AcuteCare Telemedicine Blog


The Era of Resisting Telemedicine is Fleeing

Despite the promise of significant consumer benefits of access and costs and the overall growth of Telemedicine, many patients and physicians are slow to adopt new communication technologies in the delivery of healthcare. A recent article in Medical Economics News reported that “A HealthMine Survey of 500 consumers who use mobile/Internet-connected health applications finds that 39% still have not heard of telemedicine, and only one-third of respondents say their health plan offers telehealth as an option.” And while many patients have not yet signed on to telehealth services, nearly three quarters of patients are interested in using it in place of in-person medical appointments. Could it be that the slow progression of patient participation may be due to resistance and lack of participation from care providers?

One of the most prolific reasons many providers resist the technology is the concern that patients would be unwilling to replace traditional face-to-face physician encounters with a virtual relationship and that many consumers would be fearful of the technology, particularly those among the growing number of “Baby Boomer” patients. But in a recent Georgetown University study, the results indicated that more than half of the aging generation preferred to use this technology. And among those 34 years of age and under, 60 percent desired a virtual interaction with their physician.

Some of the complaints from cautious physicians revolve around the complexity and cost of technology hardware and software and the difficulties in merging new platforms into existing operations, particularly syncing virtual experiences with current EHR systems. Ongoing design improvements in the technology and simpler user interfaces are driving down cost and simplifying required functions. The reality today is that telemedicine improves the bottom line for most medical practices while reducing appointment management and patient flow issues.

As legislatures across the country continue to make progress on modifying existing regulatory barriers and concerns involving payment parity, payer participation and individual state licensing and credentialing, many early telemedicine supporters are beginning to see the light at the end of the increased adoption tunnel. For those providers who continue to resist the trends of virtual medical technology, the time is nearing to overcome the natural tendency to resist and fear change. The simple truth is patients prefer and want telehealth choices and the technology is here to stay.



What’s In Your Digital Health Tool Box?

The early implementers of telemedicine faced resistance, skepticism, and predicted peril from an industry that has followed a standard of care, governed by regulations. Those initial trailblazers have prevailed in their efforts to improve access to specialized care for patients living afar from major medical centers, enhancing patient’s healthcare experiences and reducing the unnecessary cost of specialized treatment and ongoing chronic care. Their persistent efforts to merge the latest digital technologies in communication with modern medical care has spawned new terms to languages all around the world; Telepsychiatry, Telestroke, Telemedicine, TeleICU and Telehealth, just to name a few.

Technology is having a wider impact on how healthcare providers connect with their patients and dispense treatment. This connected health revolution is making everyone active participant’s in their healthcare through an ever expanding network of devices and platforms. But as is often the case, development of new technology can outpace the ability of an industry and their consumers to accept and engage the new methods.

Consumers have demonstrated an impressive demand and utilization of digital healthcare tools like activity trackers, smart watches and their accompanying health apps, but nearly half of the users complain that their caregiver is failing to integrate the data into a personalized healthcare plan. A survey, conducted by HealthMine, called “The State and Impact of Digital Health Tools,” found that “a significant amount of digital health data is not reaching doctors or health plans and that there appears to be a disconnect between where consumers would like their self-collected health data to go and how easy it is to share it.”

Many physicians articulate an understandable concern about the accuracy of many of these devices and the process of collecting and transferring the data. In a recent article Vaughn Kauffman, a global practice leader in PwC’s Health Industries Advisory, indicated that physicians have some apprehension around taking in data from mHealth devices and wearables. “Some providers are further down the road than others around utilizing these kinds of data for engagement. There’s the potential to extend the doctor-patient relationship to beyond the direct doctor visit interaction. And obviously, this would involve individuals opting in, as opposed to kind of a Big Brother phenomenon.”

While wearables continue to be popular, many once avid users are discontinuing their engagement with the technology. Some indicate their waning interest is due to not understanding how the data collection will benefit them or enhance their digital health plan. Education and better understanding of the technology and how it can benefit both providers and patients in improving the delivery of healthcare will solidify the acceptance and use of the technology. The early pioneers of telemedicine have opened the trail to a much larger spectrum of services but wider engagement is still dependent on the ability of technology to deliver on its promises.



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.



Healthcare Regulatory & Policy Environment Impacts Telehealth Adoption

For those who first thought telemedicine’s role would be limited to a supportive, “add-on” process focused on a narrow list of ailments and other procedures and treatments, today’s reality must be shocking, if not a bit frightening.

Unlike technology where advances are frequent and common, changes to industry governing regulations are often found at the other end of the spectrum, and perhaps rightfully so. While some may argue that the healthcare industry is overly regulated, others argue that well designed regulations and practice standards is the fundamental reason that our healthcare system is the envy of the world. The suspicious practices of past centuries of treating patients have been replaced by a complex set of regulations that are diverse across all fifty states but is universally founded on all responsible care givers guiding mantra, “First, do no harm”.

But no matter how well intentioned and successful, the massive healthcare regulatory system with its myriad of governing bodies, Boards, and legislatures is a formidable foe when it comes to interjecting new technology that promises to greatly improve and enhance the experience between healthcare provider and patient. The changes perhaps once thought to require mere tweaking around the edges of the regulatory giant are proving to be far more involved and are likely to require a restructuring of the healthcare regulatory environment, a process that will certainly slow the advancement and adoption of telehealth. Progress is occurring, at a disruptive but deliberate pace perhaps, as dedicated industry leaders tackle the challenges of integrating advanced remote medical technologies into the existing mainstream healthcare delivery model.

The American Telemedicine Association, the leading international resource and advocate promoting the use of advanced remote medical technologies is leading the way and monitoring the progress of change across all fifty states through two annual publications; The 50 State Telemedicine Gaps Analysis, Physician Practice Standards & Licensure and The State Telemedicine Gaps Analysis, Coverage & Reimbursement.

Ultimately, the future of telemedicine and its rate of adoption are dependent on reimbursement and regulatory policies at the industry, federal and state level. Jon Linkous, the CEO of the American Telemedicine Association, counts understanding healthcare’s regulatory and economic structure as one of his top To Do’s for companies active in the telehealth industry.



AcuteCare Telemedicine Team of Neurological Specialists Publish New Study

A new study published by the Journal of Stroke & Cerebrovascular Diseases indicates a practice-based telemedicine system can produce meaningful improvement in markers of telestroke efficiency in the face of rapid growth of a telestroke network. “Improving Telestroke Treatment Times in an Expanding Network of Hospitals” is authored by Keith A. Sanders, MD, James M. Kiely, MD, PhD, Matthews W. Gwynn, MD, Lisa H. Johnston, MD and Rahul Patel, BS.

AcuteCare Telemedicine (ACT) has remained committed to working with healthcare organizations to establish telestroke programs that not only improve access to specialty care but also significantly improve patient outcomes,” comments Dr. Keith Sanders, Partner, ACT. “It is critical to prove that our business is able to create telestroke programs that are not only effective but sustainable.”

As stated in the background for this study, telestroke must demonstrate successful outcomes to achieve sustained growth and acceptance. Asserting that telemedicine is faster, employs the latest technology, or promotes a better use of limited re-sources is laudable but insufficient. An analysis of stroke treatment within a telemedicine network in 2013 showed that tissue-type plasminogen activator (tPA) could be safely and reliably administered within a practice-based model of telestroke care. Since then, hospital volume and tPA administration within this network have tripled. We hypothesize that a practice-based model of telestroke can maintain positive outcomes in the face of rapid growth. As a result, the study demonstrates meaningful improvement in markers of telestroke efficiency in the face of rapid growth of a telestroke network.

“Success in our business isn’t just about adding new healthcare organizations to our client portfolio,’ says Dr. Matthews Gwynn, Partner, ACT. “As clinicians, we measure our success on consistently providing the highest level of stroke care and improving patient outcomes.  This study is representative of our ongoing commitment to serve as a leader in telestroke care, establishing a standard of care and a model that supports the positive growth of telestroke programs across the country.”

Download the full article here.

 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.



Robots and Doctors Help Improve Stroke Treatment

The issue of delivering consistent medical care across all geographic areas from large populated urban centers to the outlying rural communities has been a critical area of focus for healthcare organizations. Typically smaller, financially stressed rural hospitals and clinics suffer from limited access to medical specialists, particularly in emergency situations involving stroke and other neurological and coronary events. These medical emergencies demanded quick and immediate treatment to save the affected patient from significant disability or death.

In the three years since the first telestroke robot was installed at Covenant Health Hospitals in East Tennessee, doctors at LeConte Medical Center (LMC) have used the technology on a weekly basis. Using the latest in virtual presence technology the dedicated medical professionals at LMC can connect immediately with a team of neurological specialists at AcuteCare Telemedicine in Atlanta, GA. “It’s an amazing thing that we have this expertise in a small rural hospital,” said Steve Dronen, M.D., Emergency Room at LeConte Medical Center. While the hospital has a well demonstrated history of providing quality care to stroke patients, the extra advantage of having highly trained and experienced neurological specialist available for consultation around the clock, 24/7 assures LMC patients the highest level of stroke care available anywhere in the country.

Dr. James Kiely, a partner in Atlanta Neurology, P.C. and AcuteCare Telemedicine said, “As Medical Director of the Neurophysiology Departments at St. Joseph’s Hospital of Atlanta I was aware of how fortunate our patients were to have the most immediate lifesaving treatment for stroke 24 hours a day, seven days a week.” The most effective stroke care requires that it be delivered to the patient within the “golden window” of stroke onset. 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 recovery after a stroke. “AcuteCare Telemedicine was created”, Dr. Kiely says, “to impact the well-being of patients with severe neurological emergencies who otherwise wouldn’t have rapid access to vital expertise simply because of where they live.”

The other major benefit of the technology, described by Dr. S. Arthur Moore, Medical Director of Stroke Program at Covenant Health’s Fort Sanders Regional Medical Center, is how quickly the tele-robot allows doctors to make life-saving decisions. “We can now do something about it. It doesn’t matter if you are in rural East Tennessee or in Knoxville, we can provide the same care,” said Dr. Moore. Doctors only have a small window of time to make a treatment decision before the damage from stroke becomes permanent. The new technology is helping to accelerate the treatment process.



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.”



The Importance of Educating Legislators on Telehealth

Telemedicine legislation has been a frequent subject of much debate among healthcare professionals, Federal agencies, and State legislators. In recent news, the Governor of Delaware signed a new comprehensive telemedicine bill into law which requires healthcare companies to pay for telemedicine services at the same rate as in-person visits. Delaware joins 29 other states who have adopted similar requirements. U.S. Representative Mike Thompson is also actively working on the Medicare Telehealth Payment Parity Bill expanding the list of telehealth services available to Medicare patients.

In an effort to increase national attention on telehealth related issues, the American Telemedicine Association (ATA) is announcing The ATA Fall Forum, an event to educate members of Congress and push for important telemedicine policies. National Telehealth Lobby Day will be held on Capitol Hill in Washington DC. on September 16, 2015, and will be part of the event that includes training sessions on telehealth legislative priorities and expert tips on how telemedicine supporters can start discussions with Congressional leaders.

“Telemedicine has rapidly become the new standard of care,” comments Dr. Matthews Gwynn, Partner, AcuteCare Telemedicine. “In order to drive positive legislative change, we must educate legislators on the importance of access to telemedicine as well as the overall impact of telemedicine to patients and healthcare organizations.”

The Association leadership believes the best way to influence members of Congress is through face-to-face interactions with legislators. Federal and state legislation regarding physician licensing, care quality, scope of treatment and reimbursement of telemedicine is critical to expanding healthcare access and improving patient outcomes.

The ATA is the leading international resource and advocate for advanced remote medical technologies. Established in 1993, as a non-profit organization, the ATA membership works to fully integrate telemedicine into a transformed healthcare system to improve quality, equity and affordability of healthcare throughout the world. Their mission is to promote professional, ethical and equitable improvement in health care delivery through telecommunications and information technology. The ATA Fall Forum in an opportunity to further this mission.

“As a leading practice-based provider of telestroke care, we support initiatives that open a dialogue with legislators, practitioners, and healthcare leaders with the intent on drafting smart legislation that will have a positive impact on our healthcare system,” said Dr. Keith Sanders, Partner, AcuteCare Telemedicine.