Filed under: Telemedicine | Tags: ACT, acute care, AcuteCare Telemedicine, advancing telemedicine, congress, department of veterans affairs, healthcare, hospitals, Medicaid, medicare, modern medicine, regulations, Technology, telehealth, telemedicine, VA
Initially used to reach those who live in rural areas, telemedicine is quickly expanding its reach into every area and genre of medical care delivery.
Interestingly, when the history of telemedicine is written, significant credit for hastening the advancement of telemedicine will go to a government health care agency that is not always credited with innovation and exemplary delivery of patient care and service. The Department of Veterans Affairs (VA) is successfully deploying telemedicine on a large scale. In fiscal 2013, more than 600,000 veterans accessed VA care using telemedicine programs, for a total of more than 1.7 million episodes of care. The reach of VA’s telehealth services is growing at 22 percent a year. The agency is currently in the midst of a pilot program that allows veterans to enter vital information into an online tool that is accessible via mobile phones, tablets or desktop PCs to help their caregivers manage chronic conditions. The VA is launching another service that allows larger, better-resourced hospitals to connect with smaller facilities to provide remote support for intensive care.
“The VA did not get into telemedicine out of an inherent interest in technology”, said Dr. Adam Darkins, who leads national telehealth programs at the agency. Rather, VA officials wanted to help aging veterans with chronic disease live independently, for clinical and financial reasons. Although the VA has a network of 152 hospitals and more than 1,100 other caregiving facilities, it still faced the problem of having to cover a lot of territory in terms of reaching veterans. Additionally, officials found that 45 percent of those requiring treatment resided in counties classified as rural by the U.S. Census Bureau.
One big reason the Administration has been able to lead in the expansion of telehealth is attributed to its network of physicians who are able to treat veterans throughout the system without regard to state licensing rules, an advantage that private medical industry practitioners do not enjoy. The growing telemedicine industry is still working toward standardization and interoperability but the biggest impediments to the rapid expansion of telehealth remains state licensing and regulations that restrict treatment by out-of-state doctors.
Congress is beginning to take necessary legislative action to resolve many of the issues that are slowing telemedicine advancement in the private sector. The Telehealth Modernization Act, a companion bill backed by Reps. Bill Johnson (R-Ohio) and Doris Matsui (D-Calif.), would create a single, federal standard for telemedicine for use in national health care programs. And the Telehealth Enhancement Act from Reps. Gregg Harper (R-Miss.) and Peter Welch (D-Vt.) would expand reimbursement for telemedicine services under Medicare and Medicaid. It would also amend the Communications Act to support health care providers under the universal service requirement.
It’s not clear if any of those bills will pass, but the bipartisan focus on expanding telemedicine on that powerful committee indicates an interest in establishing some federal rules to make the patchwork of state laws more manageable for providers and insurance carriers. The VA has certainly provided an example of leadership as legislators clear the way for advancing the use of telecommunication technology in delivery medical care.
Filed under: News, Telemedicine | Tags: ACT, acute care, AcuteCare Telemedicine, clinicians, CSpire, diabetes, GE Healthcare, government, Governor Phil Bryant, healthcare, Intel-GE Care Innovations, mississippi, North Sunflower Medical Center, NSMC, patients, RNSMC, Technology, telehealth, telemedicine, telemedicine technology, The Diabetes Telehealth Network, UMMC, University of Mississippi Medical Center
Governor Phil Bryant of Mississippi is standing up in support of telemedicine technology. In Mississippi, Gov. Bryant has introduced a new initiative “The Diabetes Telehealth Network”. Unveiled recently in his State of the State address, the Network is a partnership of University of Mississippi Medical Center (UMMC), North Sunflower Medical Center (NSMC), GE Healthcare, Intel-GE Care Innovations and CSpire. It’s designed to offer those with diabetes consistent and timely access to UMMC clinicians via telehealth technology.
Patients in the 18-month program will have a tablet with mobile broadband access to record vital signs like blood sugar levels and send that information to UMMC doctors, specialists, nurses and pharmacists. The results of those daily interactions will allow doctors to adjust treatment plans accordingly, said Dr. Kristi Henderson, UMMC’s director of telehealth.
The program’s base will be Ruleville’s North Sunflower Medical Center (RNSMC), which has an existing telehealth partnership with the UMMC. The program’s private partners will provide the technological infrastructure. The initiative resulted from a meeting more than a year ago at the Paris Air Show between state and GE officials. GE operates jet engine and component assembly facilities in Batesville and Ellisville.
Gov. Bryant said the program is centered at RNSMC because, “That was unfortunately the area where diabetes was most concentrated. It’s a rural area. Lack of transportation is a big issue, and that affects access to care.” But there are 372,000 people in the state diagnosed with diabetes, according to the Diabetes Foundation of Mississippi. More than 12 percent of adults in the Mississippi Delta were diagnosed in 2010 with type 2 diabetes, according to UMMC statistics. The American Diabetes Association, in a 2012 study, found Mississippians with the disease spent $2.7 billion on health care related to treating it.
If this initiative is successful, it can be scaled up and expanded to meet the needs of diabetic patients throughout the state of Mississippi. Supporting new telecommunication technologies to improve and expand specialized care for chronic disease sufferers is an example of how Mississippi and other state governments appear to be out in front of Congressional law makers when it comes to putting forth initiatives that remove barriers and implement new strategies that seek to modernize our established healthcare delivery model and improve access and quality of care to patients across the country.
Filed under: Telemedicine | Tags: ACT, acute care, AcuteCare Telemedicine, affordable care act, care, doctor, er, Harvard Medical School, health, Health Affairs, health care, healthcare, infections, medical, medical services, pain, patient protection and affordable care act, patients, physicians, RAND, RAND Corporation, Rochester Medical Center, skin problems, Technology, telemedicine, teleneurology, telephone
According to a new RAND Corporation study, people who are younger, more affluent and do not have established health care relationships are more likely to use a telemedicine program that allows patients to get medical help by talking to a doctor over the telephone. Patients who used the service suffered from a wide assortment of acute medical problems such as respiratory illnesses and skin problems, and researchers found little evidence of misdiagnosis or treatment failure among those who used the service. The findings, published in the February edition of the journal Health Affairs, are from the first assessment of a telemedicine program offered to a large, diverse group of patients across the United States.
“Telemedicine services such as the one we studied that directly links physicians and patients via telephone or Internet have the potential to expand access to care and lower costs,” said Lori Uscher-Pines, lead author of the study and a policy researcher at RAND, a nonprofit research organization. “However, little is known about how these services are being used and whether they provide good quality care. Our study provides a first step to better understand this growing health care trend.”
Among patients studied, the most common problems treated during a visit were acute respiratory conditions, urinary tract infections and skin problems, which accounted for more than half the cases. Other frequent reasons for were abdominal pain, back and joint problems, viral illnesses, eye problems and ear infections. More than a third of the visits occurred on weekends or holidays. Interest has grown in telemedicine programs because of the shortage of primary care physicians, which will likely worsen as more Americans acquire medical coverage under the Affordable Care Act. Telemedicine is one of the alternatives touted as a way to better provide primary health care without greatly expanding the number of doctors.
The implementation of the Patient Protection and Affordable Care Act is leading to increased demand that physicians interact with more patients, pointing to telemedicine as a potential solution. Most physicians believe that the quality of patient care is not compromised by telemedicine because it is delivered through different channels. Physicians can consult with more patients, and patients can meet with their physicians in a shorter time period. In terms of economic advantages, telemedicine can save a great deal of time for patients who otherwise would have to leave work, and it can reduce ER visits. According to Kenneth McConnochie, M.D., M.P.H., director of the Health-e-Access Telemedicine Program and professor of pediatrics at the University of Rochester Medical Center in Rochester, N.Y., parents with young children consider time and lower expenses to be valuable commodities. By increasing its use of telemedicine, the medical center reported a 22 percent reduction in ER visits among schoolchildren. McConnochie pointed out that the average telemedicine visit costs $75 compared with $750 for a typical ER visit.
“The people who are attracted to this type of telemedicine may be a more technologically savvy group that has less time to obtain medical care through traditional settings,” said Dr. Ateev Mehrotra, a RAND researcher, co-author and an associate professor at the Harvard Medical School. However, researchers caution that more research is necessary to further assess the quality and safety of telemedicine services and to more adequately address concerns that expanded use of this type of telemedicine may lead to fragmentation of care. Still, the general consensus among patients and parents who used the service appeared to indicate that they believed that accessing medical services via telemedicine technology was much more convenient, saving them time and money. For these consumers the convenience factor dominated over other concerns.
Filed under: Telemedicine | Tags: ACT, acute care, acute stroke, AcuteCare Telemedicine, critical care, healthcare, James Kiely, Keith Sanders, Lisa Johnston, matthews gwynn, Mayo Clinic, medicine, patients, rural, stroke, Technology, telehealth, telemedicine, teleneurology, telestroke, Telestroke Program
Telestroke programs have been proving themselves very effective in bringing critical care to patients in rural areas throughout the country for a few years now and testimonials about patients who have benefitted from advanced, specialized treatment via telemedicine technology are becoming more common place. Receiving advanced stroke care faster is saving lives and resulting in less debilitating recoveries. Telemedicine programs help extend higher quality care to patients living in more rural areas, but some have questioned whether the cost to implement and maintain the technology and services has been thoroughly vetted and considered.
According to a new study by Mayo Clinic researchers, a telestroke program is leading to lower cost. Stroke patients living in rural areas who receive care via a telestroke network see, on average, nearly $1,500 in lower costs over their lifetime compared to stroke patients who do not receive telestroke care, researchers found. The savings are primarily attributed to reduced resource utilization, including nursing home care and inpatient rehabilitation. Researchers also estimate that, compared with no network, a modeled telestroke system consisting of a single hub and seven spoke hospitals may result in the appropriate use of more clot-busting drugs, more catheter based interventional procedures and other stroke therapies, with more stroke patients discharged home independently.
Despite the considerable upfront and maintenance expenses, the entire network of hospitals realizes a greater total cost savings, officials say. “This study shows that a hub-and-spoke telestroke network is not only cost-effective from the societal perspective, but it’s cost-saving,” said neurologist Bart Demaerschalk, MD, director of the Mayo Clinic Telestroke Program, and lead investigator of the study, in a press statement. “We can assess medical services, like telemedicine, in terms of the net costs to society for each year of life gained.”
“The results serve to inform government organizations, insurers, healthcare institutions, practitioners, patients and the general public that an upfront investment in telemedicine and stroke network personnel can be justified in our health system,” added Demaerschalk.
Today there are 10 million people utilizing telemedicine and the number will continue to rise as more state legislatures and medical insurance providers realize the benefits to providing payment and reimbursements for telestroke and telehealth services.
Filed under: Telemedicine | Tags: ACT, acute care, AcuteCare Telemedicine, atlanta neurology, device, gadget, iTREAT, iTREAT mobile telemedicine kit, James Kiely, Keith Sanders, Lisa Johnston, paramedics, patient, RDT, remote diagnostic technologies, Technology, telecommunications, telehealth, telemedicine, teleneurology, tPA, University of Virginia Health System, UVA
Gadget and device gurus are working hard to fill the need for advanced tools to help medical care providers in the field bring the best medical care to the patient even in the remotest corners of the world. Remote Diagnostic Technologies (RDT) in the UK, with funding from ESA’s Advanced Research in Telecommunications Systems Program has developed a robust portable device for monitoring vital signs and providing communications for medics in the field. The Tempus Pro combines the diagnostic facilities found in standard hospital vital signs monitors with extensive two-way communications, packaged in a compact, rugged, highly portable unit that can be tailored to user needs. The key to the unit’s success is that it is a fully functional, hospital-grade vital signs monitor and takes less than an hour for an experienced medical professional to learn the basic functions.
In the United States, a University of Virginia Health System (UVA) team is working with local rescue squads to diagnose stroke patients before they reach the hospital, enabling more patients to receive lifesaving treatment and have a full recovery. UVA clinicians are raising $10,000 to equip two additional local ambulances with the iTREAT mobile telemedicine kit. The goal: Connect paramedics through a secure video link with UVA’s specially trained stroke neurologists and emergency medicine physicians, who can diagnose stroke patients while they’re in the ambulance and enable treatment to begin as soon as patients arrive at the hospital. Fast diagnosis and treatment is vital because the most effective treatment for acute ischemic stroke patients — the clot-busting drug tPA — is only safe and effective if delivered within three hours of when symptoms begin. Due to delays in reaching a hospital and receiving a diagnosis, less than 5 percent of all stroke patients receive tPA. Promising faster care for a variety of patients and treatments, The iTREAT technology is in the testing stage with local rescue squads, with the hope of using it to care for Central Virginia patients in early 2014.
A debate as to what or who spawned the revolution in using communication technology to advance a new medical care delivery model, the need or the gadget, is unimportant. Teaming the hospital based life-savers and their dedicated field associates with savvy techies is creating an environment where patients are receiving better and faster advanced life support no matter where they are located. Telemedicine is taking to the patient!