AcuteCare Telemedicine Blog


Telehealth Can Play a Key Role in Saving Rural Hospitals

No matter the location, rural communities across America have one thing in common. Residents tend to be older and sicker than their fellow, “urbanites”. The introduction of the Affordable Care Act (ACA), designed to provide millions of previously uninsured or underinsured patients access to health insurance, accompanied by Medicare reimbursement cuts and other regulations is beginning to negatively impact rural hospitals. The trend has many pondering; “If you decide to live in a rural community, are you deciding to have a worse outcome if you have a stroke?” asked Dr. Jeff Feit, vice president of population health at the Valley Health system.

To date, 51 rural hospitals have closed in the US since 2010, according to the North Carolina Rural Health Research Program at the University of North Carolina at Chapel Hill. Southern states have been disproportionately affected by the increase in closing of rural facilities. Texas has seen 10 rural hospitals close, while Alabama and Georgia have each lost five just in the past five years. The National Rural Health Association has identified 283 more rural hospitals in danger of going out of business. Many rural hospitals “have been struggling on the cusp for a long time,” said Mark Holmes, director of the North Carolina Rural Health Research Program. The future of many rural hospitals is threatened by the ongoing cuts to Medicare and the failure of more than 20 states to expand Medicaid.

Maggie Elehwany, vice president of government affairs for the National Rural Health Association, says significant Medicaid cuts in the past few years have been suffocating rural hospitals. “The greatest crisis right now is the hospital closure issue,” she said. In Kansas, The Kansas Hospital Association has repeatedly told its lawmakers that failure to expand Medicaid will have dire consequences, leading some rural hospitals to shut down. Terry Hill, a senior policy adviser at the National Rural Health Resource Center has predicted, “You’re going to see a predominance of closures in the next year or so in those states that have not expanded their Medicaid eligibility.” Congress is attempting to respond to the crisis by initiating several bills to help rural hospitals recover, but they are receiving little attention by the majority of lawmakers.

In the interim, an increasing number of rural hospitals are looking to virtual healthcare options to remain financially viable and operationally relevant in a new, emerging healthcare delivery model. Telemedicine can provide many of them the means for resuscitating a community’s hospital by connecting rural patients to primary care and medical specialists as well as remote monitoring of many chronic diseases.

Establishing virtual healthcare solutions requires investment, but the investment will pay significant dividends for patients, providers and hospitals by creating broader access to healthcare networks, experts and outlying resources. While some small hospitals are debating whether they can afford to implement telemedicine, others are debating if the hospital can afford not to make the investment.



The 21st Annual ATA Telemedicine Meeting & Exposition

The American Telemedicine Association (ATA), the leading international resource and advocate promoting the use of advanced remote medical technologies, announces the dates for its annual meeting and exposition for 2016. For 20 years, the ATA has focused fully on telemedicine solutions to transform healthcare systems. The results of the ATA’s efforts have generated significant impact for overall quality of care, equity and healthcare affordability.

The 2016 American Telemedicine Association Meeting and Exposition is expected to host as many as 6,000 thousand attendees at the Minneapolis Convention Center in Minneapolis, MN. The four day event will get underway on May 14 and conclude on May 17, 2016. ATA 2016 is the largest trade show in the world for healthcare professionals and entrepreneurs in the telemedicine, telehealth and mHealth space. The event will showcase a wide range of educational seminars, speakers and products and services related to telemedicine industry from over 300 exhibitors.

“AcuteCare Telemedicine (ACT) looks forward to participating at the event in 2016,” comments Dr. Matthews Gwynn, Partner, ACT. “We applaud the efforts of the ATA in advancing telemedicine opportunities and providing a platform for practitioners to share insights, research, and best practices.”

Established in 1993, The American Telemedicine Association is a non-profit association of individuals, healthcare institutions, companies and other organizations with an interest in promoting professional, ethical and equitable improvement in health care delivery through telecommunications and information technology.

For more information on the event, click here.

ATA Trade Show



Is Telemedicine and Telehealth the Future of Healthcare Delivery?

With the global telemedicine market predicted to soar past the $30 billion mark by 2020 it is becoming increasingly difficult to overestimate the impact telemedicine, or it’s broader application telehealth, is about to have on the broader healthcare delivery model. Much of the considerable focus of discussions thus far has been about the effects of virtual technology on the safety and quality of service to patients, the creation of new methods of payment for virtual services rendered and massaging the concerns of the industries evaluators and licensors. But the ongoing advance of mobility and affordability of communication technology is opening up vast new opportunities to apply telemedical technology to a much larger spectrum of healthcare delivery.

It is true that even if the whole of telemedicine’s promise were to be fully realized, it is likely never to completely replace the face to face relationship between the healer and the afflicted. But with the rising cost of healthcare, anticipated physician shortages and a general increase in demand for healthcare, virtual medical care is attracting a much wider audience of support across the medical care industry. In a recent Wall Street Journal report on private equity firms, investors are increasingly interested in investing in the health-care sector, creating a tipping point for a newer early stage virtual healthcare industry. Until recently the technology, devices, applications, operating platforms and processes have been the elements receiving most of the attention, but with the increasing appearance of virtual telehealth centers at shopping malls and big box retailers, it may be time to expand our thinking on just how dramatic the disruption on the industry will be.

Some well-established healthcare systems are now facing a decision on where to most effectively invest their capital. Should it be in traditional brick and mortar facilities or in the newest telehealth information technology? While advancement of diagnostic technology and ground breaking progress in treatment options has been common in the industry for decades, the “hard” methods of engaging patients by the healer has seen little change since the “industrialization” period of healthcare more than a half-century ago. As mobile health monitoring devices become more reliable and capable, patients with chronic diseases are being monitored, evaluated and often treated without leaving the confines of their home or work areas, reducing the usefulness of centralized physical structures used to connect and treat patients with chronic diseases. Advances in surgical robotics, techniques and technology has resulted in less invasive surgeries being “off-loaded” from heavily supported hospital based surgical suites into less costly outpatient surgical facilities.

Telemedicine has made significant changes in delivery models for clinical and acute care in the last 5 years and is certain to provide expanded application and creative solutions for meeting challenges across the whole of the healthcare delivery spectrum. It’s time to expand our vision for utilizing communication technology in the delivery of healthcare. Telemedicine and telehealth is the future of healthcare delivery.



Telemedicine Creates Opportunities to Improve Access to Neurologists

Discussions over an impending shortage of doctors in America are nothing new. The debate and predictions of an increasing shortage of general practitioners, neurologists, radiologists and other medical specialties has raged for nearly a decade. A study by the Association of American Medical Colleges (AAMC), a lobby for medical schools and teaching hospitals, said “the doctor shortage is real” with total physician demand projected to grow by up to 17 percent as a population of baby boomers ages. The nation’s shortage of doctors may rise to between 46,000 and 90,000 by 2025. “The doctor shortage is worse than most people think,” says Steven Berk, M.D., dean of the School of Medicine at Texas Tech University. “The population is getting older, so there’s a greater need for physicians. At the same time, physicians are getting older, too, and they’re retiring earlier,” Berk says.

Neurology is one specialty impacted by the shortage. 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 surviving the effects of stroke. More than 800,000 strokes occur in the United States each year and the number of strokes is expected to grow significantly due to a growing elderly population. The need to encourage more young physicians to specialize in stroke is critical.

Dr. Harold P. Adams, Jr., of the University of Iowa Carver College of Medicine and Dr. Jose Biller, of Loyola University Chicago Stritch School of Medicine believes, “Unless the number of neurologists focusing their careers on the diagnosis and treatment of patients with cerebrovascular diseases increases, a professional void will develop, leaders of professional neurology associations “need to develop and vigorously support a broad range of initiatives to encourage residents to enter vascular neurology. These efforts need to be started immediately. Time is short.”

Other experts believe that new technologies may hasten the response to the pending crisis and may extend the reach of medicine in ways that will address the problem. Health care professionals can serve more people by using telemedicine technologies to examine, treat and monitor patients remotely as well as providing patients increased access to advanced stroke care. These technologies are already keeping patients out of hospitals and doctors’ offices and providing improved recovery results. Whereas many hospitals with existing neurology departments simply do not have the resources to maintain around-the-clock clinician capacity, AcuteCare Telemedicine (ACT), a leading practice-based provider of Telemedicine services, has managed to successfully disrupt the trend and bring patient and physician together, regardless of geographic boundaries. AcuteCare CEO, Dr. Matthews Gwynn says, “Increasing access to stroke specialists requires a certain level of investment in technology and trust in the people behind it. Technology affords healthcare organizations the ability to select a platform that meets budgetary and organizational parameters while extending the highest quality of neurological care to the patients they serve.”

Telestroke is one of the most adopted forms of telemedicine, providing solutions to healthcare providers looking for 24/7 neurology coverage for patients. “Telestroke is filling a gap in terms of the speed and accuracy of stroke diagnosis and start of critical therapy, says Lee Schwamm, vice chair of the Department of Neurology at Massachusetts General Hospital in Boston and director of the hospital’s Telestroke and Acute Stroke Services, “Telestroke is the poster child of telemedicine. It’s a really nice example of where the business case is so evident and the benefit to patients is well-documented.”

“The shortage of doctors is definitely impacting the future of medicine,” comments Gwynn. “In response, we remain focused on providing access to quality neurologists to small hospitals in underserved communities as well as to enterprise level healthcare organizations via telemedicine.”



Best Integrated Campaign for Stroke Month Awarded to Bon Secours Richmond

ACT Blog Bonsecour Award

From Left to Right: Bob Silverstein, Enterprise Executive Sales Director, ACT; Dionne Henderson Director of Community & Multi-Cultural Initiatives at American Heart Association, American Stroke Association; Patricia C. Lane MBA, SCRN|Bon Secours Richmond Administrative Director Neurosciences, Bon Secours Richmond Health System; Dr. Stacey Epps, Executive Medical Director Bon Secours Virginia Neuroscience Institute.

The American Heart Association/American Stroke Association recognizes American Stroke Month by focusing on efforts to teach family, friends and coworkers how to recognize the signs of stroke.

This year The American Heart Association awarded Bon Secours Richmond Health System the Best Integrated Campaign Award for 2015. The fourth largest and only faith-based health system in Virginia, Bon Secours Virginia provides full range of services to thousands of Virginians through a network of hospitals, primary and specialty care practices, ambulatory care sites and continuing care facilities across the Commonwealth.

Bon Secours is accustomed to taking a leadership role in Neurological care, having established teleneurology initiatives more than five years ago with a goal to have all of its area hospitals joint commission certified. AcuteCare Telemedicine, the leading practice-based provider of Telemedicine services for hospitals seeking around-the-clock stroke and other urgent Neurological care is collaborating with Bon Secours Neuroscience Institute (BSNI), the neuroscience division at the not-for-profit Catholic health system sponsored by Bon Secours Ministries.

Dr. Keith Sanders, Partner, AcuteCare Telemedicine, comments, “ACT is aligned with Bon Secours and its ongoing commitment to utilizing the finest and latest technology for the treatment of stroke. This award is evidence of their outstanding efforts to promote a fully integrated stroke program that improves awareness of the dangers of stroke and provides the best in acute stroke care to the communities we serve.”



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.