History of Massachusetts General Hospital Telehealth

Dr. Kenneth Bird, an internist and pulmonologist at Mass General, founded the first telemedicine (practice of medicine to deliver care at a distance) program in the United States. Using a closed-circuit television system connecting Mass General with Boston’s Logan Airport, Dr. Bird could virtually examine ill travelers arriving at Boston's Logan Airport, situated approximately 3 miles from the hospital's main campus.

In 1970 a telemedicine link was established between Mass General and Bedford, Massachusetts, Veterans Administration Hospital in enabling psychiatric consultation between the two hospitals.

The practice of remotely treating patients was pioneered at Mass General by Dr. Lee Schwamm in 1996, for acute stroke. During the initial four years, Dr. Schwamm and his colleagues worked tirelessly to fine-tune the processes and protocols that would enable a remote model of clinical care for acute stroke.

The first remotely provided second opinion (using fax machines and phones) was completed in late summer 1997. This early program was the precursor for what would become Partners Online Specialty Consultations (POSC) which later was renamed Partners Online Second Opinions (POSO).

In 1999, Martha’s Vineyard Hospital became Mass General TeleNeurology’s first community hospital receiving TeleNeurology services (Spoke), followed by a handful of other spoke hospitals that allowed Dr. Schwamm to clinically validate this paradigm-changing concept. The first virtual consult occurred in April.

In 2001 the Partners TeleStroke Center was established. Partners TeleStroke enables stroke specialists from Mass General and Brigham and Women’s to provide world class stroke care to community hospitals.
The first online second opinion using an early version of the POSC/POSO website was completed in July 2001. This first opinion was completed by Dr. William Butler, a pediatric neurosurgeon.

As Mass General celebrated it’s 200th anniversary, the hospital decided to make an investment in telehealth and created the Mass General TeleHealth department to centralize its telehealth resources and strategy. Community providers and Mass General providers connected through virtual technology to provide high-quality, coordinated care to patients and families across clinical services. At this same time, the Home Base program began conducting visits over video to patient homes, led by Dr. Bonnie Ohye, through separate grant funding.

The eVisit program allows for online exchange of medical information between a Mass General provider and a patient. The eVisit pilot began in December 2012 and experienced meaningful volume growth in 2013 at Mass General. In 2012, Mass General grew the portfolio of Virtual Consult programs, which provide real-time interaction between provider to patient’s provider and can be either a new or follow up consult for a patient located in an external facility. Virtual Consults established programs in new services lines beyond those in TeleStroke, with Routine and Urgent TeleNeurology’s first visit to Cooley Dickinson Hospital taking place that year.

The Virtual Visit program was deployed in the Department of Psychiatry and Department of Neurology, giving patients the ability to meet with their provider over video, saving time and money. Since 2013 the program has continued to evolve and expand across Mass General. In 2013, 10 virtual visits were completed in the first month of the program going live.

At the end of 2013 and in 2014, the eConsult program was piloted which allows for electronic, asynchronous, provider-to-provider communications on a non-urgent specific question. The eConsult program has continued to grow, with expansion across many specialty areas of services at Mass General. The Virtual Consult program continued to expand, by establishing programs in new services lines beyond those in TeleNeurology and TeleStroke, such as broader types of neurology consultations, and TelePulmonology, and expansion of existing programs to other sites.

The first commercial payer started reimbursing for virtual visits in Massachusetts. The number of payers reimbursing has continued to expand since this time.

In 2017, Mass General formally established the Center for TeleHealth. The Center focuses on expanding efforts in existing telehealth programs in synchronous care delivery and continues to partner with related telehealth services.

2019 was a year of notable growth in volume, programs offered, and depth of services across the organization. In FY2019, more than 10,000 virtual visits were completed across Mass General and more than 36,000 virtual encounters overall. New programs and services were added including dermatology eConsults and newborn medicine virtual consults. The Virtual Visits program completed a phased integration of its digital platform and patient portal across the Partners organization. All existing Virtual Visit programs transitioned to the new platform in December 2019. This solution will allow for further scalability across programs and services. Mass General is committed to continued advancement in this rapidly changing delivery model, demonstrated by its five-year strategic plan which include significant investment in digital innovation and prioritization of improving the patient experience.

Starting in March 2020, the COVID-19 pandemic marked a pivotal point in telehealth adoption at Mass General. Since then, we continue to evolve our telehealth programs and services for the needs of our community and look forward to continuing our expansion in the years to come.