History of Minnechaduza Medicine
MMC was established in 2005 to deliver medicine to patients in a new way - a way that delivered quality care, as all Americans expect, but to actually make it accessible AND affordable.
MMC's founder, Tim Ryschon, developed these objectives over a 14 year period of federal service, 5 years at NIH and 9 years in the Indian Health Service. In both settings, he was struck by a basic flaw in the design of western medical systems. Though many HCO’s and clinics touted "patient-centered" care, it seemed that most if not all systems required the patient to go to the system of care. This was true for both NIH and the Indian Health Services (IHS). Though NIH was a giant in research, it required patients with specialized diseased to travel to the Bethesda campus for their care. IHS, often touted as a model public health system, had a long history of building hospitals in the middle of reservations - making the system of care equally distant and inaccessible for all patients. This geographical disparity was and remains a major barrier to IHS beneficiaries who struggle with burdens of poverty and disease. Both models of care screamed for a different approach to care delivery - an approach that is truly patient-centered. But how to redistribute care to patients in a way to makes it accessible on a continuous basis?
While in the IHS, Ryschon struggled with the complex challenge of how to deliver specialty care to his beneficiaries who lived hundreds of miles from tertiary centers. This is where specialists congregate and depended entirely on IHS to coordinate their referrals to such specialists. He was struck by a paradox: even when IHS would pay for specialist consultation, the distance to these specialists obviated the actual consultation. The outcome was the same as if either the system did not offer the consultation or couldn't make the referral. There had to be a way to surmount this geographic barrier. Telemedicine was the way.
Ryschon established a customized network - big-box AV systems (Polycom) using ISDN ad hoc connections that permitted volunteer specialists in Rochester, NY, Peoria, IL, and Beverly Hills, CA to consult on patients in rural South Dakota, facilitated most importantly by telemedicine coordinators at both ends of the pipeline. It was amazing - consultations needed and ordered by his rural staff actually got delivered through this highly tuned system. It worked well for all kinds of specialty care including complex areas involving real-time ultrasound imaging of pregnant patients in need of perinatology consultation.
At Rosebud, Ryschon had been successful in recruiting a staff of primary care providers – a true accomplishment. In reality, outside of his microcosmic world at Rosebud, he found that most patients - regardless of their geography (city vs. rural) have a hard time accessing primary care, with predictable and catastrophic consequences: all care, from urgent to disease management is uncoordinated, erratic, often duplicative, and ultimately ineffective.
Ryschon believed that telemedicine could fix this giant gap in effective care delivery. Many basic questions had to be answered: What technology would work best to "virtualize" health care? How would reimbursement work to provide meaningful sustainability for such care? How would medical record documentation for geographically disparate sites occur? How would care be coordinated using virtual medical homes?
Those questions have been answered. The resulting "package" of care delivery is a unique product, developed with MMC guiding philosophy in mind: Care must be accessibility, high quality, well-documented, financially sustainable, and affordable to the patient/client. MMC is now equipped, staffed, and fully prepared to deliver wellness to patients wherever they are by providing coordinated, continuous medical care that is aligned with these guiding principles.