of the patient. Thismight be an opportunity to give them what they want instead of whatwe've always thought they should have.”

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Bernard notes the experienceof the retail clinics, which raised similar concernsfrom physicians. “They got busy pretty quick,” he says. “You canfight that, but the reality is that it's providing a service thatpatients want.”

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Cashman says that the remote sensors will give physicians datasimilar to what they would get in person. “The HealthSpot platformis more than just a virtual face-to-face visit. It has beenrecognized by medical boards and health systems as being trulyequivalent to an in-person visit, including the ability to have aremote physical exam,” he says. “HealthSpot's platform establishesface-to-face dialogue, sets a path to follow-up treatment,maintains a readily available medical record, and documentselectronic prescription information as part of the patient medicalrecord.”

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Finally, Cashman says, the HealthSpot visit is an interactiveexperience for patients.

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“Patients are empowered by seeing what the doctor sees duringthe visit,” Cashman says. “[It] gets people excited about their ownhealth care.”

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An emerging technology

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In general, experts describe the telehealth kiosks as atechnology that is still evolving. Cashman says developing newhealth delivery solutions can be a “long road.”

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“There are many stakeholders,” he says. “Policy regulation lagsbehind technological innovation, and changing insurance policieshave created confusion.” He notes that his company is working withlawmakers in Ohio on legislation to require telehealth visits to bereimbursed by insurance plans.

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“Our goal is to make the patient insurance piece work the sameway a regular in-office visit would work,” he says, adding that inmany cases, carriers already do cover telehealth.

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The practical economics of the system also need to worked outbetween employers and technology companies, as well as healthsystems. HealthSpot charges a one-time implementation fee, butthere are also maintenance and licensing costs.

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Capistrant says one of the attractive features of the kioskapproach is that it doesn't require an employer to create a newclinic in a facility — the kiosk is a self-contained unit. “It canbe dropped on the site and be up and running quickly,” he says.“One of the selling features is the ease of setup.”

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Bernard says Mayo Health System sites currently have retailclinic-type sites for employees, but a kiosk site could be anothertool to help find the best fit for employee health. The new kiosksite in Austin allows the clinic to “kick the tires, work out thebugs, and partner with local organizations to see where it's a goodfit,” he says.

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“It might not work, but it takes us a step in a direction wewant to go,” Bernard adds. “And it helps us educate our patients;to start to change the dynamics of always having to come in [to aclinic] for everything.”

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So could delivery of primary health care services continue toevolve, from clinic appointments, to retail sites, to kiosks, andeven beyond?

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“I can envision a time where you don't even have to leave yourhome to have a visit. As long as the technology is good, you couldbe on your smart phone and have an office visit,” Bernard says. “Ithink the opportunities are unlimited.”

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