An early job in the health care arena for payroll services leader ADP led to a spot at now-defunct Cabrini Medical Center in New York, where Martinez learned that health I.T. was lagging 20 years behind anything in corporate America. "[Health care institutions] were stuck in their old ways and not embracing new technologies, but then managed care came into play and we had to automate to make some money," he says. "Things changed almost overnight."
Now he thinks the industry has substantially caught up, and certainly Miami Children's Hospital has bounded forward. It's now at HIMSS Analytics Stage 7 (up from Stage 2 when Martinez arrived in 2009). Martinez estimates the hospital has made five years' worth of I.T. transitions in 18 months on the clinical side, and he's planning to do the same trick on the financial side over the next 18 months as he replaces a 41-year-old billing system. Meanwhile, an e-health initiative with an elaborate telemedicine component is putting MCH's pediatric subspecialists within reach of patients across the country, and even the world. (MCH has agreements with several other countries to provide services, including Russia, Ecuador, Peru, and the Vatican.) HDM talked with Martinez about how telehealth is transforming care.
On provider shortages
There are not enough pediatric subspecialists to go around. To see a pediatric neurologist, there's a four to six month wait time. If a concerned parent has to wait six months to get their kid in to see someone, they'll go somewhere else, and the care might not be as good. If I can facilitate having them see a kid [via telehealth] and determine the next step in their treatment, it could be done in hours. If we can provide the quality to more kids remotely, we'll have created a huge shift in the paradigm of how health care works.
The cost of a telehealth visit is significantly less than a physical visit and specialists can do four times the volume with less overhead. They're mostly looking at electronic information-the history, the EKG, the X-ray-and they can make an immediate diagnosis. All of this is a reduction in the cost of care, so it makes it easier to provide more care. That's why we want ACA (the Florida Medicaid program) to embrace this model. If we can reduce its cost from $30 to $15 per visit, that's a substantial savings for the state.