AcuteCare Telemedicine Blog


Telemedicine Joins the Fight against Ebola

As news outlets report the increased number of healthcare workers becoming infected with Ebola while treating patients with the deadly disease, concern for the welfare of healthcare workers around the globe is mounting. Ebola is an extremely infectious and deadly virus which is spread through the exchange of bodily fluids. Doctor and nurses who treat patients are highly prone to becoming infected while administering treatment to Ebola patients. More than 320 health workers who have treated Ebola patients have died of the disease and several others have been infected and survived.

Telemedicine is becoming a very effective weapon in treating Ebola patients while protecting care givers from being infected. From the evaluation of a potentially infected person to the routine communication of treatment, telemedicine can be a remote vehicle used to administer treatment while the patient is in isolation. Medical staff or specialists located anywhere around the globe can be consulted and participate in providing the best and latest care. Many healthcare providers will be spared the time, expense and inconvenience of relocating to areas where the disease poses the greatest risk. Telemedical technology can be useful to containment efforts at points of entry such as airports, emergency rooms, border crossings, schools and military installations.

In the military and Veterans Administration the benefits of telemedicine to the treatment of infectious diseases is not new. Telemedicine has been used to care for U.S. troops dispersed throughout the world and to veterans at home for nearly a decade. According to the Association of Military Surgeons, infectious disease tele-consults ranked second in the total number of online consults, and a study of the infectious disease tele-consultation service found the service to be providing beneficial and relevant recommendations for treatment in a timely fashion.

Telemedicine has become very successful in the private sector as well; improving access to specialized care to rural communities throughout the United States and remote areas of the world. Advanced treatments for stoke and other neurological diseases are now readily available remotely to patients, who were once too far removed from urban medical centers to benefit from time-sensitive treatment, improving recovery prospects and saving lives.

Defenders against contagious diseases can learn important lessons from these successful experiences and gain vital insights as to how telemedicine can improve care for patients and healthcare workers alike.



Telemedicine is Providing Improved Access to Neurological Care

Before the introduction of telemedicine, small to medium sized rural hospitals often played the role of stabilize and transport centers, a brief stop-over for patients needing specialized treatment and care. Patients would receive treatment to stabilize their condition, were packed-up and then transported to urban healthcare centers where specialist were standing-by to administer much needed specialized treatment.

The process often results in delay for patients receiving important, often life-saving, treatment, inconvenience and increased costs. “Attracting and recruiting medical specialists is an ongoing challenge for smaller, regional hospitals who must balance the needs of their patients with the financial realities of healthcare in this demanding economy,” says Dr. Matthews Gwynn, Director and Founder of the Stroke Center of Northside Hospital and AcuteCare Telemedicine CEO.   The merging of telemedicine with neurology is changing the “stabilize, pack and ship” role of smaller hospitals and is bringing life-saving neurological and advanced stroke care to their patients within their own communities.

AcuteCare Telemedicine (ACT), the leading practice-based provider of Telemedicine services for hospitals seeking around-the-clock stroke and other urgent Neurological care is continuing to expand their portfolio of client hospitals with the recent addition of Dodge County Hospital. Located in Eastman, GA, the 94 bed healthcare facility is a Hospital Corporation of America (HCA) affiliate that is dedicated to meeting the challenges of a changing healthcare environment.

Dodge County Hospital is a prime example of how telemedicine is helping smaller regional medical facilities achieve their mission of delivering the highest quality healthcare services to their patients and their communities. “Having the ability to consult with a neurologist remotely for treatment of stroke and other neurological maladies is allowing these hospitals to meet the needs of the patients in the communities they serve,” says Dr. Gwynn.

ACT partners with InTouch Health (InTouch), a leading developer and provider of remote presence devices and software, to bring remote telemedical care to its client hospitals. InTouch and ACT closely collaborate with their hospitals to easily integrate and improve the efficiency of the new remote service workflow processes as well as improve clinical performance and cost containment.  The client hospitals dedicated staff of medical professionals receive important, on-site training in the operation of the telecommunication robots and its software and form critical consultative relationships with ACT neurologist to ensure the highest quality patient care.

Smaller hospitals all across America are finding the cost of telemedicine an affordable solution to ensuring improved accessibility of critical care and specialized treatment for their patients no matter where they live



A Better Model of Delivery Realized

We buy groceries, trade stocks, and chat with friends, surf and cultivate new relationships around the country and the world all without leaving our home or office. Yet seeing a doctor remains an old-fashioned routine: minutes of medical attention can cost hours spent in transit or in a waiting room, only to have a face-to-face with a doctor. The familiar choreography dates back several generations, virtually unchanged since treatment from your family physician moved from your home to his or her office, where the newest diagnostic equipment of the day and the best trained supporting staff could more efficiently provide the most up to date medical care for the time. The technology revolution has brought amazing new diagnostic equipment, treatments and medications over the past several decades, but until now the process of visiting the doctor has remained nearly the same.

Telemedicine involves locating available doctors over the Internet and connecting with them, at a moment’s notice. It lets a patient see a doctor whenever and wherever you want, freeing them to choose a doctor based on merit rather than location. It can also improve the quality of medical care and reduce costs and it works well for urgent care, ongoing diagnostic monitoring and illnesses that can be diagnosed and treated without personal contact with a care giver. Telestroke, the practice of providing emergency stroke care through telemedical technology has brought lifesaving care to patients who were once located outside of the golden hour of treatment and chronically ill patients who were accustomed to spending many hours of travel time to receive treatment for a variety of illnesses and injuries have realized a new level of convenience and quality of healthcare.

In 2010, telemedicine and telehealth appeared to be on the verge of an acceptance break though. Recognizing an oncoming shortage of physicians and escalating medical care costs, the healthcare community recognized how the technology could significantly impact the future medical care costs and streamline the delivery of a broad array of healthcare services. The benefits of a new technological healthcare delivery model faced some rather significant hurdles on its way to acceptance and meaningful implementation. Much of the healthcare infrastructure, fiscal processes and protective regulations, many in place for nearly a century, needed to be revised to take advantage of the promised benefits of telemedicine. Policymakers, politicians and those early doubters within the medical community are warming to the new model and once formidable barriers to the advancement of telemedicine are beginning to tumble. Removing process barriers may be the easy part of bringing the benefits of telehealth to the everyday life of patients, changing life-long rituals and perceptions associated with traditional medical care delivery may take a bit longer. Simply recognizing the benefits of telemedicine isn’t enough; patients must embrace the concept, understand how the features benefit them and motivate them to use it.

Some say that there is no substitute for the human touch and a healing bedside manner. Consumers will always insist on traditional, face to face encounters with their doctor. Yet the advantages, convenience in particular, of new technologies and cutting edge devices are being accepted and utilized by virtually all generations. Social interactions are now ongoing connections and rarely limited to special occasion or planned encounters. Acceptance and utilization of technology in medicine will advance as the options and variety of healthcare services, accessible and the benefits of convenience and costs are realized by more and more patients.

Regardless of the methods of delivery, those who choose to enter the practice of healthcare will still be motivated to do so by the desire to help others in need, to provide treatments to those who suffer the fates of life’s many malady’s and to save lives. Having to adjust their bedside manner to accommodate the medium of delivery will do little to deter their aspirations to heal others.

In the words of Thomas Nesbitt, the Associate Vice-chancellor for Technology at the University of California Davis Health System, “A lot of people think it’s about the technology, but it’s really about a new model of care that the technology facilitates.”



Removing Well Entrenched Impediments to Advancing Telemedicine Benefits

A recently published study in Telemedicine and e-Health found that despite numerous benefits to expanding telemedicine that there are three major barriers that remain to fully implementing the benefits of telehealth. Health care professionals agree that Telemedicine has and will continue to change care delivery and patient outcomes by expanding patient access, reducing service gaps, improving service quality, providing additional clinical support, delivering enhanced patient satisfaction and improved adherence to care standards.

Advances in powerful technology is transforming care facilitation, making real-time audiovisual communication more feasible and permitting physicians the ability to remotely consult with a patient via a robot and LCD screen.  Remote specialists and physicians can treat patients and save lives with the use of a broadband card, an internet connection from a cell phone tower and a laptop. This illustrates the amazing potential of telemedicine but the study found that serious human barriers to nationwide telemedicine still remain.

The study surveyed emergency and critical care remote presence telemedicine users from 53 healthcare institutions across North America and Ireland. One hundred-and-six surveys were completed. Sixty-eight percent of respondents were physicians, 17 percent nurses and nurse practitioners and 8 percent were administrators. The results indicated that three major human barriers for telemedicine in the areas of regulation and finance need eradication to fully implement the benefits of telemedicine.

     – Licensing for Physicians. A major benefit of telemedicine is the ability to consult remotely with physicians and patients across state boundaries, but today the current approach to medical licensing requires health providers to obtain multiple state licenses and adhere to diverse and sometimes conflicting state medical practice rules. The medical licensing process is not only complicated but also lengthy and expensive and it represents a major barrier to the expansion of telemedicine.

     – Credentialing. Credentialing can become very complicated especially for hospitals with hub and spoke models because physicians from each hospital have to have the credentials at every hospital.  The time it takes it to acquire all necessary documents and finish an application is time that could be used training medical staff to use telemedicine and bring the benefits of telemedicine to deserving patients. The current method for credentialing should be streamlined to facilitate easier credentialing at multiple facilities leading the way to wider telemedicine implementation and increased accessibility.

     – Reimbursement. A huge financial issue for telemedicine is the lack of reimbursement and capital expenditure for services. Similar to licensing issues, reimbursement models are different across the states with each having its own regulation for private payers with little or no consistency for telemedicine reimbursement.

Removing these impediments to the expansion of telemedicine remains a daunting task. Change never comes easy, particularly when it requires the cooperation of various bureaucratic agencies, multiple governing bodies and a wealth of well entrenched administrative procedures and regulations that were designed and implemented in a time when advanced communication technologies were little more than fantasy and science fiction. A continued focus on removing these barriers must intensify in order to bring the many proven benefits of telemedicine to patients throughout the country and the world.



AcuteCare Telemedicine Leading Acute Care Telemedicine

The effort to provide high-quality healthcare solutions to every patient, regardless of geographic location, while reducing delivery costs is at the foundation of industry leaders efforts to revolutionize the traditional healthcare delivery model. Telemedicine is becoming the cornerstone of the solutions. Advances in telecommunication technologies is providing increased opportunities to decrease complications for patients in areas of high acuity like the critical care unit, as well as provide assistance in time-sensitive treatment decisions for emergencies such as stroke care.

InTouch Health® is the leader in acute care remote presence telemedicine. The company through its network of clinical care providers delivers innovative healthcare solutions that extend a doctor’s ability to manage patient care remotely, thereby removing critical time and distance barriers. The InTouch Telemedicine System allows physicians and other healthcare providers to conduct highly reliable, real-time, remote consultations.

AcuteCare Telemedicine (ACT), the largest practiced based provider of acute stroke and neurological care is now linked as a preferred provider with InTouch Health. Acute care telemedicine is an approach to urgent healthcare delivery in which specialists are focused on providing comprehensive, end-to-end remote presence clinical services, enabling a remote clinician to be interactively present in the patient environment and gather pertinent medical information through examination and data access to form a medical decision and care plan. With their remote expertise available at a moment’s notice, ACT is able to increase the likelihood that patients will obtain necessary stroke care within the critical “golden hour” following stroke recognition. The importance of using acute care telemedicine in the advancement of emergency healthcare is supported by the efforts of InTouch Health.

The ACT team of expert Neurologists is being recognized for setting new standards for excellence in Telestroke and urgent Teleneurology care. As clinical partners with hospital based and emergency physicians, they are positioned to successfully deliver remote, live and interactive Telestroke and other Teleneurology solutions that deliver the highest quality, affordable services and superior clinical outcomes for hospitals all around the world.



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.



Technology is Advancing the Practice of Telepsychiatry

Telepsychiatry and other long-distance options for providing mental health care can help overcome problems related to location and distribution of specialty mental health services but should not be seen as a panacea for delivering care to rural areas in the United States, reported a research and policy brief from the Maine Rural Health Research Center. “Telemental health” (yet another new term) once depended on heavy-duty audio and video technology based in fixed studios to initiate care. Despite this coarse beginning, advances in computer technology and its near-universal adoption have resulted in improved delivery of Telepsychiatry and made it more cost effective and available to a wider audience, however, some non-technical hurdles remain to be cleared.

Until recently, “Telemental health” services were most commonly provided by psychiatrists, clinical psychologists, clinical social workers, and psychiatric nurse practitioners, but now a pilot project begun at one critical-access hospital in collaboration with a psychiatrist and specialty mental health staff at a community mental health center has expanded to five additional hospitals. This system provides round-the-clock crisis evaluation and support at the hospital emergency departments and some say that “Telemental health” enabled them to provide services to rural persons that otherwise would not be available, but some nontechnical barriers such as poor Medicaid and commercial reimbursement rates, recruitment and retention difficulties, high numbers of patients without insurance, and high no-show rates serve as a drag on expansion of current programs.

The barriers experienced with “Telemental health” expansion is shared by other medical service disciplines seeking to enter or expand the utilization of telecommunication technologies that promise to revolutionize the delivery of medical care in the United States and across the world.  While progress is being made to overcome many of the most significant structural road blocks to expansion and adoption of these new technologies, much remains to be done to clear the path to a new medical care delivery model.

Maintaining a consistent push to encourage state and congressional representatives and health insurance industry leaders to move forward and embrace the revolution in healthcare must continue until each barrier is removed or neutralized.  The promise of delivering better, less expensive and more available medical care to millions of patients across the country depends on these continued efforts progressing and succeeding.