AcuteCare Telemedicine Blog


Telemedicine as Beneficial as In-Person visits for Parkinson’s Patients

A recent article in Fierce Health Information Technology reports on a study that indicates that Parkinson’s patients who received treatment via telemedicine did not show a decline in quality of life when compared to typical in-clinic patients.  The new research published in JAMA Neurology aims to address the problem of the prevalent burden of neurological disorders paired with limited access to care by testing home telemedicine for patients with Parkinson’s’ disease.

Skeptics have long argued that taking the face time out of the medical care experience between doctor and patient would result in a lesser quality of care being delivered to patients and some physicians remain adamant that healthcare by remote control is no substitute for in-person doctor visits, particularly when a patient needs care for a serious problem.  While there still remains significant and justifiable sentiments among medical professionals that in-person visits with a doctor plays a crucial role in the quality of health care, the evidence is beginning to indicate that the advantages of telemedicine is chipping away at the real impact these in-person visits have on the quality of care.

The study’s authors admitted that a larger trial would be needed to show if clinical benefits of telemedicine are comparable to in-person care.  They also reported that telemedicine patients, on average, were saved roughly 100 miles of travel and 3 hours of time.  Lead author Ray Dorsey, an associate professor of neurology at the Johns Hopkins University School of Medicine, said in the announcement. “If this proof-of-concept study is affirmed, the findings open the door to a new era where anyone anywhere can receive the care she or he needs. It appears we can use the same technology Grandma uses to chat with her grandson to provide her with valuable medical care in her home.”

There continues to remain many obstacles in the path of full blown acceptance of telemedicine as a quality health care delivery mechanism, but some long standing negative perceptions are beginning to fade away in response to increased successful utilization of the new technology.  With the promise of new, more accurate, comprehensive and sophisticated medical devices making their way into the market place, many more, well established opponents are sure to be challenged to defend their long standing positions and practices as it relates to delivering health care to their patients.



Telemedicine, Bringing Improved Medical Care to India’s Rural Poor

In the United States, much has been said about how Telemedicine technologies are offering improved access and medical care to rural locations, particularly access to specialized medical care providers. But in many countries such as India, the opportunity to advance medical care to rural areas has a much more profound meaning to those in need of health care services.

India is administratively organized into state towns, district towns, block marketplaces, and then villages and healthcare, as such, is distributed along that supply chain with each level of infrastructure offering a lower standard of care.  Even in some of the fastest growing regions of India, as many as 85 percent of the 100 million residents only have access to healthcare that is at the bottom of the quality spectrum.  Private, better quality medical services may be located hundreds of miles away and take hours or days to reach by rural patients and are only available for those who have the money to pay.

Enter World Health Partners (WHP), an international nonprofit organization that provides health and reproductive health services in low-income countries by harnessing local market forces to work for the poor. Leveraging existing social and economic infrastructure, WHP utilizes the latest advances in communication, diagnostic and medical technology to build an ecosystem atop the existing private sector to bring improved medical services to even the most rural areas of India.

WHP is teaming up with out of the way, unlicensed, village health practitioners, or Quacks as they are known in India, to connect poor, rural patients with doctors located in Patna and Delhi.  For an investment of about $1000.00, each of the more than 433 quacks currently in WHP’s network of telemedicine practitioners can set up a Wifi network, laptop computer and the necessary equipment to make it all work, or at least work most of the time.  The system is not perfect and experiences frequent break downs but it saves time, money, and in some cases can save lives, for rural families that would otherwise have to travel hours to larger cities.

World Health Partners is working towards setting up 16,000, mostly privately owned and operated, telemedicine centers throughout India’s most rural provinces in hopes of bringing the convenience and benefits of telemedicine to the poorest of India’s population.  In addition, the concept is being scaled to be exported to countries and regions well beyond India, with hopes of reaching millions of world’s neediest populations.



Mobile Healthcare and Monitoring on the Brink of Revolution

Wireless in-home health monitoring is expected to increase six-fold in the next four years. A recent study by InMedica indicates that 308,000 patients were remotely monitored by their healthcare provider for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes, hypertension, and mental health conditions worldwide in 2012. While congestive heart failure accounts for the majority of remote monitoring, it is expected that diabetes will supplant COPD with the second largest share of telehealth patients by 2017.  It is predicted that more than 1.8 million people worldwide will utilize mobile monitoring in the next four years.

Telemedicine is seen as a significant tool among healthcare providers for reducing hospital readmission rates, track patients chronic disease progression or provide advanced specialized medical treatment to patients in remote areas.  Four main factors are driving the demand for increased use of telemedicine and telehealth; Federal Readmission penalties introduced by the U.S. Center for Medicare and Medicaid Services (CMS);  healthcare providers desires to increase ties to patients and improve quality of care; insurance providers who are looking to increase their competitiveness and reduce in-patient pay-outs by working directly with telehealth suppliers to monitor their patient base; and an anticipation for future increased demand for telehealth services by patients.

Of the billions of dollars spent on health care each year, 75% to 80% of it goes for patients with chronic illnesses such as diabetes, heart disease, asthma and Alzheimer’s disease.  With rising costs and the anticipated shortage of physicians and healthcare providers over the next decade, utilizing the telemedicine technologies is becoming increasingly important to the routine delivery of medical services and monitoring of chronic diseases.

Even telepsychiatry, the use of secure Web-based video conferencing technology, and ambulatory patients, those who have been diagnosed with a disease at an ambulatory care facility but have not been hospitalized are expected to experience significant increased utilization of telemedicine among healthcare professionals in the next four years.  A plethora of emerging mobile technology, such as wearable wireless monitors to smartphone attachments will offer consumers the ability to track everything from core vital signs to impending heart attacks by discovering problems with heart tissue are on the horizon, offering a revolution in digital medical technology.

Speaking to those resisting the new mobile technology, Dr. Eric Topol, a professor of genomics at the Scripps Research Institute, recently encouraged the medical community to end paternal medicine, where only the physician has access to healthcare information, and to embark on a new beginning where patients own their data.  Dr. Topol compared the new mobile technology to the Gutenberg press and the way it revolutionized the way information was shared throughout the world.

We are embarking into a new era where patients have the mobile tools to better enable them to participate in their own medical diagnoses and treatment.



Georgia Continues to Lead the Way with Telemedicine in Public Schools

The usual topics of public school board meetings generally include such topics as the state of school budgets, discussions on appropriate text books, disciplinary policies, dress codes, or the progress report on new building construction. But during the regular monthly meeting of the Coffee County Board of Education, on February 13, 2013, Coffee Schools Nursing Supervisor Kathy Cole and Family Connections Director April Thomason announced that the Coffee County School System was recently awarded a $500,000 grant, which will be used to purchase telemedicine equipment. Utilizing telecommunications and information technologies in order to provide clinical health care at a distance is revolutionizing the delivery of medical care and services, and Cole stated, “By receiving this grant, we truly are on the cusp of something so very innovative.”

The state of Georgia continues to set the pace nationally for promoting telemedicine as a preferred mode of healthcare delivery, particularly in regions where the nearest doctors are often hours away from their patients. “Georgia is definitely a model for other states,” said Sherilyn Pruitt, director of the Office for the Advancement of Telehealth, part of the division of rural health in the U.S. Health Resources Services Administration.

School boards across the country continue to struggle with providing appropriate levels of medical care to students attending public schools. The U.S. Supreme Court has held that medical services can be required as a part of the educational services school districts must provide. The Individuals with Disabilities Education Act (IDEA) requires that schools provide “related aids and services” so that children with disabilities can be educated to the maximum extent appropriate with their non-disabled peers, and the Rehabilitation Act of 1973 prohibits discrimination against students with disabilities, requiring school districts to provide accommodations for students with disabilities.

The use of telemedicine is proving to be a viable alternative to providing this mandated coverage in a cost effective manner, while increasing the quality and availability of these services to students.

The new equipment in Coffee County, for example, will allow students and school employees and staff to be seen by a certified medical physician without ever having to leave the classroom or school. With over 240 doctors in the physicians’ network the school will utilize, coverage will be very complete. Statistics have shown that this practice results in a dramatic reduction of student and employee absences, benefitting not just the health of the schools, but also efficiency in working towards educational goals.