AcuteCare Telemedicine Blog


Study Reveals Application of Telemedicine Delivers Positive Outcomes

A recent study by The Agency for Healthcare Research and Quality (AHRQ) entitled Telehealth: Mapping the Evidence for Patient Outcomes from Systematic Reviews, indicates that that the application of telehealth delivers the most positive outcomes when used for remote patient monitoring, the treatment of several chronic health conditions and for psychotherapy as part of overall behavioral health. The leading chronic conditions, for telehealth success was cardiovascular and respiratory disease, according to the AHRQ study. The study’s authors also said that “research into practice-level implementation should be the next step, particularly since the vast majority of research conducted to date has been conducted within old and possibly soon-to-be-outdated care delivery models.”

The purpose of the study was to provide an overview of the large body of data about telehealth for use by healthcare decision makers. The approach used was to create an evidence map of systematic reviews published to date that assess the impact of telehealth on clinical outcomes. According to the report, the focus of future systematic reviews could include telehealth for consultation, uses in intensive care units and applications in maternal and child health. In addition, telemedicine for triage in urgent or primary care, management of serious pediatric conditions, patient outcomes for TeleDermatology, and the integration of behavioral and physical health were earmarked by AHRQ as ripe for analysis.

Healthcare remains a system where service is delivered primarily through in-person interactions, but many hospitals, physician groups and clinics as well as tech-savvy patient/consumers are turning to telemedicine to effectively and efficiently deliver and receive healthcare services regardless of their geographical location. The rise of utilization of telemedicine is one of the largest and most disruptive shifts in healthcare delivery over the last decade. With recent advances in telemedicine technology, an impending evolution in legislation governing the use of telehealth and falling regulatory barriers predicate that 2016 may be a turning point for the increased adoption of telemedical technology in the delivery of healthcare across a full spectrum of healthcare disciplines.



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.



Telemedical Technology: Creating a Healthcare World without Barriers

As with many other high tech gadgetry, revolutionary processes and scientific inventions telemedicine has its roots in the NASA space program. For those early adopters of telemedicine, the efficacy of the doctor/patient consultation and the ability to improve patient outcomes were on the top of the list for barriers to entry. Many thought that patients would be hesitant to trade personal face-to-face visits with their doctor for a consultation through a virtual robot. But as early adopters used the technology to bring specialized care to remote and distant rural areas, patients soon realized the convenience and cost savings of not having to travel long distances to receive the latest in specialized healthcare, and soon embraced the new experience in connecting with a doctor.

The process is now considered to be an ideal use of technology to monitor and connect healthcare professionals with patients over long distances. With the introduction and increasing popularity of wearable technology, the existing digital info-structure in many rural areas of the country limited the expansion of telehealth. With the recent introduction of ConnectAll, a new federal initiative aimed at building broadband parity across America, is expected to provide nearly 20 million more Americans with access to telemedicine. “The expansion of affordable Broadband will further solidify the rapidly growing telemedicine sector, which is transforming the healthcare paradigm,” said Jonathan Linkous, CEO, American Telemedicine Association (ATA). “This initiative helps to deliver the promise of more cost-effective healthcare delivery models, and promotes the expansion of telehealth services for all.”

With Medicare, Medicaid, and private health insurance carriers continually expanding the number of virtual services approved for reimbursement, a once formidable obstruction is disappearing all across the country and the world. A growing number of healthcare providers are now expanding their reach. “This is a world without boundaries, and that’s what we’re seeing,” said Andrew Watson, MD, chief medical information officer for University of Pittsburgh Medical Center’s (UPMC’s) International and Commercial Services Division, “The advent of telemedicine in a world without boundaries is no different than using Facebook or Skype around the world. We’re just seeing this technology impact medicine.”

But not all of the walls to expansion have been breached. Much remains to be done to remove existing impediments such as state by state licensing and credentialing requirements. The established healthcare regulatory system with its myriad of governing bodies, Boards, and legislatures continues to be a formidable foe when it comes to interjecting new technology into the traditional face-to-face experience between the healthcare provider and patient. “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,” says Matthews W. Gwynn, M.D., Partner, ACT.

ACT has been on the forefront of the use of telecommunication technology for years, remotely delivering live and interactive telestroke and other teleneurology solutions anytime, anywhere to hospitals and emergency medical centers throughout the Southeast. Progress in reforming the massive healthcare regulatory system is occurring as dedicated industry leaders tackle the challenges of integrating advanced remote medical technologies into the existing mainstream healthcare delivery model.



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.”



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.



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



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.”