TAMPA, Fla. — The bright blue box isn’t big. But squeezed inside it, there’s a video conferencing system, cutting-edge cameras, and a highly secured vault.
There’s also a blood pressure cuff, a scale, and a few paper bags for good measure, in case anyone inside gets sick.
The pod — it looks something like an oversized phone booth — is a free-standing telehealth clinic, stocked with all the instruments a virtual practitioner might need to diagnose run-of-the-mill illnesses or dole out common prescriptions. On the wall, there’s a roughly 3-foot-tall video screen where a nurse practitioner can pop up for a chat. There’s a high-resolution camera on a cord, waiting to drop down from the ceiling if a provider needs to see a problem up close. And there’s even a hidden little robotic pharmacy — the highly secured vault — stocked with basic prescription medicines, plus a credit card reader that lets patients pay for them.
This station was set up in the corner of the Tampa General Hospital cafeteria about a month ago, and it’s still surrounded by the matching blue balloons to draw people over to the station. It’s in the hospital cafeteria for a pilot program — right now, the station is only available to the hospital’s 8,000 employees, not the patients they care for.
But the hospital and the Florida-based company that created the pod, OnMed, have far bigger plans for the stations: They want to put them in airports and amusement parks, station them on college campuses, and build them inside corporate offices.
“As you start thinking of the potential uses, it just sparks other ideas for where these could be used,” said Adam Smith, senior vice president of ambulatory services at Tampa General Hospital. Smith has helped lead the effort to work with OnMed.
It’s the latest in a string of deals to bring telehealth kiosks like OnMed’s into pharmacies, hospitals, and other public spaces. Pharmacy giants like Walgreens (WBA) and Rite Aid have dipped their toes in the water, as have academic medical centers and health systems. University of Pittsburgh Medical Center has placed its AnywhereCare telehealth kiosks in Pennsylvania supermarkets, while BayCare Health System has done the same with Publix grocery stores in Florida.
“What things like these stations do is really offer a way to consumers to get care where and when they need it,” said Ann Mond Johnson, president of the American Telemedicine Association.
By and large, the kiosks are designed to provide the kind of care that Dr. Lee Schwamm, a neurologist and director of the Center for TeleHealth at Massachusetts General Hospital, calls “telesniffles”: visits for stuffy noses, sore throats, ear infections, and other relatively simple complaints that often don’t require complex care.
“That’s where the market has largely flourished in consumer-facing, on-demand telehealth care,” he said. That’s because both telehealth kiosks and smartphone app counterparts have the potential to offer consumers something that’s often hard to find: convenient, affordable care.
But Schwamm said there are still big questions about how and where it makes the most sense to use such stations — and how to actually get people to step inside them.
“We can build that kiosk to do the job we want it to do. But the questions are where should it be, who should staff it, and is it financially feasible, or is it really just a large advertising box [to show] how advanced your health care system really is?” Schwamm said.
Tampa General Hospital is betting the stations will offer patients a new, affordable option and demonstrate the hospital’s self-proclaimed commitment to innovation. But first, it’s testing the waters by using the station as a supplement to its own employee health and wellness programs. The hospital paid to have the kiosk installed in the cafeteria and pays a per-month, per-employee fee.
In other settings — like the Tampa airport or other locations where the hospital already has an existing relationship as a health care partner — the hospital would front the cost of the station’s installation. The station would be branded with the logos of both Tampa General Hospital and OnMed, and the two companies would split the fees charged to patients who use the pod.
Schwamm said he’d like to see OnMed and other such stations placed in the spots where they are most needed or are most likely to be useful.
“We want to avoid market forces driving where these telehealth boxes are put, and rather focus on determination of need,” he said.
For its pilot program, Tampa General Hospital opted for the cafeteria, in part, because it’s a high-traffic area that staffers might be near frequently throughout the day. They can pop into the pod anytime between 7 a.m. and 7 p.m.
“It’s kind of like a telehealth version of our employee health clinic, but incorporating the pharmacy piece takes [the station] to the next level,” said Smith.
To drum up interest, the hospital has set up a table with two certified nurse assistants, ready to answer questions. It’s sent out emails and even notified people in the existing employee health clinic that they can head down to the OnMed pod if they prefer.
Uptake has been slow but steady — a trend experts said is to be expected. Getting consumers to use new virtual health tools has been a challenge for the telehealth industry more broadly.
“The uptake has been really anemic, by both clinicians and consumers,” said Johnson of the ATA, which works with member companies to drive adoption of new telemedicine tools.
In the first three weeks after the station’s launch, there were 77 visits by staffers (though that tally included a handful of demos from people simply checking out the station). There have been an average of four visits per day.
To get a better sense of what’s working and what isn’t, the hospital has been surveying everyone who has used the station for a consult with a provider. Most said they were satisfied with their visit. Among the most common complaints: cold, sinus problems, and gastrointestinal issues.
The hospital is hopeful the station can help curb health care costs by keeping people from seeking pricier care. In its survey of staffers who have used OnMed, the hospital also asked where the patients would have gone if the station hadn’t been available. Of those patients, 42% said they would’ve gone to urgent care or a retail clinic, 28% to the doctor’s office. Some said they would have gone to the emergency room, while others said they would have just stuck it out without care. Smith said those avoided visits have already saved thousands of dollars in care.
OnMed allows hospitals to use their own health care providers for virtual visits or to tap into OnMed’s network of nurse practitioners. Tampa General Hospital has opted to use OnMed’s group of clinicians, but might switch to using its own pool of providers if enough foot traffic starts coming into the OnMed stations.
Experts said it’s critical for health systems working with telemedicine companies to be transparent about who is providing care to patients. And ideally, they said, patients should be able to get the same level of care at a hospital-backed telemedicine station as they would at the hospital itself.
“Who is providing the care, and do they have the same standing and the same level of expertise if they were being hired at the hospital directly?” Schwamm said.
So far, Tampa General Hospital has not linked the records from the OnMed station to its own existing electronic medical records system, though the station could be linked to records. But experts said that raises a concern that’s common across several types of telemedicine: the risk of fragmented care.
“If you have a sinus infection every three weeks and get antibiotics from [several] different providers over a four-month period, that’s an indication of a serious health problem,” Schwamm said. “But nobody is picking it up, because everyone is just getting a teeny slice,” he added.
Smith said that as Tampa General ramps up its use of telemedicine stations, the hospital and OnMed will work to make the experience “seamless” for consumers who might use both telemedicine and traditional care. And they plan to ramp up quickly: Smith said the hospital hopes to launch 15 stations in the next three years.