Health Care and Telemedicine

Telemedicine is the practice of health care delivery, diagnosis, consultation, treatment and the transfer of medical data through interactive audio, video or data communications that occur in the physical presence of the patient, including audio or video communications sent to a health care provider for diagnostic or treatment consultation, according to Telemed.org. Thanks to factors including a looming physician shortage, the health care reform debate and the increasing willingness of insurance companies to pay for the practice, telehealth is on the verge of becoming routine, according to the Baltimore Sun. Remote consultation and diagnosis are ways for medicine to become more efficient even as physicians and other health professionals are increasingly in short supply. For patients living away from advanced hospitals in urban areas, they add, it's potentially lifesaving. Telehealth systems can screen patients for diabetes, eye disease, kidney problems, nerve damage, vascular disease and complicated pregnancies.

According to the American Telemedicine Association (ATA), telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients' health status. Closely associated with telemedicine is the term "telehealth," which is often used to encompass a broader definition of remote healthcare that does not always involve clinical services. Videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and telehealth. Telemedicine is not a separate medical specialty. Products and services related to telemedicine are often part of a larger investment by health care institutions in either information technology or the delivery of clinical care. Even in the reimbursement fee structure, there is usually no distinction made between services provided on site and those provided through telemedicine and often no separate coding required for billing of remote services. More info about the Association can be found at their website: http://www.americantelemed.org/i4a/pages/index.cfm?pageID=3308 .

According to the Baltimore Sun, the technology is available and relatively inexpensive. It's the regulatory hurdles that present the challenge. Because of licensing restrictions, specialists might have trouble treating and prescribing medicine for patients they are examining electronically across state lines. Also, only a handful of states require insurers to cover telehealth care. Telehealth equipment can be installed in physicians' offices, small clinics, hospitals, and even workplaces for from $10,000 to $100,000. Hardware could include an electronic records system, digital diagnostic equipment, video monitors and cameras. With federal subsidies toward incorporating the latest electronic systems, physicians and hospitals have at least some incentive to upgrade their computer networks. Such technology isn't intended to replace patients' connection to a primary care physician. Instead, it's meant to hook them up quickly to specialized care that's sometimes difficult to find.

Universal coverage could clog the healthcare system unless new care-delivery models are created, such as telehealth and online doctor appointments, according to a survey from PricewaterhouseCoopers and reported by Modern Medicine. Fifty percent of consumers surveyed said they would be willing to seek healthcare through the internet or other computer technology instead of face-to-face, non-emergency visits. E-mail consultation was the top choice (76 percent), followed by telehealth, question-answer consults and an online forum monitored by a doctor. The second alternative to access was retail and worksite clinics for patients. Of consumers surveyed, 37 percent said they would likely use a worksite clinic, and 36 percent said they would use a retail health clinic. The third alternative was the use of telehealth technologies. This method could expand access to specialty physicians for patients in remote and underserved areas. Seventy-three percent of consumers said they would use biometric electronic remote monitoring services to track their condition and vital signs. A fourth alternative is shared medical appointments (SMAs). Of consumers surveyed, 28 percent said they would be willing to participate in a shared medical appointment. This would consist of a 60- to 90-minute session that includes a private or personal exam, integrated with patient education and discussion with a group of 10-to-15 people.

Twitter, according to Telemed.org, the increasingly popular social networking tool that was at first merely a convenient way to stay in touch with friends and family, is emerging as a potentially valuable means of real-time, on-the-go communication of healthcare information and medical alerts, as described in latest issue of Telemedicine and e-Health. Physician groups, hospitals, and healthcare organizations are discovering a range of beneficial applications for using Twitter to communicate timely information both within the medical community and to patients and the public. Short messages, or "tweets," delivered through Twitter go out from a sender to a group of recipients simultaneously, providing a fast and easy way to reach a lot of people in a short time. This has obvious advantages for sharing time-critical information such as disaster alerts and drug safety warnings, tracking disease outbreaks, or disseminating healthcare information. Twitter applications are available to help patients find out about clinical trials, for example, or to link brief news alerts from the Centers for Disease Control and Prevention (CDC) to reliable websites that provide more detailed information. The use of social media and Internet-based outlets such as Twitter to communicate medical information requires a high degree of caution, however, to preserve confidentiality and patient privacy in the clinical care setting, and to ensure that information sources are accurate, reliable, and current.

Dozens of large and small companies are turning to wireless technology to achieve a health-care system that keeps people healthier for less, according to the Wall Street Journal. But claims about cost savings from new technology often don't pan out; and, if reimbursements from Medicare or private insurers don't cover the cost of high-tech approaches, doctors and hospitals won't want to deploy them. Using wireless technology has the potential to reduce costs in part because part of the infrastructure already is in place. With more than four billion cellphones sold to date, a large percentage of the world's population has access to devices and networks that can send medical data to doctors. Private health insurance companies have yet to create separate reimbursements for telemedicine that can cover the cost of equipment and technical support, according to the Buffalo News.

According to the American Telemedicine Association, telemedicine and telehealth to be interchangeable terms, encompassing a wide definition of remote healthcare. Patient consultations via videoconferencing, transmission of still images, e‐health including patient portals, remote monitoring of vital signs, continuing medical education, consumer‐focused wireless applications and nursing call centers, among other applications, are all considered part of telemedicine and telehealth. While the term telehealth is sometimes used to refer to a broader definition of remote healthcare that does not always involve clinical services. Telemedicine is closely allied with the term health information technology (HIT). However, HIT more commonly refers to electronic medical records and related information systems while telemedicine refers to the actual delivery of remote health services using technology.

According to the ATA, telemedicine has been growing rapidly because it offers three fundamental benefits:
• Improved Access – For over 40 years, telemedicine has been used to bring healthcare services to patients in distant locations. Not only does telemedicine improve access to patients but it also
allows physicians and health facilities to expand their reach, beyond their own offices.
• Cost Efficiencies ‐ Reducing or containing the cost of healthcare is one of the most important
reasons for funding and adopting telehealth technologies. Telemedicine has been shown to reduce the cost of healthcare and increase efficiency through better management of chronic diseases, shared health professional staffing, reduced travel times, and fewer or shorter hospital stays.
• Patient Demand ‐ Consumers want telemedicine. The greatest impact of telemedicine is on the
patient, their family and their community. Using telemedicine technologies reduces travel time and related stresses to the patient. Over the past 15 years study after study has documented patient satisfaction and support for telemedical services. Such services offer patients the access to providers that might not be available otherwise as well as medical services without the need to travel long distances.

Telemedicine has measurable cost effective results and the ability to transfer live saving data during critical needs diagnosis. The need to upgrade current medical offices and health care providers is urgent to help save precious dollars and time in order to effectively better treat patients. Those companies and professionals who make best use of telemedicine for their practices should see more efficiences on a clinical basis as well as increased profitability and return on investments. Patients who learn how to access telehealth points of service have the ability to increase options to manage their health care and be able to save money and time.

Until next time. Let me know what you think.