AcuteCare Telemedicine Blog


DR. MATTHEWS GWYNN RESPONDS TO WALL STREET JOURNAL ARTICLE

As telemedicine becomes a model for the delivery of healthcare, The Wall Street Journal recently published an article questioning if telemedicine could replace an ER visit. Read the full article included below as published in the Wall Street Journal on August 2, 2015 followed by Dr. Gwynn’s comments.

When a Doctor Is Always a Phone Call Away Many of the 136 million ER visits in 2011 could have been replaced with a $50 telemedicine consultation.

By

Richard Boxer

Aug. 2, 2015 5:30 p.m. ET 

A 39-year-old truck driver was hauling through the Midwest in the middle of the night in 2011 when he began to feel a bit of indigestion. Then a lot of indigestion. He pulled over, recalling that his company had recently signed on with Teladoc, for which I was then the chief medical officer. The service allowed him to get a doctor on the phone within 15 minutes. He called and described his symptoms: nausea, chest pain, a little numbness in his left arm. He was having a heart attack, and his GPS guided him to the nearest emergency room.

Getting that doctor on the phone saved his life, and potentially the lives of whoever his 10-ton rig might have plowed into had he keeled over behind the wheel. If efficient and affordable quality treatment is the goal, telemedicine should be the future of health care.

When it comes to health care, “efficient” is a word that frightens people, calling to mind a soulless bureaucracy with an eye on the company’s bottom line. But it is inefficiency that is overburdening the medical system. Consider a woman with a urinary-tract infection who has to leave work to obtain a prescription from a doctor for a drug she already knows she needs. Or a man with a fever and hacking cough who has good health insurance, but who goes to the emergency room because his doctor’s office is closed.

Americans are struggling to obtain affordable, convenient care, and 103 million people in the U.S. live in areas with a shortage of primary health-care providers, according to the Health Resources and Services Administration. Yet the country is dependent on expensive, brick-and-mortar facilities that require time-consuming travel. 

Primary-care doctors tend to cluster in urban areas. If you get sick in rural Wyoming, even during the workweek, your only choice might be the emergency room. In 2011, the Centers for Disease Control and Prevention reports, 136 million people were seen in an ER; many of those visits could have been replaced with a $50 telemedicine consultation. Researchers at the University of Rochester found that 28% of the visits at one pediatric emergency room involved ailments such as ear infections or sore throats that could be diagnosed over the phone.

These problems are exacerbated by the increase in the elderly population, coupled with tens of millions of patients newly insured by the Affordable Care Act. A study in the Annals of Family Medicine projects that the U.S. will need 52,000 more primary-care doctors by 2025. Those positions aren’t filled easily. It takes 12 years and hundreds of thousands of public dollars to educate one primary-care doctor.

But there is an untapped resource: the many doctors leaving their practices, fed up with the regulations and other hassles, but who love their patients, and the older physicians eyeing retirement because they no longer want to maintain an office. Why not let these doctors offer their expertise to patients by smartphone?

Doctors who contract with a telemedicine company can opt for a specific block of time when they are “on call” to patients, picking up the phone and answering questions in 10- to 15-minute intervals. The doctor is paid and the patient gets a prompt and inexpensive answer to a concern.

Home care of individuals with major chronic conditions would also substantially benefit from telemedicine. Millions of houses have cable and satellite connections that can be used to monitor patients wearing wireless devices, allowing health professionals to intercede at the first sign of trouble. This can reduce rates of hospitalization by half or more, some studies suggest.

While there is worry about the quality of these interactions, telemedicine companies assess their doctors routinely and maintain strong quality-assurance programs. Every doctor is taught in medical school that 80% of diagnoses are obtained through a medical history and symptoms, and not by what a doctor sees, touches or tests.

Telemedicine will never completely supplant face-to-face visits, and most doctors naturally would prefer to treat a patient in person. The American Medical Association, for instance, has encouraged restriction of telemedicine to patients who have an established relationship with a doctor, and some state medical boards try to enforce that view.

But the perfect cannot be the enemy of the good—and by continuing to practice medicine as usual, we are making it so. Millions of Americans live in areas that are short of primary-care doctors, and millions more go to the emergency room when they have a sore throat. Entrepreneurs have responded by creating methods of connecting patients to doctors remotely, which reduces costs and satisfies patients.

There is no scenario for sustaining or improving health care in America without telemedicine. State and federal governments, as well as the medical establishment, should embrace the technology. For one thing, they should change Medicare and Medicaid to allow reimbursement for telemedicine consultations, most of which are currently not covered. Ask that truck driver if he thinks talking to a doctor over the phone has value: He is still alive and trucking.

Dr. Boxer is the chief telehealth officer of Pager and chief medical officer of Well Via. 

Corrections & Amplifications

An earlier version of this article misstated the name of the journal that published a study of the need for 52,000 more primary-care doctors by 2025. It is the Annals of Family Medicine.

Dr. Matthews Gwynn, Partner, ACT, responds to the article saying, “One may argue plausibly whether a phone call, such as in Dr. Boxer’s example of the trucker, is adequate or not for general medical care, but there is no reasonable argument against audiovisual encounters combating emergency medical conditions such as stroke, provided remotely by experienced physicians to underserved urban, suburban and rural hospitals.”

Gwynn also comments, “In-person visits will likely remain the mainstay for local care for those fortunate enough to be around many physicians, but when minutes count in emergencies experts can step in and make the decisions that will determine a lifetime of health instead of a lifetime of disability. Telemedicine isn’t a fad but rather a disruptive innovation that flows naturally out of technological advances and has already contributed immensely to our society’s health. It’s a perfect fit for our shrinking resources.”

Telemedicine is a critical part of the new healthcare delivery model. As healthcare organizations begin adopting new practices, the conversation around proper use, application, and the effect on patient outcomes will continue.



ACT and Bon Secours Committed to Improving Patient Outcomes

ACT Bob Secour photo1

(Left to Right: Rahul Patel, ACT Data Manager, Dr. Keith Sanders, Partner at ACT, Patricia Lane, Administrative Director Neuroscience at Bon Secours Health System Richmond, Suzanne Doolan, Hospital Systems Manager at Genentech, and Dr. Lisa Johnston, Partner at ACT.)

Atlanta, GA: AcuteCare Telemedicine (ACT), the leading practice-based provider of Telemedicine services for hospitals seeking stroke and other urgent Neurological care, and the Bon Secours Neuroscience Institute (BSNI) established a collaborative partnership earlier this year to enhance BSNI’s “around the clock” neurological service. ACT and Bon Secours have developed a telemedicine model focused on improving the delivery of care and overall patient outcomes.

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, orthopedics, oncology, neurosciences and surgery at eight award-winning hospitals. Bon Secours established its teleneurology program 5 years ago with a goal of having all of its area hospitals joint commission certified. Patricia Lane comments, “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 an invested team member who takes pride in providing the best quality of neurological care to our patients.”

BSNI patients are the focus and the most important benefactors of this collaboration. Patients are able to receive timely, remote, emergency consultations with AcuteCare Telemedicine neurology specialists. “Our commitment to providing the highest quality of care and ongoing collaboration with BSNI is sure to have a significant impact on the patients and the communities BSNI serves,” say Dr. Keith Sanders, Partner, ACT.

ACT hosted Patricia Lane, Administrative Director Neuroscience at Bon Secours Health System Richmond, and Suzanne Doolan, Hospital Systems Manager at Genentech to review stroke treatment processes and patient outcomes. “The advancements in teleneurology not only allow us to access more patients in need of our specialized care, but in providing acute stroke care we are able to improve patient outcomes overall,” commented Sanders. “The success of this collaboration hinges on a seamless execution and a continued effort to evaluate and implement improvements.”

AcuteCare Telemedicine continues to expand its geographic imprint in telestroke care, advancing the opportunity for healthcare institutions to gain access to highly-respected, expert neurologists and telemedicine technologies. For more information on how to implement teleneurology services at your healthcare organization, contact ACT. 

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.



Telemedicine, the Future Venue for Healthcare

While many believe that telemedicine first made its debut just a little more than a decade ago, the practice of telemedicine can be traced back to the early years of the space program. The National Aeronautics and Space Administration (NASA) pioneered the remote use of physiological measurements of astronauts and telemetered the data back to earth from the spacecraft. These early efforts from the 1960’s enhanced the development of satellite technology which led to the development of telemedicine. The decades since have brought significant advances to the technology, lower costs of equipment and an expansion of the potential uses in the medical industry.

Advancements in the fidelity, mobility and affordability of technology is changing the landscape for healthcare delivery. As the digital gadgetry becomes smaller, more portable and easier to use patient/consumers are advancing their expectations of telemedicine as payers look to reduce the costs of routine medical care and shorten the length of hospitalization. There is a vast array of new technology being applied to healthcare that promises to give patients more responsibility and control over their health and fitness. Wearable technology and wellness devices enable users to continuously monitor their vital signs and track their progress towards their fitness goals.

Future wearable devises will focus on accuracy and data integration as well as visualization capabilities; virtual models that promote the patients understanding and significance of the all the wellness data generated by the wearable devise.

The newest digital health trend, nanotechnology, may have a significant impact on healthcare. Nanotechnology’s precision and accuracy can aid in designing new drugs to specifically match a patients needs or monitor the progress of cancerous tumors in a patient’s body. While still in its infancy, nanotechnology is expected to be a significant digital health trend in coming years. Artificial intelligence is another digital health trend that will help physicians track a patient’s health and identify danger signs before an onset of a heart attack or stroke. As the costs of genome sequencing continues to decline, integration of personal genetics and research will advance the practice of genomics in the next few years.

“Access, cost, and convenience are driving it (technology) forward, plus advancement in technological capabilities”, says John Jesser, vice president of engagement strategy at Anthem Blue Cross, an affiliate of the Indianapolis-based WellPoint. “Historically, telehealth meant expensive video conferencing equipment in a clinic at one location and expensive video conferencing in a hospital somewhere else. (The technology) now allows doctors to log in and log out easily at their convenience and it allows patients to seek care when they want it, from their iPhone or Android. That’s changed everything,”

As virtual health initiatives move forward, new and valuable trends and telehealth technology solutions will continue to emerge and be adopted as the traditional methods of delivering medical care are challenged and disrupted at medical facilities, physicians’ offices and hospitals. The venue of choice for patients seeking medical in the future will more likely be smartphones, laptops, and tablets. The preferred provider will have to be knowlegable and comfortable with this rapidly changing healthcare delivery landscape.



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.



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.