AcuteCare Telemedicine Blog


Continuity of Care in Telemedicine

Continuity of care is a fundamental factor in the delivery of quality healthcare and a bedrock principle of the patient-doctor relationship. It is understood to be a critical element in all health care systems and has shown to be responsible for reducing hospitalizations and lowering costs, particularly among chronically ill patients.

Traditionally, continuity of care is the delivery of a “seamless service through integration, coordination and the sharing of information between different providers.” The increasing complexity of healthcare delivery is complicating the assurance of continuity of care. Virtual interactions between patient and caregiver and a plethora of health related monitors, devises and mobile apps, has some believing the increasing complexity in healthcare delivery might impede the achievement of continuity of care. Even in a traditional face-to-face care relationship, it is common to have more than one care provider across the process of diagnosis and treatment. Add options like retail clinics, e-visit websites, smartphone apps, freestanding urgent care centers and kiosks and continuity of care could be compromised by all the disruptive innovation.

For this reason much debate about telemedicine and the effect it is imposing on healthcare delivery has been centered on the doctor/patient relationship and the adherence to maintaining a high standard of care, regardless of the method of interaction. While the importance of the patient and physician in the new electronic relationship is well understood, there is a third component essential to the successful integration of telemedicine. The ability to access patient’s medical information is critical to extending continuity of care for patients as well as improving transparency between telemedicine providers and healthcare organizations.

AcuteCare Telemedicine (ACT), the leading practice-based provider of telemedicine services for healthcare organizations for stroke and other neurological care, is providing technology enabled services to healthcare providers for the delivery of high-quality clinical care virtually anywhere, anytime. ACT has been on the forefront of the use of this technology for years, remotely delivering live and interactive Telestroke and other Teleneurology assessments to patients at hospitals and emergency medical centers throughout the nation. At Bon Secours Neuroscience Institute in Richmond, Virginia, Patricia Lane comments on their collaboration with ACT, “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.”

Integrating telemedicine connections into a secure electronic medical record system designed with familiar digital formats, functions and cutting edge security measures in order to ensure the highest level of patient confidentiality will be essential to insuring quality and continuity of care and answer much of the concern over the new disruptive healthcare delivery model.



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.



ACT Expands to Meet the Increasing Demands for Technology-Based Care

ResearchMoz.us recently published the results of new market research study titled ‘Telehealth and Telemedicine Market in HealthCare Industry 2015-2020’ which projects the global telemedicine market to grow 18.5 (CAGR) percent through 2019. It is clear that the healthcare industry is experiencing considerable growth in the use of digital technologies across a wide range of healthcare specialties such as telehealth, telestroke, wireless health monitoring, wearable health devices, and EMR.

One of the earliest adopters of telemedicine continues to advance in popularity with hospitals who seek around-the-clock stroke and other urgent Neurological care. As the demand for Neurologists increases, there is a growing shortage of experienced physicians available to provide continuous coverage at many facilities throughout the United States. AcuteCare Telemedicine (ACT), the leading practice-based provider of telemedicine services located in Atlanta, GA was founded in 2009 to help hospitals overcome medical staff obstacles, ER diversion and help improve patient outcomes for stroke and other Neurological conditions. Since the fourth quarter of 2015, ACT has added numerous client hospitals to their expanding network and is responding to the increased demand for these services by adding qualified neurologists to their team.

“We are dedicated to preserving and strengthening our reputation as leaders in the field of telestroke care and continue to be fully committed to serve the needs of both our patients and client hospitals in a manner that is personal and highly professional,” says James M. Kiely, ACT Partner.

ACT is experiencing an impressive performance by demonstrating its values of integrity, transparency, accountability, collaboration and expertise. Matthews W. Gwynn, CEO, and ACT Partner comments, “We’ve set the standard of care for teleneurology and acute stroke care. We also believe in the importance of remaining technology agnostic and agile, permitting our client hospitals and enterprise-level systems to select the specific technology that best fits the needs of their respective facilities.”

The growing firm is also focused on results, continuously measuring performance across all of the healthcare organizations it serves to identify how to improve the process so as to positively impact patient outcomes. “We are one of the only telestroke providers publishing data centered on the success of our program,” says Lisa H. Johnston, ACT Partner. “We’re proud of setting a standard for other providers to follow.” The study, titled “Improving Telestroke Treatment Times in an Expanding Network of Hospitals”, was published by the Journal of Stroke & Cerebrovascular Diseases and authored by Keith A. Sanders, MD, James M. Kiely, MD, PhD, Matthews W. Gwynn, MD, Lisa H. Johnston, MD and Rahul Patel, BS. The results indicate that a practice-based telemedicine system can produce meaningful improvement in markers of telestroke efficiency in the face of rapid growth of a telestroke network.

“ACT has developed a model of telestroke care that many of our competitors aren’t able to replicate,” comments Dr. Keith Sanders, Partner, ACT. “Our results prove that our business is able to create telestroke programs that are not only effective but sustainable. As clinicians, we measure our success on consistently providing the highest level of stroke care.”



The Importance of Measuring Performance

Telestroke, the use of communication technology to remotely treat victims of acute stroke, continues to grow and has entered the mainstream of care in an ever evolving and increasingly disruptive healthcare delivery model. Like all medical innovations, telestroke must demonstrate successful outcomes to achieve sustained growth and acceptance. Merely asserting that telemedicine is faster, employs the latest technology, or promotes a better use of limited re-sources is laudable but insufficient.

AcuteCare Telemedicine (ACT), a leading practice-based provider of Telemedicine services for hospitals seeking around-the-clock stroke and other urgent Neurological care, understands the importance of evaluating and documenting telestroke performance. In their recently published study “Improving Telestroke Treatment Times in an Expanding Network of Hospitals” the authors reveal that a practice-based telemedicine system can produce meaningful improvement in markers of telestroke efficiency.

“Success in our business isn’t just about adding new healthcare organizations to our client portfolio,’ says Dr. Matthews Gwynn, co-author and ACT partner. “As clinicians, we measure our success on consistently providing the highest level of stroke care and improving patient outcomes. This study is representative of our ongoing commitment to serve as a leader in telestroke care, establishing a standard of care and a model that supports the positive growth of telestroke programs across the country.”

As virtual health initiatives continue to move forward, new and valuable trends and telehealth technology solutions will continue to emerge. Traditional methods of delivering medical care will be challenged and disrupted at medical facilities, physicians’ offices and hospitals. Dr. Keith Sanders, ACT Partner and co-author comments, “It is critical to prove that our business is able to create telestroke programs that are not only effective but sustainable.”

For more information on how AcuteCare Telemedicine can assist you with acute stroke care, contact us!



Legislator Introduces New Bill to Remove Medicare Telehealth Barriers

Senator Roger Wicker, R-Mississippi has introduced legislation that seeks to remove barriers to telehealth services in Medicare. Medicare fee for service (FFS) does currently provide reimbursement for telehealth services to patients at rural area health clinics, however, current law limits telehealth reimbursement to rural areas, disallows the storage of information to physicians via electronic medical records, email and other communications technology and doesn’t reimburse telehealth services provided by physical or occupational therapists or for physicians who treat patients within their own home.

The bill, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, attempts to broaden telehealth services across the country and offer an added opportunity to serve the needs of the elderly. The bill, which has broad bipartisan congressional support, would allow Medicare patients to use video conferencing, remote patient monitoring and technology to transfer patient data and will expand Medicare reimbursement of telehealth consultations and remote patient monitoring with fewer restrictions.

“This legislation has the potential to remove barriers to new healthcare delivery models that promote coordinated and patient-centered care. Importantly, the bill aims to maintain high standards whether a patient is seeing a physician in an office or via telemedicine,” said American Medical Association (AMA) President Steven Stack. “Telemedicine can strengthen the patient-physician relationship and improve access for patients with chronic conditions and limited access to quality care. The AMA’s guiding principles on telemedicine seek to foster innovation while promoting quality care.”

According to an analysis by the health-care consulting firm Avalere, expanded Telehealth services could save $1.8 billion dollars in medical cost over the next ten years by removing the current restrictions, and would make healthcare more available for patients who often struggle with access to the latest high quality care.

“We strongly believe in the importance of implementing processes and procedures for telemedicine. Our experience working with regional hospitals as well as enterprise level healthcare systems, has demonstrated that effectively executed telemedicine programs can drive significant value,” comments Dr. James Kiely, Partner, ACT. “In our most recent peer-reviewed article, we’ve proven that a telemedicine system can produce meaningful improvement in markers of telestroke efficiency in the face of rapid growth of a telestroke network.”

With a vastly aging population, Federal and State legislators must continue to make improvements in access to quality healthcare for Medicare patients even if it means establishing new legislation designed to govern telemedicine responsibly.



AcuteCare Telemedicine Team of Neurological Specialists Publish New Study

A new study published by the Journal of Stroke & Cerebrovascular Diseases indicates a practice-based telemedicine system can produce meaningful improvement in markers of telestroke efficiency in the face of rapid growth of a telestroke network. “Improving Telestroke Treatment Times in an Expanding Network of Hospitals” is authored by Keith A. Sanders, MD, James M. Kiely, MD, PhD, Matthews W. Gwynn, MD, Lisa H. Johnston, MD and Rahul Patel, BS.

AcuteCare Telemedicine (ACT) has remained committed to working with healthcare organizations to establish telestroke programs that not only improve access to specialty care but also significantly improve patient outcomes,” comments Dr. Keith Sanders, Partner, ACT. “It is critical to prove that our business is able to create telestroke programs that are not only effective but sustainable.”

As stated in the background for this study, telestroke must demonstrate successful outcomes to achieve sustained growth and acceptance. Asserting that telemedicine is faster, employs the latest technology, or promotes a better use of limited re-sources is laudable but insufficient. An analysis of stroke treatment within a telemedicine network in 2013 showed that tissue-type plasminogen activator (tPA) could be safely and reliably administered within a practice-based model of telestroke care. Since then, hospital volume and tPA administration within this network have tripled. We hypothesize that a practice-based model of telestroke can maintain positive outcomes in the face of rapid growth. As a result, the study demonstrates meaningful improvement in markers of telestroke efficiency in the face of rapid growth of a telestroke network.

“Success in our business isn’t just about adding new healthcare organizations to our client portfolio,’ says Dr. Matthews Gwynn, Partner, ACT. “As clinicians, we measure our success on consistently providing the highest level of stroke care and improving patient outcomes.  This study is representative of our ongoing commitment to serve as a leader in telestroke care, establishing a standard of care and a model that supports the positive growth of telestroke programs across the country.”

Download the full article here.

 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.



Robots and Doctors Help Improve Stroke Treatment

The issue of delivering consistent medical care across all geographic areas from large populated urban centers to the outlying rural communities has been a critical area of focus for healthcare organizations. Typically smaller, financially stressed rural hospitals and clinics suffer from limited access to medical specialists, particularly in emergency situations involving stroke and other neurological and coronary events. These medical emergencies demanded quick and immediate treatment to save the affected patient from significant disability or death.

In the three years since the first telestroke robot was installed at Covenant Health Hospitals in East Tennessee, doctors at LeConte Medical Center (LMC) have used the technology on a weekly basis. Using the latest in virtual presence technology the dedicated medical professionals at LMC can connect immediately with a team of neurological specialists at AcuteCare Telemedicine in Atlanta, GA. “It’s an amazing thing that we have this expertise in a small rural hospital,” said Steve Dronen, M.D., Emergency Room at LeConte Medical Center. While the hospital has a well demonstrated history of providing quality care to stroke patients, the extra advantage of having highly trained and experienced neurological specialist available for consultation around the clock, 24/7 assures LMC patients the highest level of stroke care available anywhere in the country.

Dr. James Kiely, a partner in Atlanta Neurology, P.C. and AcuteCare Telemedicine said, “As Medical Director of the Neurophysiology Departments at St. Joseph’s Hospital of Atlanta I was aware of how fortunate our patients were to have the most immediate lifesaving treatment for stroke 24 hours a day, seven days a week.” The most effective stroke care requires that it be delivered to the patient within the “golden window” of stroke onset. With stroke being the number four cause of death and a leading cause of disability in the United States, lack of access to neurologists who specialize in stroke care threatens to deprive many patients the best chance of recovery after a stroke. “AcuteCare Telemedicine was created”, Dr. Kiely says, “to impact the well-being of patients with severe neurological emergencies who otherwise wouldn’t have rapid access to vital expertise simply because of where they live.”

The other major benefit of the technology, described by Dr. S. Arthur Moore, Medical Director of Stroke Program at Covenant Health’s Fort Sanders Regional Medical Center, is how quickly the tele-robot allows doctors to make life-saving decisions. “We can now do something about it. It doesn’t matter if you are in rural East Tennessee or in Knoxville, we can provide the same care,” said Dr. Moore. Doctors only have a small window of time to make a treatment decision before the damage from stroke becomes permanent. The new technology is helping to accelerate the treatment process.