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Cathy Carver Talks Joslin Everywhere

Wednesday, November 07, 2012

Catherine Carver, M.S., A.N.P., C.D.E., Vice President for Advocacy and Planning is one of the key movers behind Joslin’s bid to bring diabetes care into the 21st century with Joslin Everywhere, a digital care and education platform in the works at Joslin Diabetes Center.

So what is Joslin Everywhere?
Imagine Joslin’s resources being available to everybody, anywhere, on their phone, on their computer or tablet, by live video chat.  But not as boilerplate, instead, in a form tailored to the patient’s individual needs.  For example, suppose the patient is Mexican and wants to know about nutrition and diabetes- Joslin Everywhere would present him with food choices in Spanish that are common to the Mexican food mores. 
Expanding beyond face- to- face office visits is the only way we can remain relevant in the face of the  tsunami of new  diabetes cases coming our way.  The only way we can hope to stem this epidemic is to reach people through other mediums.

How will Joslin Everywhere take shape?
We are starting small with a patient portal where patients will be able to access a significant portion of their medical record.   Joslin physicians, patients and staff were involved in the design of the portal and will have another opportunity to make comments when we roll out the pilot in January of this year.   Patients will be able to email their health care providers with confidence knowing their medical information is secure and meets all the HIPPA guidelines.

Many other hospitals already allow patients to see their medical records on-line, what else will it include?
Giving patients on-line access to their medical records is only one small piece of Joslin Everywhere.

Joslin is about clinical care, research and education.  Getting patients the care they need in the location that best suits them is one of the things that make Joslin Everywhere so exciting.  Take patients just transitioning from the hospital.  Now 40 percent of our patients coming directly from the hospital don’t show up for their appointments.  Patients are discharged from the hospital so quickly today, they often aren’t ready either physically or mentally to come back into Boston.  But with Joslin Everywhere we will eventually be able to use live video conferencing to have providers conduct their appointments with the patient in the comfort of their own home.   And because new technology will allow the different electronic medical systems at different hospitals to talk with each other, we will have a much clearer understanding of a patient’s full medical picture when we make recommendations.

Currently, the Joslin has 25,000 patients and sees 80,000 patient visits a year, but with virtual access the possibilities become endless.  Joslin Everywhere has the capacity to change our very definition of who we consider a Joslin patient. 

One of the things we are excited about is the ability to make our educational resources, especially classes, available to so many more patients.  We have some patient groups, the elderly for example, or some of our pregnant patients who find it difficult to come in regularly.  Educators could set up individual appointment with patients virtually or conduct a group visit with patients from Manhattan to La Jolla all the way to New Delhi.

And, Joslin has a variety of group programs, for example, our DO IT, You Turn, Why WAIT and pump programs that are available only to those patients who can physically come to the Joslin.  But with Joslin Everywhere, that has the possibility of changing quickly.   One of them, Why WAIT, is going to be piloted as an on-line weight management program.

How are all these virtual visits going to be paid for?
Right now private insurers don’t cover tele- or video-medicine, but the world is changing.  Medicare  has some provisions for payment of non-face-to-face patient/provider interaction and in our home state, Massachusetts, Law 224, An Act Improving the Quality of Health Care and Reducing Costs Through Increased Transparency, Efficiency and Innovation which was signed into law on August 4, 2012 and  to be enacted on  November 5 2012  states: “Alternative payments have the potential to provide incentives for efficiency in the delivery of services that are absent in the fee-for-service system, while potentially promoting improvements in quality through better coordination of care.”  Insurers are beginning to realize the benefits of touching patients in the best venue for them which often includes reduced costs for the insurer in the long run. 

Where do you think Joslin Everywhere will be a year from now?
I don’t know but I know but I can’t wait to see how far we will go.

Page last updated: January 17, 2013