AcuteCare Telemedicine Blog

Evolution / Revolution

After more than two decades in experimental and somewhat limited practice, telemedicine is poised to experience a revolution in use and acceptance by medical care providers and patients alike. The journey since its practical inception has been fraught with challenges, both in the tangible technical arena as well as the human/emotional one, and the pace to this point has been more accurately described as evolution as opposed to revolution.

Significant barriers remain to be removed from the telemedicine pathway to full acceptance as an innovative healthcare delivery model, but many of the once formidable obstacles are rapidly falling by the wayside. Paula Guy, CEO of the Georgia Partnership for Telehealth, says “It’s not about the technology anymore, it’s about applying it… In the next few years, it will no longer be known as telehealth. It’s just going to be the way we do healthcare.” Still, the intangibles are lagging behind in the acceptance curve, the most predominant being the persistent concern for the effects of technology on redefining the doctor-patient relationship.

From the patient standpoint, the level of acceptance is gaining at a quicker pace than that of the doctors and their service provider associates. Greater access to specialized medicine, convenience factors, and the concern for rising healthcare costs have eased the reluctance of patients, who are now accepting lessened one-on-one contact with their care providers, although nobody is predicting this personal interaction will go away for good.

Physician’s reluctance is based in part on a good deal of research that indicates a clinician’s physical presence in the room, along with simple companionate personal consultation, has therapeutic value. There’s also a worry that without face-to-face access to the patient, the physician will miss something important or that over-enthusiasm for telemedicine services will deprive patients of the essential hands-on component of care.

To many, the advantages of telemedicine in terms of bolstering the quality and availability of enhanced medical care must be weighed against the potential harm that could result from patients not having in-person contact with their physicians. The real solution to overcoming this challenge is to discover an optimal intersection of technology and personal, hands on care. It remains just ahead in the evolutionary path of telemedicine, where it can enable a true revolution instead.

2013 – The Year Telemedicine Breaks Out?

After more than 40 years of development, tweaking and testing, telemedicine appears to be approaching a major break out by joining the mainstream medical establishment to innovate the delivery of medical care in the United States. Considering the banking, entertainment and publishing industries years of success in delivering products and services efficiently to customers through telecommunication technologies, the growth and acceptance of telemedicine has been a long time coming.

According to the American Telemedicine Association, a leading problem is the red tape and top-down regulatory reticence demonstrated by various government agencies. The leading barriers to the deployment of telemedicine in the U.S. have almost all involved government policy: reimbursement by Medicare and Medicaid, state-based standards of care and professional licensing, device regulation and telecommunications policy.

With rising medical care costs, the shortage of medical practitioners and the increasing demand for health care services, the pundits of delay may soon need to get out of the way or risk getting run over.  Last year more than five million Americans received remote evaluations of medical images and more than 10 million patients directly benefited from some form of telemedicine.  Could 2013 be the year to end the bureaucratic procrastination?

The campaign for change has begun as State legislators, Patient Groups, Medical Societies, Private Health Service Payers and Health System Leaders are banding together to promote and accelerate change.  State government will most likely be leading the way towards reforming state funding of telemedicine services and regulations that govern the medical industry.  Sixteen states have already adopted legislation requiring private medical service payers to reimburse for telemedicine and several more states are expected to follow in 2013.

The Federal government can be expected to take some steps towards acceptance and participation but, as is usually the case, Washington will likely move at a much more deliberate pace, taking every opportunity to secure a position of playing catch-up. As the cost benefits and increased availability of specialized medical services through the practice of telemedicine continue to become apparent to many more thousands of patients, the barriers to nationwide innovation of medical services will continue to fall at an increasing rate.

To all those who are blocking the path to progress, it is time to get out of the way and become part of a technological solution.

Beam Me Up, Doc!

Telemedicine, the rapidly developing application of clinical medical services utilizing today’s advanced communication technology, is moving forward at an escalating pace. Challenges to its wide spread implementation are being overcome with advancements and refinements to the technology. As physicians and patients concerns over the effectiveness of care and information security are addressed, the promises of lower cost, more accessible, quality, health care conducted via the internet is gaining popularity among healthcare providers and patients alike.

With the concept of telemedicine now having been successfully established, AcuteCare Telemedicine is utilizing the modern communication technology to enable personal neurology consultation when doctor and patient are in different locations. ACT makes urgent stroke care accessible for more patients and cost-effective for hospitals and clinicians. Expanding clinical services where physicians electronically treat patients directly without a clinician being present with the patient is the most logical next step in the technology’s progression.

Patients and physicians in Hawaii are now able to enroll in Hawaii Medical Service Association (HMSA) Online Care program where patients receive care from participating doctors who are scheduled to be reachable at that moment. HMSA says thousands of patients have registered, and in New York, about 10,000 individuals, most of them residents of the New York metropolitan area, can already get an online emergency consultation with emergency room physicians.

Jay Sanders, president emeritus of the American Telemedicine Association says, “Probably the most powerful aspect of telemedicine is improving access and improving the convenience of a lot of elements of healthcare, so, whether you’re talking about folks who would have a hard time getting to a specialist or whether you’re talking about someone who is in a jam and needs to see a doctor before they go on a business trip, telemedicine clinics are very valuable. These technologies are unlikely to replace office or hospital visits entirely”, says Sanders. “But they are tools physicians can add to an evolving ‘electronic black bag,’ as he calls it—the updated equivalent of the battered leather case brought along on house calls in a bygone age.

If You Build It, Will They Come?

A recent report from the Pew Research Center measuring the number of adults using technology to track their health has presented some surprising findings.

The results of the Pew Internet & American Life Project survey, which were recently reported in iHealthbeat and supported by The California Healthcare Foundation, found that of 3,014 adults interviewed by phone, just 21 percent of the respondents actively used technology to track their health care. What may be even more surprising is that just 19 percent of those surveyed who owned smart phones, or just 7 percent of all respondents, had acquired an app to monitor their health. Susannah Fox, lead author of the report was surprised by the results and commented, “We’ve been looking at health apps since 2010, and health app uptake has been essentially flat for three years.”

A look at the science of the report, particularly the definition of “adults,” could give some more understandable insight as to the results and may produce answers for some of the “surprise” as to the outcome. Considering that most, older adults have a seemingly natural long acceptance curve when it comes to adopting technology and gadgets, and considering the well-entrenched privacy attitudes about everything to do with personal health information, the results may not be all that unexpected.

Purveyors of new communication technologies operate in environment where todays new devise and idea is often well into obsolescence by tomorrow; such rapid progression of invention to development is unmatched by other industries and beyond the understanding of most consumers. Expecting an equally aggressive acceptance rate by the markets is unreasonable, even when the benefits of convenience and utilization are so obvious to so many.

Given the generally slow acceptance rate of consumer health products, a three year period of market penetration may not be a reasonable benchmark to measure the success or failure of health care applications. Only more time will reveal if the “acceptance curve” will sharpen and the adoption and usage rates grow more dramatically.

“Build it and they will come”. Perhaps, but it may just take a bit longer for their arrival.