AcuteCare Telemedicine Blog


The VA Deploys Telemedicine and Telehealth Programs

The Department of Veterans Affairs  (VA) has released a comprehensive 400-page report that outlines its successes last year in the effort to improve veterans’ access to quality healthcare, including the implementation of an extensive telemedicine program. The report concludes that the use of telemedicine and telehealth has significantly improved veterans’ access to quality healthcare, and quality of life, by reducing the amount of time and travel needed to receive care.

The news is particularly encouraging given the performance level of the federal agency that is charged with providing ongoing medical care for millions of our nation’s military veterans.  Veteran Hospitals (VA Hospitals) have historically been located near large metropolitan areas, requiring patients to travel long distances for even the most basic of medical services.  The agency is making significant changes to its system, consolidating specific treatment into regional locations, causing some patients to be concerned about traveling even longer distances to receive their VA Medical Benefits.

Most recently the Agency has come under attack for its inability to process a long backlog of claims resulting in some veterans who have been waiting for treatment to coin the phrase, “Delay, Deny, and Wait Till I Die”.  Embracing the new telemedicine and telehealth technology programs may be the most promising decision the agency has made in the recent past to help turn the long history of inefficiency and questioned quality of care around.

The Department of Veterans Affairs (VA) 2012 Performance and Accountability Report, submitted by Secretary of Veterans Affairs Eric Shinseki in November, discusses the Department’s achievements in improving healthcare and benefits service delivery to veterans.  The report states that in 2012, the VA maintained the largest integrated healthcare system in America and implemented “new innovative practices to improve Veterans’ access to health care, such as telemedicine and mobile clinics, to provide care to more than 6 million unique patients.” Throughout 2012, nearly 500,000 veteran patients received 1.4 million telehealth-based consultations, which were delivered from 150 VA Medical Centers and 750 Outpatient Clinics.

Supporters of the VA’s utilization of the latest technologies to expand access to quality, primary and specialty care believe that it will transform healthcare delivery at VA Medical Centers while providing veterans solutions that enable greater access to their benefits, at a lower cost, all while improving the quality and outcomes of the medical care.

Telemedicine and telehealth technology is demonstrating its benefits of improved care, increased access and lower costs in the private sector.  Let’s hope that its application and practice at the VA demonstrates an equal measure of success.  Our military members risked their lives and suffered countless injuries in service to our country.  They deserve efficient, accessible, quality medical care for their commitment and sacrifice for protecting our freedoms and our country’s security.



New Technologies Improving Health Care

Much has been said and written about technology and its effects on the practice of medicine regarding how telemedicine and telehealth promises positive economic availability of health care going forth into the future.  As the doctor shortage and increase in the costs of medical services continue to front and center the debate, medical technology companies focus their resources on providing less expensive, faster and more efficient patient care.

To speed up and simplify the approval process of new medical devices, the Federal Drug Administration (FDA) recently formed the Medical Device Innovation Consortium (MDIC).  The organization seeks input from industry, government, and other nonprofit organizations and will prioritize the regulatory science needs of the medical device community and fund projects to streamline the process.  “By sharing and leveraging resources, MDIC may help the industry to be better equipped to bring safe and effective medical devices to market more quickly and at a lower cost,” says Jeffrey Shuren, M.D., J.D., director of the FDA’s Center for Devices and Radiological Health.

Every year industry observers and media select their favorite technology trends that propose to have the most favorable impact on overall medical care costs, patient care quality and safety.  Here are just five of this year’s technologies that fit the criteria.

The Optical Scanner

Melanoma, the most deadly form of skin cancer, has always been impossible to diagnosis without an invasive surgical biopsy.  The MelaFind optical scanner is not for definitive diagnosis but rather to provide additional information a doctor can use in determining whether or not to order a biopsy.  The new device is manufactured by MELA Sciences and uses missile navigation technologies originally developed by the Department of Defense and scans the surface of suspicious lesions.  The data is collected and processed using heavy-duty algorithms and matched against a registry of 10,000 digital images of melanoma and skin disease.

Electronic Aspirin

A reliable, long-lasting treatment for the most severe form of headache, chronic Cluster Headache (CH), is lacking. CH has long been associated with the sphenopalatine ganglion (SPG), a sensory nerve bundle in the head. Blocking pain directly at the SPG has been an elusive goal. A technology under clinical investigation at Autonomic Technologies, Inc., is a patient-powered tool for blocking SPG signals at the first sign of a headache.  The system involves the permanent implant of a small nerve stimulating device in the upper gum on the side of the head normally affected by CH.   The lead tip of the implant connects with the SPG bundle, and when a patient senses the onset of a headache, he or she places a handheld remote controller on the cheek nearest the implant. The resulting signals stimulate the SPG nerves and block the pain-causing neurotransmitters.

Needle-Free Diabetes Care

Anyone who suffers from Diabetes has to deal with the constant need to draw blood for glucose testing, the need for daily insulin shots and the heightened risk of infection from all that pricking and poking.  Echo Therapeutics is developing technologies that would replace the poke with a patch.  The transdermal biosensor reads blood analytes through the skin without drawing blood. The technology involves a handheld electric-toothbrush-like device that removes just enough top-layer skin cells to put the patient’s blood chemistry within signal range of a patch-borne biosensor. The sensor collects one reading per minute and sends the data wirelessly to a remote monitor, triggering audible alarms when levels go out of the patient’s optimal range and tracking glucose levels over time.

Autonomous Navigation Robots 

Telemedicine is well established as a tool for triage and assessment in emergencies, but new medical robots are taking the process one step further.  With the capability to patrol hospital hallways on more routine rounds, checking on patients in different rooms and managing their individual charts and vital signs without direct human intervention these new robotic devices are improving routine health care to hospitalized patients.  One of these new devices, the RP-VITA Remote Presence Robot produced jointly by iRobot Corp. and InTouch Health is the first such autonomous navigation remote-presence robot to receive FDA clearance for hospital use. The device is a mobile cart with a two-way video screen and medical monitoring equipment, programmed to maneuver through the busy halls of a hospital.

The Sapien Valve

The Sapien trans catheter aortic valve is a life-saving alternative to open-heart surgery for patients who need new a new valve but can’t endure the rigors of the operation. Manufactured by Edwards Life Sciences, the Sapien valve is now finding its first use in U.S. heart centers where it is being limited only to the frailest patients. The Sapien is guided through the femoral artery by catheter from a small incision near the grown or rib cage. The valve material, made of bovine tissue, is attached to a stainless-steel stent, which is expanded by inflating a small balloon when correctly placed in the valve space. This new device and simpler procedure promises dramatically shorter hospitalizations and is bound to have a positive effect on the cost of care.

Medical industry leaders agree that today’s most desirable technologies, whether telemedical communications or Sci-Fi-gadgets, strike a balance between reducing the overall cost of medical care while increasing safety and survival rates among patients.   While not immune from controversy and push-back from both health care providers and patients alike, new technologies hold the greatest promise to bringing higher quality and more efficient and affordable health care to millions of people around the world.



Telemedicine Increases Access to Critical Stroke Care

Researchers in studying the effectiveness of telemedicine programs in Oregon found that stroke coverage was pushed into previously uncovered less populated areas and expanded stroke coverage to rural areas. The results were found in a new study by researchers from the Perelman School of Medicine at the University of Pennsylvania studying telemedicine programs.

By employing telemedicine in concert with in-person care, nearly 80 percent of residents had access to expert stroke care within “the golden hour”.  Immediate access to high-quality emergency care is less common than one might think, leading to strokes being the fourth most common cause of death in the United States.  In-person stroke care is usually centered in large urban areas, and while telemedical stroke care is also available in urban centers, it is able to reach less populated areas that have low rates of uninsured patients.

The new study by researchers from the Perelman School of Medicine at the University of Pennsylvania was presented at the American Academy of Neurology’s 65th Annual Meeting in San Diego in March.  The study found that telemedicine programs in Oregon expanded coverage by approximately 40 percent.

“Telestroke programs can reach patients in smaller communities and provide time-critical treatment to previously unreached people,” said senior study author Brendan Carr, MD, MA, Assistant Professor of Emergency Medicine, Surgery, & Epidemiology in the Perelman School of Medicine at the University of Pennsylvania. “Increasing telestroke networks gives everyone a better chance of surviving a stroke.”

While many hospitals recognize the enormous benefits of providing immediate treatment to a patient using this technology, insurance plans are unlikely to cover the charges, and lack of financial support was cited by a third of hospitals as significantly limiting the growth of their programs.  Other factors, such as the absence of a robust, secure internet connection that can stream high-quality video, also prevent some hospitals from joining in regional programs.  Such inequities lead to disparities in access to health care.

Some supporters of the technology’s expansion argue that a combination of government and private initiatives will be necessary to ensure wide spread access to secure high-quality and high-speed bandwidth for telehealth applications.



AcuteCare Telemedicine and Ty Cobb Regional Medical Center Team Up to Improve Access to Immediate Stroke Care

Throughout Georgia and all around the country, Emergency Medical Services (EMS) responders are charged with reacting to emergency calls for assistance, providing emergency evaluation and treatment of a vast array of injuries and illnesses and delivery victims to emergency rooms for more advanced treatment.

The work requires split-second decisions that may affect the patient’s recovery.  Often the decision to bypass the nearest, more rural hospital for an urban medical center, known for its specialized treatment for such illnesses as stroke, can delay the patient’s arrival to that facility beyond the “golden hour”, the first sixty minutes after a patient begins to experience stroke symptoms and the critical window for providing care that can minimize long-term disabilities or prevent a stroke death.

At a recent conference at Ty Cobb Regional Medical Center (TCRMC) in Lavonia, GA, area EMS responders learned of a new program at the hospital that offers advanced critical, specialized care for victims of stroke. The goal was to educate emergency responders about its new telestroke program and how it can benefit the community, and TCRMC by capturing potential stroke patients that may have been otherwise bypassed by EMS personnel in the past.

The new teleneurology/telestroke program is a relationship between TCRMC and AcuteCare Telemedicine (ACT), a leading practice-based provider of Telemedicine services for hospitals seeking advanced around-the-clock stroke and other urgent Neurological care.  Presenting the conference was Dr. David Stone, TCRMC Emergency Room Director and ACT’s CIO Dr. James M. Kiely, who is also partner at Atlanta Neurology, P.C. and Medical Director of the Neurophysiology Departments at Northside Hospital and St. Joseph’s Hospital of Atlanta.

Members of the Franklin County and Hart County EMS were on hand to receive information about the new service line and EMS’ role in triaging potential stroke patients.  “The goal of this new relationship with TCRMC is to build awareness in the area about ACT’s 24/7 stroke treatment coverage and to advance the area residence understanding of stroke, its symptoms and the importance of receiving immediate specialized treatment, said Dr. Kiely.”

Attending EMS personnel received information regarding strokes “golden hour”, and when it is appropriate to take patients directly to TY Cobb Regional Medical Center or when it is better indicated to take patients directly to an advanced tertiary treatment center.

Recent studies indicate that telestroke programs, like the one provided by AcuteCare Telemedicine, may improve access to immediate stroke care by 40 percent and bring advanced care within reach of millions of stroke victims now located outside the hour of critical care for the fourth most common cause of death in the United States.



Georgia Continues to Lead the Way with Telemedicine in Public Schools

The usual topics of public school board meetings generally include such topics as the state of school budgets, discussions on appropriate text books, disciplinary policies, dress codes, or the progress report on new building construction. But during the regular monthly meeting of the Coffee County Board of Education, on February 13, 2013, Coffee Schools Nursing Supervisor Kathy Cole and Family Connections Director April Thomason announced that the Coffee County School System was recently awarded a $500,000 grant, which will be used to purchase telemedicine equipment. Utilizing telecommunications and information technologies in order to provide clinical health care at a distance is revolutionizing the delivery of medical care and services, and Cole stated, “By receiving this grant, we truly are on the cusp of something so very innovative.”

The state of Georgia continues to set the pace nationally for promoting telemedicine as a preferred mode of healthcare delivery, particularly in regions where the nearest doctors are often hours away from their patients. “Georgia is definitely a model for other states,” said Sherilyn Pruitt, director of the Office for the Advancement of Telehealth, part of the division of rural health in the U.S. Health Resources Services Administration.

School boards across the country continue to struggle with providing appropriate levels of medical care to students attending public schools. The U.S. Supreme Court has held that medical services can be required as a part of the educational services school districts must provide. The Individuals with Disabilities Education Act (IDEA) requires that schools provide “related aids and services” so that children with disabilities can be educated to the maximum extent appropriate with their non-disabled peers, and the Rehabilitation Act of 1973 prohibits discrimination against students with disabilities, requiring school districts to provide accommodations for students with disabilities.

The use of telemedicine is proving to be a viable alternative to providing this mandated coverage in a cost effective manner, while increasing the quality and availability of these services to students.

The new equipment in Coffee County, for example, will allow students and school employees and staff to be seen by a certified medical physician without ever having to leave the classroom or school. With over 240 doctors in the physicians’ network the school will utilize, coverage will be very complete. Statistics have shown that this practice results in a dramatic reduction of student and employee absences, benefitting not just the health of the schools, but also efficiency in working towards educational goals.



2013 – The Year Telemedicine Breaks Out?

After more than 40 years of development, tweaking and testing, telemedicine appears to be approaching a major break out by joining the mainstream medical establishment to innovate the delivery of medical care in the United States. Considering the banking, entertainment and publishing industries years of success in delivering products and services efficiently to customers through telecommunication technologies, the growth and acceptance of telemedicine has been a long time coming.

According to the American Telemedicine Association, a leading problem is the red tape and top-down regulatory reticence demonstrated by various government agencies. The leading barriers to the deployment of telemedicine in the U.S. have almost all involved government policy: reimbursement by Medicare and Medicaid, state-based standards of care and professional licensing, device regulation and telecommunications policy.

With rising medical care costs, the shortage of medical practitioners and the increasing demand for health care services, the pundits of delay may soon need to get out of the way or risk getting run over.  Last year more than five million Americans received remote evaluations of medical images and more than 10 million patients directly benefited from some form of telemedicine.  Could 2013 be the year to end the bureaucratic procrastination?

The campaign for change has begun as State legislators, Patient Groups, Medical Societies, Private Health Service Payers and Health System Leaders are banding together to promote and accelerate change.  State government will most likely be leading the way towards reforming state funding of telemedicine services and regulations that govern the medical industry.  Sixteen states have already adopted legislation requiring private medical service payers to reimburse for telemedicine and several more states are expected to follow in 2013.

The Federal government can be expected to take some steps towards acceptance and participation but, as is usually the case, Washington will likely move at a much more deliberate pace, taking every opportunity to secure a position of playing catch-up. As the cost benefits and increased availability of specialized medical services through the practice of telemedicine continue to become apparent to many more thousands of patients, the barriers to nationwide innovation of medical services will continue to fall at an increasing rate.

To all those who are blocking the path to progress, it is time to get out of the way and become part of a technological solution.



If You Build It, Will They Come?

A recent report from the Pew Research Center measuring the number of adults using technology to track their health has presented some surprising findings.

The results of the Pew Internet & American Life Project survey, which were recently reported in iHealthbeat and supported by The California Healthcare Foundation, found that of 3,014 adults interviewed by phone, just 21 percent of the respondents actively used technology to track their health care. What may be even more surprising is that just 19 percent of those surveyed who owned smart phones, or just 7 percent of all respondents, had acquired an app to monitor their health. Susannah Fox, lead author of the report was surprised by the results and commented, “We’ve been looking at health apps since 2010, and health app uptake has been essentially flat for three years.”

A look at the science of the report, particularly the definition of “adults,” could give some more understandable insight as to the results and may produce answers for some of the “surprise” as to the outcome. Considering that most, older adults have a seemingly natural long acceptance curve when it comes to adopting technology and gadgets, and considering the well-entrenched privacy attitudes about everything to do with personal health information, the results may not be all that unexpected.

Purveyors of new communication technologies operate in environment where todays new devise and idea is often well into obsolescence by tomorrow; such rapid progression of invention to development is unmatched by other industries and beyond the understanding of most consumers. Expecting an equally aggressive acceptance rate by the markets is unreasonable, even when the benefits of convenience and utilization are so obvious to so many.

Given the generally slow acceptance rate of consumer health products, a three year period of market penetration may not be a reasonable benchmark to measure the success or failure of health care applications. Only more time will reveal if the “acceptance curve” will sharpen and the adoption and usage rates grow more dramatically.

“Build it and they will come”. Perhaps, but it may just take a bit longer for their arrival.



Extreme Telemedicine and the Urgency of Now

January and the New Year bring the Consumer Electronics Show, an exposition of tremendous scale where the newest and flashiest concepts and prototypes for technological marvel are put on display for the public. Innovation in medicine was a hot-button topic at this year’s show, as more and more attention has been focused on the state of the US healthcare system.

There is a new television commercial from a leading innovator in communications technology making its rounds. A segment of the ad shows a group of climbers on a snow covered mountain communicating with a doctor on a tablet computer. The doctor is explaining how to set the apparently broken leg of one of the members of the crew. This 5 second scene, interspersed with other vignettes displaying the company’s visions for the future of its technologies, is an intriguing and exciting flash forward into the vast potential that telemedicine holds for the future.

Of course, one could imagine countless such scenarios in which powerful telemedicine will eventually play a game-changing role. We are on the cusp of a huge revolution in medicine, fueled by relentless innovation like that on display at CES or in the television spot.

The fact of the matter is that telemedicine has already brought this future to our doorstep. While the ‘dreamers’ consider what capabilities advanced technology might ultimately unlock, many physicians are already working with very advanced tools to address issues that are urgent now. For AcuteCare Telemedicine, the focus remains on offering sustainable and highly effective resources to deal with the increasing prevalence of stroke and other neurological emergencies. Through means made possible by telemedicine, ACT is already hard at work shaping the future of the fight against this epidemic.

Allocating resources towards new and innovative technologies and practices is an important part of creating tomorrow’s healthcare culture equipped with the right tools to care for patients. But it is also imperative that until we achieve that goal, we concentrate on applying the amazing technology already available to us to focus on the task at hand. In solving today’s problems, we set the stage for a better understanding of where to go next.



AcuteCare Telemedicine in 2013: Cutting Edge Neurological Care, Anywhere

Following a third consecutive year of growth in 2012, AcuteCare Telemedicine (ACT), an Atlanta-based partnership of 4 board-certified neurologists, is expanding its efforts to become the leading provider expert neurological care to rural and underserved areas throughout the Southeastern United States via cutting edge telemedicine technology.

Telemedicine, once regarded as an exciting new frontier, has now been fully realized as a part of the mainstream lexicon of medicine as we enter 2013. For a large number of hospital systems, telemedicine programs are now becoming a mandate as the nation faces a growing shortage of specialized physicians.

ACT has established itself as an innovator on the forefront of the industry, taking a unique approach to telemedicine by leveraging new technologies and techniques to enable personal neurology consultation when doctor and patient are in different locations. ACT offers a broad range of customizable services including 24/7 emergency neurological consultation and support programs for facilities seeking Joint Commission accreditation as a Primary Stroke Center, but primarily specializes in telestroke: the application of telemedicine to the treatment of the acute stroke patient. With the help of ACT’s powerful and personalized services, patients throughout the ‘Stroke Belt’ states of the Southeast have drastically improved access to the care they deserve, and medical facilities increase efficiency while reducing the costs associated with maintaining a traditional emergency neurology staff.

Whereas many hospitals with existing neurology departments simply do not have the resources to maintain around-the-clock clinician capacity, ACT has managed to successfully disrupt the trend and bring patient and physician together, regardless of geographical boundaries. Achieving this goal requires a certain level of investment in technology and trust in the people behind it. ACT is truly technology-agnostic.  This agility affords healthcare organizations with the ability to select the platform that meets budgetary and organizational parameters.

ACT provides access to the best 24X7 acute neurological care. Contact Michael Woodcock to hear how teleneurology can impact your business and patients in 2013.



AcuteCare Telemedicine Turns 3!

This October marks the third anniversary of AcuteCare Telemedicine (ACT). Over the course of its first three years, ACT has grown considerably during a period of significant change in the policy and industry of healthcare in America. The 4 Board Certified partners of ACT have retained a steady focus on their mission of filling a growing need for 24/7 neurology coverage.

Telemedicine has proven to be a burgeoning facet of the healthcare industry, with technological advancements and enhanced communications allowing providers to extend their reach over geographical boundaries to patients in need while simultaneously streamlining the healthcare delivery process and reducing associated financial and environmental costs. ACT has worked hard to stay ahead of the curve, offering the most cutting-edge solutions for saving lives in cases of neurological emergency.

Entering its fourth year of providing this expert neurological consultation via telemedicine technology to rural and underserved medical facilities throughout the Southeast, ACT looks forward to continued growth. As teleneurology continues to garner attention from hospitals as a practical and effective solution to neurologist staffing needs, the outlook for the company this year and beyond is extremely positive. “The message of ACT has really started to take hold in the healthcare community, and as our efforts for finding new hospital partners ramp up, we are optimistic that we will ultimately be able to reach even more patients with and offer them the level of care they deserve,” says Dr. Lisa Johnston, Partner, ACT.

“Following our rebrand of the company in 2011, we have stayed dedicated to our values as expert practitioners and our vision as a business,” adds Dr. Keith Sanders, Partner, ACT. “The standard of service we have been able to provide has only climbed higher. We are truly passionate about combating morbidity and mortality rates of acute stroke, right here at home in the Stroke Belt (a region of the Southeastern US with higher-than average stroke rates) and beyond.”

Hard work and diligence is paying off for the partners of ACT. As the group continues to practice neurology full time and commit themselves to reaching more patients in 2013, they hope to add to an already impressive list of achievements and accolades throughout their short history.