AcuteCare Telemedicine Blog


Rising Opportunities in Virtual Healthcare

While it may not be the .com bubble of the 90’s, telehealth and virtual healthcare initiatives are gaining popularity amidst investment communities across the globe. While some challenges still remain; individual state medical licensing reform, digital medical record keeping and some regional short-falls in technology infrastructure, a recent Wall Street Journal report on private equity firms investing in the health-care sector indicate increased investor interest in earlier stage opportunities. With the rising cost of healthcare, anticipated physician shortages and an increased demand for healthcare, virtual medical care is a way to solve the access and cost issues. Nirad Jain, a Bain partner and a co-author of Bain’s latest report on global health-care private equity, said “Health care is such an important part of the economy in the U.S. and globally, it impacts society in such a fundamental way that it is hard for a private equity firm of scale not to have some part of its portfolio in health care.” Private equity last year reached a three year high of $29.6 billion globally, nearly double the level recorded for 2013.

Telemedicine has been around for several decades but advances in digital infrastructure, software and the popularity of mobile devices by consumers is creating a tipping point for a budding virtual health industry. “Telemedicine is moving like lightning. We’re able to do so much more than before,” said Andrew Watson, Chief Medical Director of Telemedicine at University of Pittsburgh Medical Center.

Researchers at Mercom Capital Group estimated a 300% increase in funding flowing toward established and startup virtual-visit firms in 2014, and StartUp Health, a New York-based accelerator, and Rock Health, a San Francisco-based accelerator and seed fund, have independently reported that funding for new digital health ventures in the United States doubled last year. Rock Health estimates that $4.1 billion of new capital was invested in digital health in 2014, up from less than $1 billion in 2011.

“As practitioners in the telemedicine space, we’ve seen many technology platforms and telehealth delivery models enter the marketplace,” comments Dr. James Kiely, Partner, AcuteCare Telemedicine LLC.  “More consumers are embracing the convenience and lower costs of virtual visits and readily seeking routine and minor healthcare services through their smart phones, laptops and pads instead of face-to-face encounters with their doctors. As a result, healthcare organizations are moving quickly to implement telehealth initiatives across specialties such as neurology, cardiology, psychiatry, and other specialty programs.”

Whether or not virtual medicine and telehealth initiatives become the Facebook and Twitter of this decade remains to be seen. As investment dollars continue to rise, the future of telemedicine looks promising.



THE AMERICAN TELEMEDICINE ASSOCIATION PROVIDES A FORUM FOR THE ADVANCEMENT OF TECHNOLOGY AND HEALTHCARE PRACTICES

For more than 20 years, the American Telemedicine Association (ATA) Annual International Meeting & Trade Show has been the premier forum for healthcare professionals and entrepreneurs in the telemedicine, telehealth and mHealth space.  The event held at the Las Angeles Convention Center brought together 5000 attendees. With nearly a dozen keynote speakers and 13 educational tracks, it was a great opportunity for like-minded professionals to connect at the largest telemedicine trade show in the world.

With a focus on interactive learning, the ATA 2015 program offered a unique opportunity to learn and engage with leaders in healthcare technology. Attendees were able to take advantage of a myriad of educational and networking opportunities, interactive experiences, informal receptions and even digital networking sessions conducted through the ATA Meetings Mobile App.

The four day event promoted conversation centered on the challenges of advancing communication technologies and the implementation of potentially new provider service models. AcuteCare Telemedicine (ACT), the leading practice-based provider of Telemedicine services for hospitals seeking around-the-clock stroke and other urgent neurological care, took the opportunity to strengthen relationships with leaders in the industry. ACT’s expert team of neurologists is setting a new standard for excellence in telestroke and urgent teleneurology care.

The meeting was a great success, according to Matthews Gwynn, CEO of ACT. “We have enjoyed our long association with the ATA and continue to support their efforts to grow telemedicine throughout the United States and the world. As we expand our business, it’s critical to understand how telemedicine is evolving not just in stroke care but other areas such as cardiology, radiology, chronic care, and global specialty programs.”

Established in 1993 as a non-profit organization, the ATA is the leading international resource and advocate promoting the use of advanced remote medical technologies. Its diverse membership works to fully integrate telemedicine into transformed healthcare systems to improve quality, equity and affordability of healthcare throughout the world. AcuteCare Telemedicine is looking forward to next year’s meeting which is scheduled for May 14 through May 17, 2016 in Minneapolis MN.



Patching the Current System Will Not Advance the Great Promise of Telehealth

The deliberate march towards meeting the Federation of State Medical Boards’ (FSMB) goal of streamlining medical licensing of physicians continues. The FSMB promises that a new compact of seven states will trigger changes that will ultimately help reduce redundant licensing requirements by creating one place where physicians submit basic information such as their education and credentials. Last month Idaho and Utah were the latest states electing to join Montana and West Virginia as this compact attempts to speed up the process of licensing doctors across state boundaries. While some question why only seven states are required for implementation of this compact, just three more states are now needed to initiate the process that promises to remove a formidable barrier to telemedicine growth nationwide.

Despite being one of the most promising technologies to improve patient care and lower the rising costs of healthcare, telehealth is surviving in a regulatory environment that was established during an era devoid of modern telecommunication devices and technology. State physician licensing is currently controlled by 50 state medical licensing boards, each with their own requirements, policies and credentialing criteria. The current licensing process is a substantial impediment to the advancement of telehealth across state lines, sparking an intense debate over the need for a traditionally unpopular nationalized licensing system.

In an attempt to ward off yet another federal intrusion into states affairs, last year the FSMB proposed a voluntary national compact on joint licensing for the states. The goal is to secure the cooperation of enough states to quiet any calls to replace state-based physician licensing with a national program. The reason for the compact is that the FSMB previously approved a telemedicine policy that defines the location of the practice of medicine as the state where the patient is located, not the physician. The model legislation calls for at least seven states to participate in the compact in order to form a governing commission made up of representatives from the participating states.

From the outset industry leaders and telemedicine supporters saw the effort as a weak attempt to stem the growing tide to replace an outdated and inefficient system. The FSMB compact does little to address the cost associated with acquiring a license in each state and in fact increases the costs by adding fees associated with handling and processing the information.

Washington Board of Osteopathic Medicine and Surgery Executive Director Blake Maresh says, “For some, the interstate compact offers a tested Constitutional precept that could creatively forestall federal intervention that might otherwise supplant the longstanding authority of state medical boards, for others the possibility of other state boards licensing physicians who practice in their states, coupled with the establishment of new governmental organizations, leaves them uneasy at best.”

It is certain that the authors of state and federal constitutions could not have envisioned the advance of modern technology and the impact of those advances on preserving and improving the lives of their constituents. Delivering the benefits of increased access to the latest and best medical care, improved patient outcomes and lower costs must trump preserving outdated constitutional precepts. We must intensify our focus on implementing new processes designed to advance the great promises of telemedicine.



Do We Risk Getting Lost, Getting There from Here?

For the healthcare industry, this is the year for consumers to leverage new communication technology and the benefits it promised to lower cost and increased access to quality medical care.  Greg Donahue of Benefitspro said, “Telemedicine is becoming a hugely popular health care product, and a great way to connect doctors and medical facilities with patients. Although many people are still not familiar with its application or availability, the medical community is acutely aware of the cost savings and efficacy of providing direct access between the healer and the sick.” And in a recent Harris survey, more than half of American healthcare consumers indicated that they want to use telemedicine to connect with a physician is an indication that providers are in sync with their patients on the subject of telehealth and its impact on developing a new healthcare delivery model.

With a dozen or so state legislature’s and medical boards currently eying legislation and regulations that could, if adopted, remove the barriers to unfettered progress in the expansion of telemedicine nationwide, the discussion now centers, not on the factual merits of telemedicine, but rather on the question; how do we get there, all together, from here? As one watches the process that a few states have been going through in recent weeks, even the most cynical and experienced observers have to be amazed at the variety of results all the individual States efforts have produced. One thing is truly obvious; determining how we all get to the same destination is taking us all over the map.

While one universal theme consistently centers on the premise that practicing telemedicine shall use the same standard of care as if the healthcare services were provided in person, commonality ends there. Some states require face to face encounters between doctor and patient to exist prior to a virtual treatment, some require a previously established doctor patient relationship via in-person or through telecommunication, some require face to face relationships with exceptions for emergency or specialized care and others ban out-right telemedical care without a previous face to face doctor patient relationship. In a few instances, state law makers have gone as far as determining and mandating the specific illnesses that can or cannot be treated via virtual care.

Addressing the rising high cost of healthcare, universal accessibility and the looming threat of a doctor shortage should be a goal shared by all entities with the responsibility to impact and initiate effective solutions to our healthcare crisis. Technology can and will play a significant role in meeting those shared objectives, but only if all stakeholders gravitate towards setting policy that permits some individuality and flexibility but promotes continuity across all existing boundaries such that it does not interfere with the efficient application of that technology.

The journey to removing the barriers to progress is not concluded and the elongated process may, in the end, produce a better set of solutions for all. Collective intentions focused on the creation of a new and better healthcare delivery model for providers and their patients will help is all get there, together, from wherever we are.



AcuteCare Telemedicine Announcing New Partnership with Bon Secours in Collaboration with InTouch Health

 

AcuteCare Telemedicine, the leading practice-based provider of Telemedicine services for hospitals seeking around-the-clock stroke and other urgent Neurological care, announces its newest collaborative partnership with Bon Secours Neuroscience Institute (BSNI), the neuroscience division at the not-for-profit Catholic health system sponsored by Bon Secours Ministries.

Bon Secours first established teleneurology initiatives 5 years ago at its smallest hospital, Richmond Community Hospital, with a goal to have all of its area hospitals joint commission certified. Patricia Lane, Bon Secours Richmond Administrative Director of Neurosciences says, “Working with the AcuteCare Telemedicine partners feels like an extension of the internal practice. They are truly in alignment with Bon Secours efforts to identify the right path to create continuity of care from the time the patient is admitted to our Emergency Room to the time they leave the hospital. AcuteCare is not just a provider, but invested team members who take pride in providing the best quality of neurological care to our patients.”

By utilizing innovative telecommunication technology, BSNI patients are able to undergo remote consultation with AcuteCare Telemedicine neurology specialists in Atlanta, Georgia. Dr. Matthews W. Gwynn, CEO AcuteCare Telemedicine says, “The neurologists of AcuteCare Telemedicine look forward to helping the Richmond and Kilmarnock areas achieve even greater quality in emergency care for their neurological patients through timely, professional medical consultations using the latest advanced communication technology with our partners at InTouch Health.”

AcuteCare Telemedicine is collaborating with InTouch Health to bring 24/7 extended teleneurology services to BSNI. InTouch Health provides technology enabled services to healthcare providers for the delivery of high-quality clinical care virtually anywhere, anytime. The InTouch® Telehealth Network enables healthcare systems to deploy telehealth applications across their enterprise. Patricia Lane comments, “I just love the technology and clinical solutions platform. It allows for continuity in communications from doctor to doctor and permits the real-time sharing of information between care-givers. Our ultimate goal is to provide a better treatment plan for each patient. AcuteCare Telemedicine and InTouch are the right solution to attain our goals and objectives with our teleneurology initiatives.”

Yulun Wang, Chairman & CEO, InTouch Health said, “We are honored to partner with the Bon Secours Health System to bring greater access to quality care at lower costs into the communities they serve.  InTouch Health’s enterprise-wide Telehealth Network, in combination with high-quality remote physician services, can touch more of Virginia’s population through Bon Secours’ extensive network of hospitals and ultimately into ambulatory care facilities, clinics, long term care and patients’ homes.”

AcuteCare Telemedicine continues to expand its geographic imprint in telestroke care, and is very excited for the opportunity to drive impact for Bon Secours as they continue to enhance their telestroke network. “The advancements in teleneurology not only allow us to access more patients in need of our specialized care, but also improves patient outcomes overall,” comments Dr. Keith Sanders, COO, AcuteCare Telemedicine. “The success of any program hinges on a seamless execution from door to needle. This collaboration is sure to have a significant impact on the patients and communities it serves.”

For more information on AcuteCare Telemedicine, visit www.acutecaretelemed.com.

 

About AcuteCare Telemedicine 

Founded in 2009, AcuteCare Telemedicine is a limited liability corporation advancing the opportunity for healthcare institutions to gain access to highly-respected, expert neurologists and telemedicine technologies. AcuteCare offers a range of services including first-rate neurological emergency response care with around-the-clock support and hospital accreditation education. AcuteCare primarily provides remote emergency neurology consultation which fills staffing needs and reduces the costs associated with 24/7 neurologist availability. As a result, healthcare institutions provide full service emergency neurology care and can earn Joint Commission Certification as a Primary Stroke Center. 

About Bon Secours Virginia Health System

Bon Secours Virginia provides good help to thousands of Virginians through a network of hospitals, primary and specialty care practices, ambulatory care sites and continuing care facilities across the Commonwealth. The not-for-profit health system employs more than 12,500 people, including nearly 800 providers as part of the Bon Secours Medical Group.

The fourth largest and only faith-based health system in Virginia, Bon Secours Virginia offers a full range of services including cardiac, women’s, children’s, orthopaedics, oncology, neurosciences and surgery at eight award-winning hospitals.

– Bon Secours Richmond is St. Mary’s Hospital, Memorial Regional Medical Center, Richmond Community Hospital, Rappahannock General Hospital and St. Francis Medical Center.

– Bon Secours Hampton Roads is Maryview Medical Center, DePaul Medical Center and Mary Immaculate Hospital. 

About Bon Secours Virginia Health Care Foundation

The Bon Secours Virginia Health Care Foundation raises charitable funds to help Bon Secours Virginia Health System address the community’s growing health care needs with compassion and excellence. Through charitable support, we are dedicated to helping create healthy communities, advancing clinical innovation and providing an extraordinary experience of care. For more information on giving, visit www.bsvaf.org. 

About InTouch Health

InTouch Health provides technology-enabled services to healthcare organizations for the delivery of high quality virtual care, anytime, anywhere.  InTouch Health has helped more than 100 healthcare systems deploy telehealth programs across their enterprise, and into other sites of care, quickly and seamlessly using its industry-leading combination of professionals, processes and practices.  The InTouch Telehealth Network provides users unmatched ease of use and diagnostic capabilities, proven reliability, FDA and HIPPA compliance, secure access control, and clinical and technical reporting.



Telemedicine Legislation is Moving; In All Directions

The use of telemedicine and telehealth is increasing becoming the subject of debate in state legislatures all across the country, making the delivery of medical care via telecommunication technology a priority legislative issue for 2015. Ten states; Arizona, Arkansas, Connecticut, Montana, New Hampshire, New Mexico, Oklahoma, Virginia, West Virginia and Wyoming are moving legislation that will impact how their state licensing boards enforce established clinical practice standards. In Arkansas, Connecticut, Indiana, New Jersey, Rhode Island, and Washington law makers are considering legislation that will require telehealth parity under private insurance.

Ron Bachman, a foremost expert on health care consumerism, consumer-centric Medicaid and Medicare, the uninsured population and mental health, predicts an estimated half a billion smartphone users worldwide will be using a health care app to connect to a healthcare giver by the end of 2015. An emerging, technology-using generation is becoming increasingly comfortable with using mobile devises to access their medical care through smartphones, tablets and laptops. Entrusted with an increased responsibility for paying the rising costs of healthcare, these new consumers are embracing disruptive technologies to command lower cost, more convenient, higher quality, consumer oriented medical care. “It is impossible to stop a mega-trend,” says Bachman. “Telehealth is the cutting-edge future of health care worldwide. Telehealth, in its various forms, will provide convenient medical services because consumers will demand it.”

In another recent Harris survey, more than half of Americans indicated that they want to use telemedicine to connect with a physician, and they also think it should cost less than an in-person visit. It is an indication that consumers identify telemedicine as a different means by which to deliver care not a different type of healthcare. Data consistently indicates that telemedicine can deliver quality healthcare outcomes comparable to in person office visits while lowering consumer costs for routine care. Emergency Room (ER) treatment tops the list as the most expensive, least efficient and most frequently utilized way to provide non-emergent care, with an ER visits costing from $1,500 to $3,000 on average. Visits to a Primary Care Physician (PCP) can coast from $130 to $190. A telemedicine visit can cost as little as $40. With the popularity among voting consumers growing there is little wonder why state lawmakers are aggressively marching telehealth legislation forward.

In a recent Forbes article entitled, “Telemedicine Is a Game-Changer for Patients, The System,” contributor Bill Frist points out that there are multiple barriers to the widespread uptake of telemedicine with the most prohibitive being regulatory policies at the state level. The laws in many states either severely limit or completely ban the practice of telemedicine. In Frist’s opinion, for consumers to gain the most benefits from telemedical technology legislation must address four persistent barriers to complete telehealth adoption:

The legislation needs to provide payment parity by requiring insurers to reimburse licensed health care providers for services delivered remotely at the same rate they would pay if the visit were in-person. This assures there would be no financial incentive to favor face to face care over telemedical services. The caveat that it cost the same acknowledges the value of the telephysicians expertise and the indirect costs of providing this service. Cost savings would still be realized through a reduction in lost workforce productivity and less reliance on emergency medical services.

For quality assurance, any legislation should establish that the same standard of practice applies whether the services are delivered in person or remotely.

Proposed legislation should prevent the use of additional rules requiring in person visits before or after telemedicine encounters or the presence of care facilitators during an encounter. Such restrictions effectively eliminate the possibility of most telemedicine models from operating.

State licensure requirements should allow exemptions for telemedicine.

The legislation that is passing through some states is attempting to encompass many of these points. The Arkansas House of Representatives was able to pass a new bill (SB133) that is more restrictive than one that had been previously voted down. While the bill does not meet all goals of an open telemedicine market for consumers and provider alike, it will allow telemedicine practitioners to be licensed as doctors in Arkansas, waives the requirement for a pre-existing, in-person relationship with the patient in cases of emergency and demands that telemedicine be reimbursed by Medicaid and private health plans.  Arkansas lawmakers, like those of many states, are finally willing to open the door to a new healthcare delivery model by way of modern technology, if only a little.

Other states have also passed or are considering telemedicine legislation that would expand telemedicine within their states. There appears to be little consistency in the various offerings except for a tendency towards over-regulation and complexity. Telehealth is exactly the type of innovation that can solve many of the challenges currently facing the healthcare system. Elected representatives must move more vigorously to craft legislation that serves to promote this innovation while limiting litigiousness and overregulation.



Researchers Use Telemedicine to Identify Patients for Clinical Trials

Using telecommunication technology to advance the delivery of healthcare is nothing new. Each day telestroke programs are demonstrating their value to patients who suffer acute ischemic stroke, particularly for those patients who live their daily lives beyond the easy reach of advanced urban healthcare centers. Well-developed “spoke and hub” telestroke programs at small to mid-sized hospitals throughout rural areas are providing advanced life-saving and quality of life benefits to thousands of stroke victims who once were just too far removed from medical specialists to benefit from the most specialized treatment. Advancements in telecommunication technology and its application to delivery medical treatment (telemedicine) are revolutionizing the healthcare delivery model by bringing the care-givers and the treatment to the patient no matter where they reside.

But a major new step in the approach to conducting clinical trials has been taken at the University of Texas Health Science Center at Houston (UTHealth). By utilizing telemedicine to remotely enroll patients with acute stroke in a new study being conducted at different hospitals, researchers are now bringing the research and clinical trials to the patients. The virtual enrollment of patient participants by a group of researchers at Baptist Beaumont Hospital and Memorial Hermann Southwest Hospital will help overcome limitations in the scientific process of testing therapies. The results of the study entitled “Telemedicine-Guided Remote Enrollment of Patients into an Acute Stroke Trial” were recently published in the journal of the American Neurological Association, Annals of Clinical and Translational Neurology. The research team identified 10 candidates and remotely enrolled six of them in a randomized, phase III study.

“One of the main drawbacks of conducting clinical trials for stroke is that we traditionally are limited to patients who arrive at large stroke centers that have the expertise to treat stroke quickly to minimize damage to the brain,” explained the first author of the study and director of the Telemedicine Program, Tzu-Ching Wu, MD. The trial was led by the associate professor of neurology at UTHealth and senior author of the study, Andew Barreto, MD. Patients were identified, screened, enrolled and randomized remotely. “Instead of the patients having to be taken to the mother ship, we brought the study to the patient. The implications are enormous,” Dr. Wu said. “This opens the doors to clinical trials for everyone and helps move science along. Because of the amount of stroke trials that are conducted, it’s hard to find enough participants. This allows us to widen the pool.”

Research and prevention efforts over the past decade have contributed to the decline in the mortality rates for stroke, but the disease still impacts approximately 800,000 people each year and remains the fourth leading cause of death in America. With the aging of the population, stroke research and clinical trials remain a vital determent to the upward progression of the disease. Telemedicine promises to have a significant impact on acute ischemic stroke and is likely to result in further declines in stroke mortality. Using telemedicine technology to assist researchers in broadening access to stroke patients for research purposes may lead to more opportunities to unlock new and beneficial treatments for the disease.




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