AcuteCare Telemedicine Blog

Making a Meaningful Difference to Lives around the World

It has been a little more than a year since Georgia Partnership for TeleHealth (GPT), the Louisiana State University Health Science Center (LSU) and Casa Para Ninos Aleluya (CASA) launched its first international telemedicine program. The mission of the collaboration is to deliver much needed primary and specialized medical care to the children of the CASA orphanage through the use of telemedicine technology.  The orphanage is home to over 400 abused, orphaned and mistreated children and is located just outside of Guatemala City. The medical needs of hundreds of the children at CASA are met daily through a few nurses that manage a clinic on-site.

Shortly after the Program got underway, Dr. James M. Kiely, a partner in Atlanta Neurology, P.C., AcuteCare Telemedicine (ACT) and Medical Director of the Neurophysiology Departments at Northside Hospital and St. Joseph’s Hospital of Atlanta was given the opportunity to demonstrate telemedicine capabilities at the orphanage and volunteered his time and talents to render virtual care to the youth of CASA.

Dr. Kiely remotely treated a 19 year old CASA patient with a history of intractable epilepsy. The young patient was on numerous medications but continued to experience recurring seizures. By using a high definition audio-visual connection provided by GPT, Dr. Kiely was able to interview the patient’s parents and examine the patient remotely. The imaging results, hemiparesis, and description of seizures allowed him to determine that the likely type and cause was attributed to porencephaly, the failure for one hemisphere of the brain to develop. Kiely was able to recommend appropriate medications to on-site doctors and to suggest additional steps to take if the patients epilepsy remained intractable. The process worked flawlessly and marked the beginning of a new relationship between the missions and medical providers across the region.

At a recent GPT Telehealth Summit this year in Florida, Dr. Kiely was brought up to date on the patient he first treated more than a year ago at the orphanage in Guatemala. A family member of the patient has recently received his Master’s Degree. He is now serving an internship with the Georgia Partnership for Telehealth who continue to provide ongoing support to the children of the Guatemala region through donated physician time. He had the opportunity to speak with Dr. Kiely and informed him that the young patient, his sister, is doing well.

Dr. James M. Kiely says, “I am so invigorated when I’m able help a patient and to make a meaningful difference in their future. Whether here at home, or around the world, it is extremely rewarding.”

Telehealth is Disrupting the Traditional Healthcare Delivery Model

Walgreens has announced that it is teaming up with MDLive to offer virtual healthcare visits through their pharmacy mobile app. Walgreens customers have been able to connect with pharmacist and Walgreens staff via the app for several years, but a new expanded telemedical service will soon be offered to Walgreens customers in their California and Michigan retail outlets. Customers, or patients, will be able to consult with physicians virtually about routine acute conditions. Walgreens’ management plans to expand the new service to their retail centers in other states.

Telemedicine has found considerable success and acceptance as a tool to connect patients located in rural areas with medical specialist in urban medical centers, bringing much needed neurological and other medical specialties to patients previously denied convenient access to advanced, specialized care. Time sensitive virtual treatment for stroke and other neurological ailments are now readily available to patients regardless of where they live, saving valuable time, improving patient outcomes and saving lives.

But the expansion of telecommunication technology to broader telehealth applications is just beginning to be introduced to consumers through retail outlets and the workplace and is likely to disrupt the normal delineation of services in the medical care industry.

Walgreens is being joined by competitors CVS and Target in an aggressive entry into virtual, in-store healthcare clinics through partnerships with a growing number of emerging or established healthcare providers. Kaiser Permanente, a leading clinical healthcare provider, is now experiencing nearly half of their patient encounters virtually, in their Northern California clinics, which has grown from 4.1 million visits in 2008 to approximately 10.5 million at the end of 2013. Permanente Medical Group CEO, Robert Pearl is predicting that Kaiser’s virtual clinic visits will exceed in-person encounters by 2016.

Typically consumers use retail clinics for services such as vaccines, strep throat tests and treatments for other common maladies but the new entrants into the retail telehealth market are predicting that patients will also use the new virtual clinics for pediatric care, well-woman care, family planning and chronic-illness management.

Investors in the expanded retail telehealth market are banking on consumer/patients to continue to respond positively to the convenience and cost savings offered by telemedicine in order to successfully navigate through the start-up to profitability curve. It has been predicted for nearly a decade that advances in telecommunication technology would lead to a vastly different and innovative medical care delivery model. It would appear that the predictions are well on the way to becoming reality.

Preparing for the New Reality of Telehealth

A little more than a decade ago, telestroke and teleneurology were words that where not even part of our language but today are synonymous with the delivery of remote life-saving treatment for stroke and other neurological maladies. Telemedicine has provided vast improvements in medical care for our nation’s troops and veterans who are deployed in remote areas across the country and around the world, and is now poised to expand to a much larger telehealth initiative which promises to bring virtual, routine medical care to the home, workplace and public facilities of millions of patients throughout the country. With this expansion, telehealth will not only change the method of delivery of healthcare but proposes to alter the dynamics of the traditional caregiver/patient relationship. Yesterday’s patients are today and tomorrows consumers.

A new study from consulting company Oliver Wyman titled “The Patient to Consumer Revolution,” is revealing how empowered-consumers and outside industry innovators are influencing important changes to a centuries-old healthcare delivery model. “Empowering the consumer is what’s toppled many markets,” says Tom Main, partner at Oliver Wyman and co-author of the report. Companies like Walgreen’s, CVS, Google and Apple are beginning to enter what was traditionally an industry driven market. These new influencers are consumer experienced and able to successfully initiate telemedical products and services to a more aware and influential consumer.

In order to adjust to the new reality of virtual care delivery; hospitals, physicians and healthcare professionals across the care giving spectrum will need to alter not only their hard technology skills but learn new methods of personal interaction with their patients. Practitioners accustomed to performing good bedside manners will need to add “laptop manners” to their set of skills.

Relating to patients in person requires a much different approach than interacting with them virtually. Randy Parker, CEO of MDLIVE, a Florida-based telehealth provider says, “There’s a whole comfort level and professionalism involved (in telehealth) that many doctors don’t get, there’s even a dress code, and a way you present yourself” in a video encounter.” The new skills are not yet taught in medical school and few practitioners have yet had the opportunity to develop and fine-tune them in practice.

Peter Antall, medical director of the Online Care Group, says “Online doctors face two unique challenges that they don’t encounter in the exam room. First, they should have a familiarization with the technology they’re using, in case the patient on the other end of the encounter isn’t tech-savvy and needs help. Second, they have to learn “how to evaluate patients without the ability to examine by touch. Developing these skills requires a physician to be open minded and willing to learn and grow.”

It could be safe to say that very few healthcare professionals envisioned the disruptive effects the arrival of the internet, social media, wearable devices and mobile technology would have on the delivery of healthcare in the 21st century.

Telemedicine Joins the Fight against Ebola

As news outlets report the increased number of healthcare workers becoming infected with Ebola while treating patients with the deadly disease, concern for the welfare of healthcare workers around the globe is mounting. Ebola is an extremely infectious and deadly virus which is spread through the exchange of bodily fluids. Doctor and nurses who treat patients are highly prone to becoming infected while administering treatment to Ebola patients. More than 320 health workers who have treated Ebola patients have died of the disease and several others have been infected and survived.

Telemedicine is becoming a very effective weapon in treating Ebola patients while protecting care givers from being infected. From the evaluation of a potentially infected person to the routine communication of treatment, telemedicine can be a remote vehicle used to administer treatment while the patient is in isolation. Medical staff or specialists located anywhere around the globe can be consulted and participate in providing the best and latest care. Many healthcare providers will be spared the time, expense and inconvenience of relocating to areas where the disease poses the greatest risk. Telemedical technology can be useful to containment efforts at points of entry such as airports, emergency rooms, border crossings, schools and military installations.

In the military and Veterans Administration the benefits of telemedicine to the treatment of infectious diseases is not new. Telemedicine has been used to care for U.S. troops dispersed throughout the world and to veterans at home for nearly a decade. According to the Association of Military Surgeons, infectious disease tele-consults ranked second in the total number of online consults, and a study of the infectious disease tele-consultation service found the service to be providing beneficial and relevant recommendations for treatment in a timely fashion.

Telemedicine has become very successful in the private sector as well; improving access to specialized care to rural communities throughout the United States and remote areas of the world. Advanced treatments for stoke and other neurological diseases are now readily available remotely to patients, who were once too far removed from urban medical centers to benefit from time-sensitive treatment, improving recovery prospects and saving lives.

Defenders against contagious diseases can learn important lessons from these successful experiences and gain vital insights as to how telemedicine can improve care for patients and healthcare workers alike.