AcuteCare Telemedicine Blog


What’s In Your Digital Health Tool Box?

The early implementers of telemedicine faced resistance, skepticism, and predicted peril from an industry that has followed a standard of care, governed by regulations. Those initial trailblazers have prevailed in their efforts to improve access to specialized care for patients living afar from major medical centers, enhancing patient’s healthcare experiences and reducing the unnecessary cost of specialized treatment and ongoing chronic care. Their persistent efforts to merge the latest digital technologies in communication with modern medical care has spawned new terms to languages all around the world; Telepsychiatry, Telestroke, Telemedicine, TeleICU and Telehealth, just to name a few.

Technology is having a wider impact on how healthcare providers connect with their patients and dispense treatment. This connected health revolution is making everyone active participant’s in their healthcare through an ever expanding network of devices and platforms. But as is often the case, development of new technology can outpace the ability of an industry and their consumers to accept and engage the new methods.

Consumers have demonstrated an impressive demand and utilization of digital healthcare tools like activity trackers, smart watches and their accompanying health apps, but nearly half of the users complain that their caregiver is failing to integrate the data into a personalized healthcare plan. A survey, conducted by HealthMine, called “The State and Impact of Digital Health Tools,” found that “a significant amount of digital health data is not reaching doctors or health plans and that there appears to be a disconnect between where consumers would like their self-collected health data to go and how easy it is to share it.”

Many physicians articulate an understandable concern about the accuracy of many of these devices and the process of collecting and transferring the data. In a recent article Vaughn Kauffman, a global practice leader in PwC’s Health Industries Advisory, indicated that physicians have some apprehension around taking in data from mHealth devices and wearables. “Some providers are further down the road than others around utilizing these kinds of data for engagement. There’s the potential to extend the doctor-patient relationship to beyond the direct doctor visit interaction. And obviously, this would involve individuals opting in, as opposed to kind of a Big Brother phenomenon.”

While wearables continue to be popular, many once avid users are discontinuing their engagement with the technology. Some indicate their waning interest is due to not understanding how the data collection will benefit them or enhance their digital health plan. Education and better understanding of the technology and how it can benefit both providers and patients in improving the delivery of healthcare will solidify the acceptance and use of the technology. The early pioneers of telemedicine have opened the trail to a much larger spectrum of services but wider engagement is still dependent on the ability of technology to deliver on its promises.



Is That The Sound Of Ice Breaking?

Until recently, the state of Arkansas was ranked last among all states in a recent report by the American Telemedicine Association on telemedicine practice standards. Like many other states, Arkansas’s treatment of healthcare via telecommunication technologies included restrictions forbidding caregivers the opportunity to treat a patient remotely without first establishing a face to face relationship. While other regulations purposefully and effectively deal with commonly acceptable policies that hold virtual healthcare treatment to the same standards of care as traditional in-person encounters; control the prescription of certain drugs via telemedicine; require the responsible handling of medical recording; and doctor/patient transparency, the restrictions on non-pre service face to face encounters and the insistence on individual state licensing of physicians is arguably the two regulations which proponents of telemedicine feel are hindering the wider adoption of telemedical services across the country.

Recently issued proposed amendments to its existing regulations have been approved by the State Legislature. Arkansas Code 17-80-117, will allow a doctor to establish a valid relationship with a patient without the need for an in-person exam, if the doctor “performs a face to face examination using real time audio and visual telemedicine technology that provides information at least equal to such information as would have been obtained by an in-person examination.” The rule also requires the doctor to establish a face to face follow-up visit when and if it is medically necessary.

The sound one hears from this action may just be the noise regulatory ice makes when it is breaking under the pressure of consumer demand and the application technological common sense. While the proposed changes do nothing to alleviate the cost and inconvenience of individual state physicians licensing requirements, the removal of the face-to-face, pre-telemedicine service requirement could open up the virtual care landscape in states where the face-to-face regulation still exists.

The Arkansas Board held a public hearing involving the proposed amendment to Regulation 2.8 and new Regulation 38 in June and encouraged telemedicine companies and healthcare providers looking to offer telemedicine services in Arkansas to review the proposed regulations and consider submitting comments.

Adoption of the proposed changes to Arkansas rules governing telehealth services may be seen as a water-shed action for healthcare professionals who believe consumers will benefit from both increased healthcare access and reduced cost when telemedicine is permitted to more freely expand across state lines.