Schneider board votes to close St. John telemedicine clinic

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ST. THOMAS ­- Citing unprofitability and low usage at its telemedicine clinic on St. John, the Schneider Hospital Board voted Wednesday to let the clinic's contract expire on Feb. 21.

The clinic allows physicians at a Florida medical facility to remotely evaluate patients at the Myrah Keating Smith Community Health Center using high-resolution video cameras and conferencing technology.

Opened in 2010, the clinic has cost the hospital about $48,000 annually to operate, but the contract with the Cleveland Clinic specified that the hospital could collect only $20 per visit from patients.

Under the contract, the Florida clinic collects fees for physician's services from patients' insurance companies.

In her report to the board, the hospital's interim Chief Executive Officer Angela Rennalls-Atkinson said the hospital had tried to renegotiate the contract to lower expenses, but the clinic would not budge from the present fee structure.

The St. John Rotary Club recently donated $34,000 to go toward the hospital's outstanding bill of $60,000 incurred in the last three years for the use of communications lines and other equipment, but no other sources of funding had been identified, Rennalls-Atkinson told the board.

The board also decided to express its regret at having to close the clinic to an unnamed private donor, who initially had given $100,000 to launch the clinic.

After reading in Rennalls-Atkinson's report that the clinic had only 94 visits last year, board Chairman Cornel Williams stressed that the clinic's low usage could in no way justify its continued operation during a time of financial crisis for the hospital.

"Because of the low usage and because of the way the contract is structured, we are losing money," he said. "It doesn't seem like it's really that much use except for the rheumatology."

According to Rennalls-Atkinson, 90 of the clinic's 94 visits in 2012 were related to rheumatology services. In 2010, the clinic had 75 visits, 59 of which were for rheumatological symptoms.

The numbers do not represent the total patients treated but are a tally of appointments.

The clinic's dermatology and cardiac follow-up services were hardly used after the first year, the report shows.

Board member Aldria Wade requested that the decision be put off until Renalls-Atkinson could provide a more detailed analysis of the services performed by the clinic, but the board decided to let the relationship with the Cleveland Clinic expire without seeking further private donations.

Board member Miles Stair, a representative from St. John, was a vocal proponent of the clinic's closure.

"Really, there never was a path to profitability," he said. "It doesn't matter if you had 100 people or 10 people or 1,000 people. If you're only getting $20 a patient, you still are looking at $23,000 a year in equipment fees."

Combining the monthly operating cost of an estimated $1,000 and the $23,000 in yearly equipment fees, Stair said, the remote service model was so cost-inefficient that it did not offer enough of an alternative to sending patients off-island.

"Maybe that's 90 trips to the states avoided for patients, but at close to $50,000 a year, you could buy them a ticket," Stair said.

In other business, the board:

- Said it is reviewing two proposals to install a software system to process data from the hemodialysis center electronically to comply with requirements of the Centers for Medicare and Medicaid Services.

- Announced that the hospital was in the process of securing a $1.2 million line of credit to serve as a safety net for discrepancies between available cash flow and monthly payroll expenses

- Approved recommendations to renew contracts for 11 doctors.

- Contact reporter Amanda Norris at 714-9104 or email

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