AcuteCare Telemedicine Blog


Telemedicine Finding Support Among the Young and Affluent

According to a new RAND Corporation study, people who are younger, more affluent and do not have established health care relationships are more likely to use a telemedicine program that allows patients to get medical help by talking to a doctor over the telephone. Patients who used the service suffered from a wide assortment of acute medical problems such as respiratory illnesses and skin problems, and researchers found little evidence of misdiagnosis or treatment failure among those who used the service.  The findings, published in the February edition of the journal Health Affairs, are from the first assessment of a telemedicine program offered to a large, diverse group of patients across the United States.

“Telemedicine services such as the one we studied that directly links physicians and patients via telephone or Internet have the potential to expand access to care and lower costs,” said Lori Uscher-Pines, lead author of the study and a policy researcher at RAND, a nonprofit research organization. “However, little is known about how these services are being used and whether they provide good quality care. Our study provides a first step to better understand this growing health care trend.”

Among patients studied, the most common problems treated during a visit were acute respiratory conditions, urinary tract infections and skin problems, which accounted for more than half the cases. Other frequent reasons for were abdominal pain, back and joint problems, viral illnesses, eye problems and ear infections. More than a third of the visits occurred on weekends or holidays. Interest has grown in telemedicine programs because of the shortage of primary care physicians, which will likely worsen as more Americans acquire medical coverage under the Affordable Care Act. Telemedicine is one of the alternatives touted as a way to better provide primary health care without greatly expanding the number of doctors.

The implementation of the Patient Protection and Affordable Care Act is leading to increased demand that physicians interact with more patients, pointing to telemedicine as a potential solution. Most physicians believe that the quality of patient care is not compromised by telemedicine because it is delivered through different channels. Physicians can consult with more patients, and patients can meet with their physicians in a shorter time period. In terms of economic advantages, telemedicine can save a great deal of time for patients who otherwise would have to leave work, and it can reduce ER visits. According to Kenneth McConnochie, M.D., M.P.H., director of the Health-e-Access Telemedicine Program and professor of pediatrics at the University of Rochester Medical Center in Rochester, N.Y., parents with young children consider time and lower expenses to be valuable commodities. By increasing its use of telemedicine, the medical center reported a 22 percent reduction in ER visits among schoolchildren. McConnochie pointed out that the average telemedicine visit costs $75 compared with $750 for a typical ER visit.

“The people who are attracted to this type of telemedicine may be a more technologically savvy group that has less time to obtain medical care through traditional settings,” said Dr. Ateev Mehrotra, a RAND researcher, co-author and an associate professor at the Harvard Medical School. However, researchers caution that more research is necessary to further assess the quality and safety of telemedicine services and to more adequately address concerns that expanded use of this type of telemedicine may lead to fragmentation of care. Still, the general consensus among patients and parents who used the service appeared to indicate that they believed that accessing medical services via telemedicine technology was much more convenient, saving them time and money.  For these consumers the convenience factor dominated over other concerns.



Growth of Telemedicine is Global and Becoming Common Place

Though the United States has been dominating the global telemedicine market, Europe and developing nations are rapidly catching up. The global telemedicine market is expected to grow at a compound annual growth rate of 19 percent, driven mainly by growth opportunities in Europe, but the enthusiastic growth may be tempered by the lack of standardized classifications. However, the increase in remote monitoring of patients is expected to keep driving the market, which is also boosted by the increase in telesurgery. The shift is occurring mainly because of the increase in the number of patients with chronic diseases and the increasing availability of online healthcare services.

The remote delivery of healthcare services over the telecommunications infrastructure, or telemedicine, is a topic of interest to the vast majority of Italian general practitioners (GPs), with 73 percent stating that they are prepared to use the technology according to a study conducted by the Italian Family Doctor’s Association FIMMG. Over half of the doctors surveyed, 52 percent, are in favor of using these new technologies if they help to develop organizational aspects of the profession, while 30 percent state that telemedicine could even improve the doctor-patient relationship.

Global virtual doctor visits could become as common as face-to-face appointments because health insurers, hospital systems and employers view it as a way to clamp down on rising medical costs. They hope that by giving patients easy access to a primary care physician, it will discourage them from visiting a costly emergency room when they get sick. The trend in the US is expected to escalate as an influx of new patients, caused by the implementation of the Affordable Care Act (ACA), promises to put a strain on some doctors’ offices for treatment of routine illnesses.  Health giants UPMC and Highmark Inc. are rolling out new services that allow patients to video-conference with doctors through computers, tablets and smartphones.  “We think more and more people, as they become more familiar with telemedicine, will see this as something that is just going to be commonplace,” said Natasa Sokolovich, executive director of telemedicine at UPMC.  Convenience is the big selling point of telemedicine services to patients.  Rather than having to wait days or weeks to schedule an appointment at a doctor’s office, a video conference could be scheduled within minutes or hours, and the patient wouldn’t have to leave their home.

While such convenience is enticing to an increasingly busy society, some doctors and medical care providers are warning that an E-visit can’t entirely replace face-to-face consultations in a physician’s office environment. Nonverbal cues can be very important in accurately diagnosing patients, said Dr. Bruce MacLeod, president of the Pennsylvania Medical Society. “Some details could be missed in a video conference.”

But as the availability and quality of telemedicine advances globally, a increasing majority of patients are willing and eager to invite the technology into their relationship with their health care providers.  The desire to make medical care more accessible and less-costly is global. Whether E-visits replace face to face medical care completely or just become some relative portion of interaction between patients and physicians, the medical services delivery model is going to be altered dramatically for the future.  The rate of acceptance of communication technology in the medical care process will be driven more by necessary changes to the well-established regulations, licensing requirements, and cost reimbursement policies from within the health care community. 



Leading Providers of Telemedicine Technology Present at Summit

The Alabama Rural Health Association (ARHA) and the Alabama Partnership for Telehealth (APT) held the 2nd Annual Alabama Rural Health & Telehealth Summit on October 16th thru the 17th in Prattville, Alabama.  The conference provided an excellent opportunity to learn about the current uses and capabilities of telehealth and telemedicine and included updated information on the Affordable Care Act (ACA) and more specific information on the Health Insurance Exchange program, Navigator program, and Accountable Care Organization program.

Cecilia Land, Director of Rehab Services, presented a session titled, “Reaching Out to Alabama with Telestroke Services.”  Land discussed the stroke mortality rates in Alabama, and more specifically stroke mortality in the counties that fall inside the Southeastern Alabama Medical Center (SAMC) footprint and its desire to help bring down those rates in the counties surrounding the SAMC Telestroke Hub and their partner spokes in southeastern Alabama.

Levonne Outlaw, SAMC Stroke Network Coordinator, discussed education and training of the individual hospital staffs at the spokes. Initial training proved to be very successful and adoption of the telemedicine and telestroke platforms was well received by the staffs. The initial concern for a potentially long learning curve on implementation was not realized.

Dr. Matt Gwynn, Acute Care Telemedicine, the leading practice-based provider of Telemedicine services in the southeast, discussed the national statistics on stroke and their dramatic impact on quality of life of survivors.  His discussion centered on the unique nature of stroke and how telemedicine can best be implemented to treat this disease. “Stroke is a perfect fit for demonstrating the life saving and life enhancing benefits of telemedicine, given that telemedicine can reduce the time to treat patients in the narrow, 3-hour window, which is so critical to stroke victims”, said Dr. Gwynn.  He went on to share a specific case of a 46-year old female stroke patient at Dale Medical Center and how she had benefited from SAMC’s new telemedicine presence.  Dale Med Center had been live with telestroke not more than a week, and the patient presented into the ER with stroke symptoms, was treated with the clot-busting drug tPA and discharged within 48 hours with minimal long-term neurological damage.

Other key topics were presented by: Gary Capistrant, Senior Director of Public Policy for the American Telemedicine Association and panelists from Auburn University, University of Alabama and Alabama College of Osteopathic Medicine.  Updates were presented on the Affordable Care Act and its effects on telemedicine throughout the United States.



AcuteCare Telemedicine Turns 3!

This October marks the third anniversary of AcuteCare Telemedicine (ACT). Over the course of its first three years, ACT has grown considerably during a period of significant change in the policy and industry of healthcare in America. The 4 Board Certified partners of ACT have retained a steady focus on their mission of filling a growing need for 24/7 neurology coverage.

Telemedicine has proven to be a burgeoning facet of the healthcare industry, with technological advancements and enhanced communications allowing providers to extend their reach over geographical boundaries to patients in need while simultaneously streamlining the healthcare delivery process and reducing associated financial and environmental costs. ACT has worked hard to stay ahead of the curve, offering the most cutting-edge solutions for saving lives in cases of neurological emergency.

Entering its fourth year of providing this expert neurological consultation via telemedicine technology to rural and underserved medical facilities throughout the Southeast, ACT looks forward to continued growth. As teleneurology continues to garner attention from hospitals as a practical and effective solution to neurologist staffing needs, the outlook for the company this year and beyond is extremely positive. “The message of ACT has really started to take hold in the healthcare community, and as our efforts for finding new hospital partners ramp up, we are optimistic that we will ultimately be able to reach even more patients with and offer them the level of care they deserve,” says Dr. Lisa Johnston, Partner, ACT.

“Following our rebrand of the company in 2011, we have stayed dedicated to our values as expert practitioners and our vision as a business,” adds Dr. Keith Sanders, Partner, ACT. “The standard of service we have been able to provide has only climbed higher. We are truly passionate about combating morbidity and mortality rates of acute stroke, right here at home in the Stroke Belt (a region of the Southeastern US with higher-than average stroke rates) and beyond.”

Hard work and diligence is paying off for the partners of ACT. As the group continues to practice neurology full time and commit themselves to reaching more patients in 2013, they hope to add to an already impressive list of achievements and accolades throughout their short history.

 



You May Already Be Acquainted

As futuristic or experimental as telemedicine may sometimes seem, patients from all demographics may unknowingly already have been engaging and reaping its benefits for years. At its core, telemedicine is interested in utilizing advances in technology to increase the speed and accuracy of communications either between patients and their physicians or among physicians in collaboration. The resulting drastic improvements in these areas that are afforded by telemedicine are what matter most, not the seemingly unorthodox techniques that facilitate them.

Following this idea, any health care protocol that leverages the internet is a practical application of telemedicine. Therefore, when a doctor retrieves lab work from the web, or a radiologist sends an electronic version of a scan to a colleague, telemedicine is already at work. For would-be telemedicine patients, videoconferencing is what is most unfamiliar. However, Americans are becoming more and more accustomed to communicating with one another via two-way video technologies; for many, platforms like Skype or Apple’s FaceTime are now commonplace. As these tools make their way into our everyday lives, more patients will grow comfortable with their powerful applications in healthcare.

According to the American Telemedicine Association, telemedicine technologies and practices has played a role in the care of as many as 10 million patients in the United States to date. With continued education and increased awareness, that number should be expected to rise exponentially as more hospitals adopt telehealth as a primary mode of monitoring patients and other individuals benefitting from remote supervision, such as the elderly or disabled. Several federal innovation grants resulting from the passage of the Affordable Care Act have also been awarded to telemedicine programs nationwide for their capability to reduce unnecessary hospitalizations.

There are obstacles, primarily related to patient and provider perceptions and fears about costs and reliance on new technologies, but telemedicine has often proved itself adaptable and efficient in the face of such doubts. Raising awareness and granting patients the confidence that they are already familiar with telemedicine’s advantages will be a major step in pushing healthcare forward.

 



Healthcare Reform and the Impact on Telemedicine

The recent announcement of the Supreme Court’s 5-4 ruling in favor of upholding the Patient Protection and Affordable Care Act (PPACA) has prompted widespread speculation among citizens of the US about the future of healthcare.  Notwithstanding the politics associated with the decision, the ruling carries significant impact for citizens in terms of access to preventive care and insurance coverage.

Telemedicine providers are heavily impacted by the ruling as well. The American Telemedicine Association (ATA) believes that it will positively impact the development of telemedicine, mHealth, and other remote technologies, citing 4 main reasons; the announcement reduces hesitation to invest in telemedicine technologies, protects existing investments in telemedicine, bolster’s telemedicine’s role in many healthcare programs, and strengthens telemedicine’s fundamental value proposition.

As healthcare enters its next era, telemedicine offers a model for streamlining care coordination and improving patient outcomes. In the period of time between healthcare reform being codified into law and the Supreme Court ruling to uphold it, there had been a great deal of uncertainty surrounding the healthcare industry implementing major changes in practice, as it would cause complications should the law be overturned, but the affirmation clears up many of the primary legal and cost concerns, opening the door for telemedicine to address logistical and financial pain points for both providers and patients.

Ultimately, telemedicine fits snugly into the PPACA. For ACO’s needing to include services unavailable in their area, a remote presence physician will be drastically most cost-effective than hiring a full time local MD. Telemedicine also helps alleviate costs for underinsured or completely uninsured patients as well as alleviating strain on the healthcare system caused by unnecessary emergency visits through improvements in preventive care. The court’s decision, while sparking some controversy on other fronts, is the latest step forward in the rapid evolution of telemedicine as a powerful solution for a multitude of healthcare issues facing Americans.