UnitedHealth Group and Cisco Wednesday announced they're launching a multi-million dollar initiative to build a national telehealth network. Although the initial focus is on patients in rural and inner city communities, the companies envision providing a platform for delivering health services wherever distance or shortages of clinicians present obstacles to affordable care.

The Connected Care initiative builds off a relationship UnitedHealth and Cisco forged last year to "change the way healthcare is delivered," said Dr. Pam Hymel, Cisco's corporate medical officer." That work included three pilot programs, including one involving 400 Cisco employees in the company's San Jose facilities who were linked for their care with physicians and other healthcare providers in Los Angeles.

Health insurer UnitedHealth Group brings to the table its network of 590,000 doctors and 4,000 hospitals, as well as relationships with labs and pharmacies, and a vast base of medical claims data and other information, said Dr. Jim Woodburn, UnitedHealth Group VP and medical director of telehealth.

Cisco is providing technology and services, including a telehealth infrastructure for exchanging health information electronically. That infrastructure includes collaborative network technologies, such as high- definition videoconferencing. The infrastructure also supports a range of multivendor products, including electronic medical records systems and biometric devices for blood pressure, glucose, and other clinical measures and testing.

The Connected Care program involves setting up local telehealth clinics in rural communities and inner cities, enabling patients to access affordable urgent and preventative care by remotely connecting to physicians, specialists, and "a host of other clinicians" including case managers and a 24-hour nurse line, said Woodburn.

The videoconferencing and digital medical gear allow the clinicians to examine patients from afar, whether it's a physician listening to a patient's heartbeat or a dermatologist examining a suspicious skin lesion.

While UnitedHealth Group and Cisco officials didn't disclose how many remote clinics will be set up, the plan is to include telehealth clinics in retail settings, workplaces, and mobile clinics that travel to patients. A Connected Care mobile clinic will be available starting in the first quarter of 2010 to diabetic and other chronically ill patients in New Mexico through a partnership between UnitedHealth Group and ProjectHope, an international health education and humanitarian assistance organization.

Eventually, the Connected Care program will also support in-home telehealth visits for chronically ill patients. UnitedHealth Group is investing "tens of millions of dollars" in the effort, including reimbursing physicians and other clinicians for the remote care they provide to telehealth patients, said Woodburn.

The remote clinics will be staffed with registered nurses and other care providers trained to work with the patients who are examined by the remote doctors and others, said Hymel.

The telehealth model helps bring down the cost of delivering quality care to patients who would otherwise need to travel long distances or who might skip seeking care altogether until they developed more serious health complications. The telehealth services also help to reduce the long waits for patients needing to consult with medical specialists.

In coming years, telehealth will likely play an important role in the lives of patients beyond those living in rural and underserved regions of the country, said Woodburn. That's because, as baby boomers age, it's predicted the United States will face a potential shortage of 159,000 primary care physicians by 2025, according to a study by the Association of American Medical Colleges.

Telehealth services are potentially "game changing" for how healthcare services will be delivered and accessed in the future, said Frances Dare, director of Cisco's healthcare consulting practice.

A survey of Cisco employees who participated in the San Jose telehealth pilot over the last year found that 95% were satisfied with the remote care, she said. Some patients even preferred the telehealth services over in-person care, she said. That's because many of those patients felt they received better attention from the remote healthcare providers using the telehealth technologies. Many telehealth patients also felt more engaged in their care, she said.

"There was less moving around the exam room, more focused" attention by healthcare providers when interacting with the patients from afar using biometric devices, videoconferencing, and other gear, said Dare. For instance, patients could "hear" the stethoscope as remote doctors listened to their hearts, providing patients with an opportunity to learn and interact, she said. The Connected Care telehealth infrastructure allows for a variety of health-related situations, including multiple doctors at various locations consulting on a complex patient case at the same time, as well as medical translational services.

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