Driven by a desire to improve the quality of and access to care, health systems both large and small are tapping into the power of telemedicine at a feverish pace.

But clinical considerations aren't the only market forces driving adoption. Supply-and-demand economics, the utility and reliability of new wireless devices and cost pressures are also significant factors.

"Development and support of telemedicine services improves referral patterns for our member hospitals, saves time and costs associated with travel, and can even improve clinical outcomes for patients through convenient follow-up visits," says Nancy Vorhees, chief operating officer for Inland Northwest Health Services, Spokane, Wash.

Vorhees says with telemedicine, the opportunity exists to provide specialty medical care to rural patients in a cost-effective and convenient model. In expansive, sparsely populated western states, round-trip driving time for specialty care from one remote area to an urban medical center can take upward of 10 hours. Telemedicine also builds referral patterns for transport of critical patients.

Plus, Vorhees says, deployment of telemedicine services improves clinical outcomes for discharged patients, enhancing the hospital's rating and reimbursement opportunities, all beneficial to its sustainability and growth.

"At the remote facility, telemedicine applications can expand the depth of services being offered locally, improve the care model in a community that has limited medical resources, and decrease the number of patients sent to other communities for medical care," Vorhees says.

INHS has deployed telemedicine applications through technology, infrastructure and program development. These applications support a range of about 18 services, from autism case management to remote triage consults to trauma and wound care.

Connecting remote hospitals through telemedicine links does not necessarily have to present a problem for handling continuity of care documents. At INHS, Vorhees says many providers utilizing Northwest TeleHealth services are on the INHS health information network already and thus are able to see the patient's electronic health records.

Marc Probst, chief information officer, Intermountain Healthcare, Salt Lake City, says telemedicine is becoming a competitive requirement as well as a competitive differentiator. "I don't see how the hospital CEO can ignore telemedicine," he says.

With all the payment changes likely to be enacted, telemedicine is one of several technology solutions that are becoming a key to success in health care delivery. "Busy, tech-savvy patients will want more user-friendly access to health care and will be far more likely to use technical solutions to aid in this convenience," Probst says.

He sees telemedicine becoming a commodity, and clinicians soon will start demanding seamless face-to-face connectivity with everyone in the care circle, from specialists and nurses to patients and families. "Forward-thinking leaders will see the potential and the absolute requirement to have telemedicine capability, and will build it into the workflow of care and business," he says.

Telemedicine also facilitates handling of continuity of care documents for Intermountain, a critical solution for meaningful use. Probst says Intermountain is able to share the CCD and other information through the statewide Utah Health Information Network and through a direct exchange connection with many of its affiliated physicians.

"We are also currently involved in a pilot activity with several major health care delivery organizations across the country to share the CCD," he says. In each instance, the patient must approve of the data sharing.

At University Health Systems of Eastern Carolina, based in Greenville, N.C., the most extensive telemedicine rollout so far is in the radiology space.

"The advantage is that we are able to provide or supplement subspecialty care to rural areas that would otherwise not be able to offer these services, or at least not on a 24/7 basis," says CIO Stuart M. James.

He says telemedicine provides a means to improve the quality of life for the communities served. "Patients in rural areas have access to appropriate specialists and enjoy a better experience because they and their families don't have lengthy commutes," James says.

Ultimately, he says, this leads to better outcomes.

Douglas Page is a freelance writer in Pine Mountain, Calif.