AcuteCare Telemedicine Blog


The Georgia Partnership for Telehealth Spring Conference

The Georgia Partnership for TeleHealth (GPT) was founded on the advances in the continually evolving telecommunications technologies. Since its formation in 2008, GPT has grown to become one of the most robust, comprehensive telehealth networks in the nation. The hallmark of GPT is the Georgia Telemedicine Program, an Open Access Network, which is a web of statewide access points based on strategicGPT Image partnerships with successful existing Telemedicine programs, and the creation of new Telemedicine locations, to maximize opportunities for timely specialty services. When fully realized, the Program will enable all rural Georgians to access specialty care within 30 miles of their homes. GPT’s services and support can provide state of the art telehealth solutions for all Georgians.

On March 25, 2015 GPT will be sponsoring their 6th Annual Spring Conference in Savannah, GA. The conference is a great opportunity for healthcare professionals from all medical disciplines and specialties to learn how the most up-to-date telecommunications technologies are impacting the delivery of stroke care and other healthcare services. Attendees will experience telemedicine in an applied framework, build network relationships and gain exposure to the latest in telehealth hardware and software technology. The conference will include a Grant Writing Workshop and will feature presentations from foremost experts in teleneurology.

Dr. Keith A. Sanders will be presenting a talk at the conference entitled “Outcome Analysis Demonstrates the Value of Telestroke”. Dr. Sanders is Director and Founder of the Stroke Center of St. Joseph’s Hospital of Atlanta and former Chairman of the Ethics Resource Committee and a partner in Atlanta Neurology, P.C. and AcuteCare Telemedicine (ACT). “As medical practitioners, we are expected to apply the latest techniques and technologies to the treatment of our patients. However, it is incumbent upon us to analyze the outcomes to gauge whether there are meaningful benefits and share that knowledge with the greater medical community. Indeed, state-of-the-art telemedicine technology is advancing stroke care and saving lives,” says Dr. Sanders. “I’m looking forward to sharing my experiences improving outcomes and expanding access to quality, advanced stroke care with my fellow Conference attendees.”

The GPT Spring Conference will begin on March 25, 2015 and run through March 27, at the Hyatt Regency-Savannah at 2 West Bay Street, Savannah GA 31401. Online registration is now open. An array of exhibitor opportunities is now available. Additional information is available by contacting Samantha Haas at samantha.wainright@gatelehealth.org.



Foundation Study Identifies Telehealth as the Cutting-Edge Future of Health Care

A new study, “Telehealth & Patient-Centered Care” conducted by Ron Bachman, a Senior Fellow at the Georgia Public Policy Foundation, provides a comprehensive analysis of the potential of telehealth and how policies in Georgia can accelerate, or inhibit, its benefits. Georgia has accepted the leadership role in the development, implementation and increased utilization of telecommunication technology in delivering quality, affordable and more accessible healthcare to its consumer-patients. Today, more than half of Georgia’s hospitals are capable of delivering virtual care to their patients and state law makers have passed legislation requiring private insurers to cover telehealth services.

Ron Bachman is one of the foremost experts on health care consumerism, consumer-centric Medicaid and Medicare, the uninsured population and mental health. His study found an estimated half a billion smartphone users worldwide will be using a health care app to connect to a healthcare giver by 2015. An emerging, technology-using generation is becoming increasingly comfortable with using mobile devises to access their medical care through smartphones, tablets and laptops. Entrusted with an increased responsibility for paying the rising costs of healthcare, these new consumers are embracing disruptive technologies to command lower cost, more convenient, higher quality, consumer oriented medical care. “It is impossible to stop a mega-trend,” says Bachman. “Telehealth is the cutting-edge future of health care worldwide. Telehealth, in its various forms, will provide convenient medical services because consumers will demand it.”

A full expansion of the benefits of telemedical services continues to be hampered by established, well-intentioned industry groups and governmental agencies. For decades, these market deciders have successfully influenced a healthcare delivery model that is the envy of the world. Their concerns and reluctance to boldly apply such wide ranging and disrupting technologies to a historically successful model is understandable. But Bachman argues that, “Too often existing self-interest groups, established guilds and status quo advocates can stifle disruptive innovations, the role government plays in providing oversight and clarity is important to prevent litigiousness and overregulation from holding Georgia, Georgia’s patients and physicians back in an era of growing needs and limited resources.”

The study concludes that health care consumerism and telehealth technology are here to stay and will offer tremendous benefits to both caregivers and patients. Kelly McCutchen, President of the Georgia Public Policy Foundation, said “The findings of Bachman’s study offer excellent opportunities to expand low-cost, quality health care to the poor and to rural parts of the state. Health care costs will bankrupt families and our country unless we find effective, high-quality solutions. Telehealth is exactly the type of innovation that can solve many of these problems, as long as we remain vigilant and ensure it is not shackled by overregulation.”



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



New Rules for Telemedicine Providers in Georgia

The Georgia Composite Medical Board (GCMB) has approved new rules (360-3-.07) for healthcare providers who are practicing telemedicine in the state.

The new rules require doctors to be licensed in the state of Georgia and, in most cases, to have either seen the patient in person or have a referral from another physician, PA or APRN who has seen the patient in person prior to providing the electronic service. The ‘‘in person’’ rule allows exceptions in cases where a patient has been referred by certain types of providers and agencies, such as public school nurses, a community mental health center, the Department of Family and Children’s Services or law enforcement. The rule also includes a broad exception to the in-person encounter requirement if the care provider ‘‘is able to examine the patient using technology and peripherals that are equal or superior to an examination done personally by a provider within that provider’s standard of care.’’

The exceptions were a departure from previous rules that were under consideration by the GCMB. As reported in the Bloomberg BNA, the original provisions offered little in the way of exceptions to the in-person rule but language was altered on the advice of the Medical Association of Georgia (MAG) and other groups. Dr. Matthews Gwynn, an Atlanta area neurologist and board secretary for MAG, told Bloomberg BNA, ‘‘As a neurologist providing care for stroke patients in emergency situations, I’ve never seen these patients before, so I said you have to have a mechanism to allow us to see these patients de novo. This version of the rules does that.’’

The new rules were also prompted, in part, as a response to a growing abuse of online prescription pain medications by unscrupulous companies selling prescriptions on demand. Georgia instituted the Prescription Drug Monitoring Program in 2013 which allows pharmacists to check to see whether patients are getting prescriptions from more than one doctor or using several pharmacies. Georgia was the second to last state to implement a system to monitor and curb what has become a significant problem all across the country. The new GCMB telemedicine rules specifically exclude the prescription and distribution of controlled substances for the treatment of pain or chronic pain by electronic means.

The GCMB rule requiring telemedicine providers to have a Georgia state license is typical of other states’ requirements. The individual state license rule is often seen as a significant barrier to the accelerated expansion of telemedicine nationwide. Consumer groups traditionally advocate for more open telemedicine policies as a way to improve access to health care for residents of rural areas across the country and in Georgia, where doctors, particularly specialists, are scarce.



Leading Centers Aiming to Revolutionize Stroke Research

Georgia StrokeNet will be one of 25 U.S. regional coordinating centers to take aim at revolutionizing stroke research under a program funded by the National Institutes of Health (NIH). Georgia StrokeNet is the only regional coordinating center in Georgia that is participating in the project that is funded by a five-year, $2 million grant.

Those taking part in the collaboration include: Emory University’s School of Medicine, Grady Memorial Hospital’s Marcus Stroke and Neuroscience Center and other local partners. Emory neurology professor and Marcus Stroke and Neuroscience Center Director Dr. Michael Frankel will serve as Georgia StrokeNet’s principal investigator: Dr. Frankel says, “The new StrokeNet will be a conduit for clinical trials for patients to participate in, so we can answer those key questions about what is the best way to prevent a stroke, what the right blood pressure to try to prevent a stroke, what is the right treatment for a patient who has an acute stroke.”

Grady Hospital’s Marcus Stroke and Neuroscience Center has earned a top designation for stroke care by an independent accrediting agency for health care organizations. The Center has been designated an Advanced Comprehensive Stroke Center by the Joint Commission and is one of 50 U.S. stroke centers who have received the designation since it began. Emory University and Georgia Regents Medical Center in Augusta are the other two Georgia centers to receive the designation.

Dr. Keith A. Sanders, Director and Founder of the Stroke Center of St. Joseph’s Hospital of Atlanta, and partner in Atlanta Neurology, P.C., is looking forward to contributing to the stroke research at Georgia StrokeNet.  “The research is important because strokes and stroke-related deaths are prevalent in Georgia and the Southeast. It is hoped that this research will lead to more treatment options to reduce disability from stroke, commented Dr. Sanders.”



New Partnerships Bring Telemedicine to Guatemala

Recently the Georgia Partnership for TeleHealth (GPT), the Louisiana State University Health Science Center (LSU) and Casa Para Ninos Aleluya (CASA) launched its first international telemedicine program. The new partnership was formed through an ongoing relationship with former Louisiana Senator and Family Medicine Practitioner, Dr. Donald Hines and GPT’s Chief Executive Officer, Paula Guy.

The mission of the collaboration is to deliver much needed primary and specialized medical care to the children of the CASA orphanage through the use of telemedicine technology.  The orphanage is home to over 400 abused, orphaned and mistreated children and is located just outside of Guatemala City.  Started in 1988 by missionaries Mike and Dottie Clark, CASA’s vision is for the kids they serve to have a chance in life by bringing pediatric specialty care to the clinic in order to change the futures of these children and so many more.  The medical needs of hundreds of the children at CASA are met daily through a few nurses that manage a clinic on-site.  The new technology will greatly aid the on-site care givers capabilities in providing quality medical care to the children. The new technology has become a magnet for other missions who are struggling to serve the estimated 200,000 orphaned children across Guatemala.

The clinic was up and online within 24 hours and the nursing staff at CASA was trained and certified as telemedicine presenters and will be supported by Georgia Partnership for TeleHealth as they continue to serve Cuidad de Los Ninos.

AcuteCare Telemedicine (ACT), the leading practice-based provider of Telemedicine services for hospitals in the southeast United States, recently donated their time and expertise to make telemedicine a reality at CASA.  Dr. James M. Kiely, a partner in Atlanta Neurology, P.C., ACT and Medical Director of the Neurophysiology Departments at Northside Hospital and St. Joseph’s Hospital of Atlanta recently demonstrated the benefits of telemedicine capabilities at the orphanage.

Dr. Kiely remotely treated a 19 year old CASA patient with a history of intractable epilepsy. The young patient was on numerous medications but continued to experience recurring seizures. By using a high definition audio-visual connection provided by GPT, Dr. Kiely was able to interview the patient’s parents and examine the patient remotely. The imaging results, hemiparesis, and description of seizures allowed him to determine that the likely type and cause was attributed to porencephaly, the failure for one hemisphere of the brain to develop. Kiely was able to recommend appropriate medications to on-site doctors and to suggest additional steps to take if the patients epilepsy remained intractable.  The process worked flawlessly and marked the beginning of a new relationship between the missions and medical providers across the region.

Georgia Partnership for TeleHealth has aligned its mission to serve domestically and internationally and is seeing lives change through getting access to care in these underserved areas. There are no limits in providing this kind of access worldwide using technology,” states Dr. Jeffrey Kesler, COO of GPT.  The Partnership’s experience in implementing Telemedicine includes nursing homes, school clinics, correction, specialty clinics, Emergency Department, ICU, stroke assessment, primary care, child advocacy, and continuing education.

GPT will be providing ongoing support to the children of the Guatemala region through donated physician time. Physicians, who are interested in investing time to serve at CASA Para Ninos Aleluya, are encouraged to contact Matt Jansen, Executive Director, Georgia Partnership for TeleHealth at matt.jansen@gatelehealth.org.



CMS Expanding Telemedicine Coverage

The Centers for Medicare and Medicaid Services have proposed rules that would provide telemedicine services to nearly 1 million new Medicare beneficiaries.  CMS proposes to increase the number of beneficiaries eligible for telemedicine by modifying their urban/rural definitions and proposes several new reimbursable telemedicine services.

The first change would extend reimbursable telehealth services to “originating sites” serving nearly one million rural beneficiaries living in large metropolitan areas. Currently, Medicare uses a strict county-based classification to enforce its rural-only rule for telemedicine coverage. The new rule would create a more precise urban/rural distinction based on geographically smaller census tracts.

The second proposed change would increase coverage for transitional care management services under Current Procedural Terminology (CPT) codes 99495 and 99496, involving post-discharge communication with a patient and/or caregiver. Reimbursement of these services will help healthcare providers deliver improved in-home care to at-risk beneficiaries and significantly reduce needless hospital readmissions.

Jonathan Linkous, Chief Executive Officer of the American Telemedicine Association cautiously supports the change and in a statement said, “This is one small step in the right direction.  For 15 years the federal government has placed strict restraints on the use of telehealth while employers, private payers, states and many other nations have moved boldly forward, improving the quality and reducing the cost of care. It is time to unleash the power of modern technology and allow Medicare beneficiaries, regardless of whether they live in a rural area, underserved inner-city, in a clinic or at home to be eligible to receive the benefits of telehealth.”

The proposal is currently open for comment and ATA encourages all telemedicine advocates to express their support.  The American Telemedicine Association is the leading international resource and advocate promoting the use of advanced remote medical technologies. ATA and its diverse membership work to fully integrate telemedicine into healthcare systems to improve quality, equity and affordability of healthcare throughout the world.