New Orleans. Atlanta. Baltimore. Austin.
No matter where psychiatrist and internist Thomas Kim, MD, has lived, he’s supported the same juvenile detention center in New Orleans for more than 14 years, thanks to telehealth.
Dr. Kim is an avid user and advocate of telehealth, and the Austinite regularly shares his expertise and experience with fellow physicians and state lawmakers. During the 2017 legislative session, Dr. Kim testified in support of Senate Bill 1107, a Texas Medical Association-backed law that clarifies the legal framework to evaluate, diagnose, and treat patients remotely via telecommunication technology.
Dr. Kim holds regular clinic hours for all his patients from his “ridiculously overcrowded” home office with “way too many screens” and redundant broadband lines so that he may “connect to anyone anywhere with pretty much anything.”
On the other end of the line, Dr. Kim’s detention center patients visit with him after a two-minute walk from the dormitories. The alternative: Getting into a van with two guards and spending at least half the day — plus additional costs to the state — to seek care from one of the area psychiatrists, Dr. Kim explained.
“If you recognize telehealth as a skill to be mastered, you can apply it to most any population you want,” he said.
Texas Medicine talked with Dr. Kim — in person —about his experience with telehealth, and here are some of his thoughts:
My first clinic, in retrospect, ran horribly — nothing worked right. But I also remember asking myself after the very first prison clinic: “Why are we not doing this everywhere?”
I love taking care of this population for one very simple reason: Many might view my patients as criminally bad thugs. But I have discovered that with persistence and timely intervention, made possible through telehealth, these same hardened youths begin to hope and dream again. It’s really quite remarkable.
I can’t fix everything. There are problems extending well beyond what a doctor can do. But I’ve been amazed at what a doctor skilled in telehealth — the right doctor with the right information at the right time — can do.
If enough people were skilled in telehealth and reimagined care delivery from a population or value-based perspective, I think we would see meaningful improvement, including the avoidance of unnecessary or excessive tests, medicines, ED visits, and other high-cost/low-value forms of care.
Technology is not magic. These are tools that if put in the right hands could be amazing. Give a hammer to a 4-year-old and they’re going to knock a bunch of holes in the wall. You give a hammer to a craftsman, they’re going to build you a house.
The best part is that our tools continue to get better and now fit in your pocket. The potential of the mobile hardware platform will completely redefine how we think about care delivery.
Resolving access to care challenges through telehealth is as close to a silver bullet solution we have because it allows patients to see the right doctor with the right information at the right time. I know I sound like a broken record, but I believe this point strikes at the heart of the problems we face.
I would never suggest telehealth as a replacement option. I always give people a choice, saying this is how I do it. If you don’t like it, if you have concerns or questions, you are most welcome to get in line and see a conventional doc in the community if there is one. I truly don’t take offense.
I am highly confident that telehealth will fix some of the many key challenges we face in health care delivery. But for all the many potential benefits, the most important one for me is time — our most precious resource. And if telehealth can effectively give us back more of our time, we could see more patients, spend more time with our family, get a hobby.
Tex Med. 2018;114(12):14-15
December 2018 Texas Medicine Contents
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