AcuteCare Telemedicine Blog


Not Yet Out of the Woods

As most Americans celebrated the New Year, our elected representatives met in Washington to approve legislation narrowly avoiding the ‘fiscal cliff.’ As part of its extensive provisions, the new legislation saved Medicare providers from an impending 2% payment reduction that would have gone into effect on January 1 and postponed spending cuts to Medicare, but only for two months. Within the terms of the agreement, negotiations on ways to cut spending are expected to resume after this period, meaning hospitals are still facing the risk of cuts triggered by uncertainty and further harm if the reduction does eventually takes effect.

While overall Medicare spending may not be affected now, hospitals are still face a long-term decrease in payments. The compromise legislation includes the “doc fix,” which negates a 26.5% decrease in Medicare payments to physicians, with hospitals bearing the brunt of financing it. The tally will come to about $15 billion over 10 years, or roughly half the total cost of the one-year fix. On top of those made by the passage of major healthcare reform in 2010, the new cuts include decreases in payout from both projected Medicare payment increases for inpatient or overnight stays and Medicaid disproportionate share payments, as well as reducing risk-adjusted payments to Medicare Advantage plans.

The kind of last-minute action taken by Congress is a reminder of the severe need to address the provider payment formula for Medicare reimbursement with a long-term solution. Short-term fixes ultimately result in a reduction of important healthcare services detrimental to both patient and provider. Until a solution is reached, hospitals simply cannot afford to cover the difference.



Collaboration Across the Pond

Relations between the US and the UK are particularly amiable, arguably at an all time high, and moving towards modernity, our cultures have engaged in a ‘give and take’ from one another. However, when it comes to discussion of healthcare policy, our politicians and citizens are often quick to dismiss one another’s perspectives.

Despite the huge disparities in approach, each country’s current desires in regards to changing their healthcare situation are fairly equivalent. Both nations are working towards getting better value from healthcare expenditures, encouraging providers to focus on quality with better incentives, and controlling rising health care costs, regardless of the differences in who is paying.

Telemedicine offers both systems huge advantages in the pursuit of these goals, and the two can learn from one another. In the US, telemedicine has helped curb unnecessary and irresponsible healthcare spending, an important consideration for a nation currently obsessed with combating rising costs detrimental to its economy. Abroad, electronic patient care records are managed efficiently, falling in line with the expectations of the unified, government-controlled National Health Service (NHS) responsible for administrating healthcare.

It is important to keep in mind the great differences in context between the implementation of telemedicine in the United Kingdom and here at home. Of course, the NHS provides citizens with what we have dubbed as “Universal” health care, which is free to the patient at the point of service. In contrast to the Brits’ centrally governed and tax-funded system, care in the US is available through a multitude of competitive providers and is paid for by a patchwork of public and private insurers. The fact of the matter is, telemedicine works as a solution to a myriad of challenges, and both countries are discovering new solutions every day.

Healthcare officials in both countries envision telemedicine playing prominent roles in the future of their respective systems. Perhaps in the short term, this vision will be a common ground on which to open a mutually beneficial dialogue to address the unique challenges facing each nation.



A Shifting Attitude

Telemedicine’s role in the current healthcare environment has been blossoming over the course of the past few years, making progress towards the full realization of the field’s potential.  A certain percentage of healthcare professionals are already there; those who have seen telemedicine at work day in and day out already know that we are providing patients with excellent care, mitigating costs to the healthcare system, and saving lives. The challenge remains getting the rest of our industry and our patients up to speed.

Improving care standards and lowering health care costs are their own rewards, but also important is the evident change in the way people think about getting medical treatment. Telemedicine is significantly changing patient behavior. We have heard astonishing figures – flirting with near 100% satisfaction rates – when it comes to positive experiences for both hospital workers and patients.

Presumably, an estimated 20% of the roughly 140 million ER visits that hospitals bear each year are able to be treated virtually. That number jumps to around 70% when considering urgent care centers and primary care physicians. The aforementioned shift in attitude about how to best access care in emergencies and non-emergencies is crucial to opening the door for telemedicine to alleviate much of the burdens these unnecessary visits place on the system. Reducing the stress on physical and financial resources also means better care across the board when patients do come to the hospital.

The speed, efficiency, and improved coordination of care are all great assets for a society battling with the challenges of an inefficient traditional healthcare system. The good news is that the many advantages of telemedicine for payers, providers, and patients are truly beginning to take root with the public, and driving behavior that will lead to even better results down the road.



Good Things Come in Small Packages

As the fall approaches and we reach the third anniversary of AcuteCare Telemedicine, we have spent some time reflecting on our company and personal growth over the last three years. From simple beginnings, serving one health care facility in the metro Atlanta area, ACT has expanded to include facilities in rural communities of both Georgia and Tennessee. We have developed alliances with Emory University Hospital and the Georgia Partnership for Teleheath, two partners who enable us to provide the highest quality of acute neurologic care where it may otherwise be lacking. Turning our attention forward, ACT continues to push to ensure that every emergency department is staffed with adequate 24/7 neurology coverage, whether in person or via remote presence.

ACT has always believed that our successes are primarily due to the quality of services we offer. Despite our expansion over the past three years, ACT has remained a small, intimate company, still owned and operated by its four founding physicians. We find unique value in our size; it allows for outstanding continuity of care, frequent “meetings of the minds,” and quick, effective identification of problems and subsequent solutions.

Weekly meetings with all four physicians cultivate innovative ideas, enable problem identification, and facilitate the creation of solutions in a timely and efficient manner, advantages rarely possible in larger corporations. Thanks to the size of the company, each physician of ACT has a specific role, but can be flexible and share duties when needed, strengthening the consistency of the quality care we provide.

Being smaller has other rewards. In the world of acute neurological emergencies, there is little time for complex communication and red tape. When problems or concerns arise at any of our serviced facilities, an ACT physician can immediately make contact remotely and work directly with a facility member on issue resolution. Try calling up the CEO of your car’s manufacturer when your check engine light comes on.

The four physician-owners of ACT continue to practice neurology in a group that has been caring for patients for more than 65 years combined. We are highly trusted neurologists in our own community, and we are committed to bringing our expertise to other communities in need. Our small size ensures that we will stay focused on keeping our standards high and our integrity intact along the way.



ACT Partner Taylor Regional Hospital Embraces Technology for Better Care Standard

AcuteCare Telemedicine (ACT) partner Taylor Regional Hospital in Hawkinsville, GA is on the cutting edge of revolutionizing healthcare in underserved areas in rural parts of the Southeastern US.

Lacking the fiscal and logistical resources to implement the comprehensive services found at larger facilities in urban centers, Taylor Regional has openly embraced a wealth of new technologies to drastically improve the quality of care it offers patients within its surrounding communities.

Choosing ACT’s 24/7 teleneurology services was an elegant solution to a major deficiency facing the hospital. Taylor Regional has no neurologists on staff, and the nearest available specialists are located more than an hour away. Prior to the partnership with ACT, the hospital lacked the capability to effectively diagnose and treat stroke-causing clots, often having to transfer patients to a larger hospital, compromising crucial ‘door-to-needle’ time and reducing potential hospital revenues.

Through the adoption of beneficial programs such as the telemedicine services offered by ACT, the hospital has not only taken strides forward in treating patients internally, but has also enhanced communications with other facilities, connecting with other physicians for consultation and collaboration as well as streamlining transfer processes to ensure patients receive timely and expert care.

Most recently, the teleneurology services provided by ACT resulted in the administration of tissue plasminogen activator (tPA) in two separate cases of acute stroke at the facility in the month of August 2012. The two successful administrations of the clot-busting agent are a significant achievement, serving as a milestone for a teleneurology partnership that has now successfully extended this potentially-life saving service to residents of the counties surrounding Taylor Regional.

“We are very pleased with our partnership with ACT. The neurologists are extremely professional and eager for our telemedicine program to make a real difference in the care we are able to extend to our stroke patients,” commented Lynn Grant, Emergency Room and ICU Nurse Manager, Taylor Regional. “ACT is available 24/7, taking the time not just to be there for the patients, but for our physicians, nurses, and staff, answering questions and educating about the technology and techniques that are helping us save lives. Having this service is very rewarding.”

“Taylor Regional Hospital is on the cutting edge of emergency stroke care in rural Georgia. ACT has been particularly impressed with their clinical judgment, leadership and organization,” said Dr. James Kiely, Partner, ACT. “Their community is well served.”

For more information about ACT, visit www.acutecaretelemed.com.



Ahead of the Curve

A recent PricewaterhouseCoopers Health Research Institute report suggested that medical costs are growing at a historically flat rate. The rate of growth is not only of interest to hospital facilities; it is also an extremely important factor in how commercial insurers and large employers set health insurance premiums, determining the changing cost of a health plan from year to year.

The report pointed to several factors combating rising cost trends; thanks to market pressure from a shifting public perception of the healthcare industry, medical supply and equipment costs are coming down and states are working towards greater transparency in disclosing true healthcare costs. A changing patent environment is leading to increased use of generic drugs over more costly name brands.

Perhaps the most influential change affecting the trends is the arrival of innovative new forms of care delivery. Although one helpful trend of reducing financial strain on hospitals by keeping non-emergency patients out of ERs can be accredited to the emerging market of retail clinics, telemedicine is truly the driving force of a broader revolution in the way patients interface with physicians. Whether physicians elect to conduct routine checkups through remote presence technologies or are able to diagnose and administer treatment in emergency cases, the benefit to not only the patient, but also to the healthcare ecosystem is immense.

Thanks to our desire to see the quality of healthcare increase and the system’s strain on the economy and environment decrease, the news that telemedicine is contributing to reducing the rate at which costs are rising is more than welcome to AcuteCare Telemedicine. Our dedication to combating these costs for both our client hospitals and our patients places us ahead of the curve.



Helping Healthcare Go Green

Telemedicine has leveraged technology to help hospitals overcome challenges associated with staffing and transportation extend higher quality healthcare to patients, regardless of their location, while simultaneously reducing costs. Now, we are beginning to understand that telemedicine not only helps hospital facilities run leaner; it may also help them be greener.

Hospital facilities are traditionally located in areas of higher population, often far away from patients living in rural communities. The transfer of these remote patients to hospitals for inpatient treatment demands relatively high energy consumption. With a foreseeable increase in numbers of patients requiring care in the future, these costs can be expected to rise if left unaddressed.

Within the context of changing environmental policy, increased focus must be placed on reducing emissions and energy usage in healthcare policy. Telemedicine has demonstrated positive effects, creating a more environmentally sustainable process by improving inpatient treatment in local community hospitals and improving monitoring of complex diseases in outpatient settings, avoiding unnecessary hospital admissions.

Physicians have traditionally placed a priority patient care over any environmental responsibility, but telemedicine offers opportunities to minimize environmental impact while developing a higher standard of care across the country. By combating energy consumption, telemedicine is improving not only the health of patients, but also the planet.