AcuteCare Telemedicine Blog


Telemedicine Achieves Its Potential for Parkinson’s Patients

Ask any patient suffering from chronic disease and they often will tell a story of isolation, uncertainty and frustration over the debilitating effects of their disease. Many times the focus of their complaints is not being afforded easy access to specialized care and consultation with caregivers. While significant inroads have been made in the treatment options for chronic maladies like Diabetes and Parkinson’s disease, gaining routine, daily access to those ground breaking discoveries is out of the reach of many sufferers.

Researchers are looking at how modern communication technology, coupled with the latest techniques in treating Parkinson disease, can revolutionize the quality of care for sufferers of the chronic neurological disorder. “We are looking at quality of life, quality of care and reducing the burden on healthcare providers”, says Dr. Ray Dorsey, co-director of the Center for Human Experimental Therapeutics at the University of Rochester (N.Y.) Medical Center. “Imagine if you thought there was a possibility you had Parkinson’s disease, but you lived 100 miles or more from the nearest medical center with a qualified neurologist. You’re faced with at least a couple of hours of driving, of navigating an unfamiliar urban environment, of parking and walking—and that’s assuming you’re able to find a neurologist within driving distance to begin with. Now think about how easy it is to buy a book or a pair of shoes online. The two should not be so different.”

Preliminary results of the Connect.Parkinson project, the nation’s first randomized clinical trial of remote treatment of Parkinson’s disease, indicate the benefits of virtual treatment for patients and caregivers alike. A recent report on the initial results of the 18-state, Connect.Parkinson project reported that 95 percent of Parkinson’s patients completing telehealth visits have experienced an increased proportion of the time with a healthcare professional of 89 percent; up from 25 percent for those opting for traditional in-person encounters.

The National Parkinson Foundation is committed to supporting efforts to demonstrate how telemedicine can enhance the delivery of care to people with Parkinson’s. Studies are indicating that telemedicine care, often delivered in the patients home, is just as good as care received at a brick and motor medical center. The fact that diagnosing and monitoring the progression of Parkinson’s disease and other movement disorders is based almost entirely on visual observation makes Parkinson uniquely suited for virtual care technologies. Christopher Goetz, MD, a leading expert on movement disorders and director of the Parkinson’s Disease and Movement Disorders Center at Rush University Medical Center says, “Ninety-five percent of the information I gather is visual. Thus, with telemedicine visits where I can see and hear my patient right in front of me on the computer screen, there is no decline in the quality of information I gather.”

Rush is located in the state of Illinois which is among those states not yet mandating payers to provide payments for telemedical services. But according to Dr. Brian Patty, Rush’s chief medical information office and chairman of Rush’s Telemedicine Steering Committee, the Medical Center has several telemedicine pilot projects underway that can likely have significant impact on Parkinson patients.

In New York, researchers at The Rochester Center for Human Experimental Therapeutics, are developing and testing mobile apps that will help Parkinson’s patients track metrics such as dexterity, balance, gait, voice patterns and cognition, then send readings to researchers.

After decades of promises, telemedicine is delivering on its promise to increase access to quality, specialty care to improve patient outcomes.



Paying for the Promises of Telemedicine

Telemedicine is living up to its hype on revolutionizing the healthcare delivery model. With many of the most formidable barriers to increased expansion being overcome, virtual technology is quickly becoming a preferred method for patients when connecting with their care provider. New advances in hardware and software coupled with faster digital info structure, is driving more and more healthcare professionals to electronic communications. Patients are warming-up to using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions in the comfort of their home.

Healthcare providers, payers and governmen supported healthcare programs are recognizing the potential cost savings of telemedicine technologies. However, payment policies for telehealth services, while expanding quickly, continue to be inconsistent and are discouraging the progress towards realizing the full potential of virtual healthcare. Providers are eager to embrace telehealth. A survey of more than 1,500 family physicians conducted for Anthem and the American Academy of Family Physicians (AAFP) found that “almost 90% of respondents would use telehealth to help treat their patients—if they were compensated for that care.” Richard Bakalar, MD, managing director at KPMG and a member of the firm’s Global Healthcare Center of Excellence says, “Healthcare providers need to figure out how to become more efficient and the technology behind telemedicine allows caregivers to connect with patients remotely, efficiently and effectively.”

Currently payments for telehealth services are as far flung as the 50 states landscape. New rules for Medicaid managed care and MACRA are becoming telehealth-friendly, but Medicare and Medicaid reimbursements are spotty, with Medicaid payment varying greatly from state to state. Today, 48 states and the District of Columbia provide some form of Medicaid payment for telehealth services, according to the National Conference of State Legislatures. Commercial insurers seem to be embracing telehealth but consistency of payment policy remains elusive. In just over half of the states and the District of Columbia, private insurers are answering the call of parity laws that require them to pay for telehealth services. Payment parity is important for providers because it protects them against arbitrary cuts in reimbursement for telehealth services as compared to services provided in-person.

While expansion of virtual technology continues to progress at a steady pace, solutions to resolving remaining barriers like payment for services, multistate licensing, credentialing, and regulation are evolving at a deliberate pace.



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.”



The Importance of Measuring Performance

Telestroke, the use of communication technology to remotely treat victims of acute stroke, continues to grow and has entered the mainstream of care in an ever evolving and increasingly disruptive healthcare delivery model. Like all medical innovations, telestroke must demonstrate successful outcomes to achieve sustained growth and acceptance. Merely asserting that telemedicine is faster, employs the latest technology, or promotes a better use of limited re-sources is laudable but insufficient.

AcuteCare Telemedicine (ACT), a leading practice-based provider of Telemedicine services for hospitals seeking around-the-clock stroke and other urgent Neurological care, understands the importance of evaluating and documenting telestroke performance. In their recently published study “Improving Telestroke Treatment Times in an Expanding Network of Hospitals” the authors reveal that a practice-based telemedicine system can produce meaningful improvement in markers of telestroke efficiency.

“Success in our business isn’t just about adding new healthcare organizations to our client portfolio,’ says Dr. Matthews Gwynn, co-author and ACT partner. “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.”

As virtual health initiatives continue to move forward, new and valuable trends and telehealth technology solutions will continue to emerge. Traditional methods of delivering medical care will be challenged and disrupted at medical facilities, physicians’ offices and hospitals. Dr. Keith Sanders, ACT Partner and co-author comments, “It is critical to prove that our business is able to create telestroke programs that are not only effective but sustainable.”

For more information on how AcuteCare Telemedicine can assist you with acute stroke care, contact us!



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.



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.



The 21st Annual ATA Telemedicine Meeting & Exposition

The American Telemedicine Association (ATA), the leading international resource and advocate promoting the use of advanced remote medical technologies, announces the dates for its annual meeting and exposition for 2016. For 20 years, the ATA has focused fully on telemedicine solutions to transform healthcare systems. The results of the ATA’s efforts have generated significant impact for overall quality of care, equity and healthcare affordability.

The 2016 American Telemedicine Association Meeting and Exposition is expected to host as many as 6,000 thousand attendees at the Minneapolis Convention Center in Minneapolis, MN. The four day event will get underway on May 14 and conclude on May 17, 2016. ATA 2016 is the largest trade show in the world for healthcare professionals and entrepreneurs in the telemedicine, telehealth and mHealth space. The event will showcase a wide range of educational seminars, speakers and products and services related to telemedicine industry from over 300 exhibitors.

“AcuteCare Telemedicine (ACT) looks forward to participating at the event in 2016,” comments Dr. Matthews Gwynn, Partner, ACT. “We applaud the efforts of the ATA in advancing telemedicine opportunities and providing a platform for practitioners to share insights, research, and best practices.”

Established in 1993, The American Telemedicine Association is a non-profit association of individuals, healthcare institutions, companies and other organizations with an interest in promoting professional, ethical and equitable improvement in health care delivery through telecommunications and information technology.

For more information on the event, click here.

ATA Trade Show



Best Integrated Campaign for Stroke Month Awarded to Bon Secours Richmond

ACT Blog Bonsecour Award

From Left to Right: Bob Silverstein, Enterprise Executive Sales Director, ACT; Dionne Henderson Director of Community & Multi-Cultural Initiatives at American Heart Association, American Stroke Association; Patricia C. Lane MBA, SCRN|Bon Secours Richmond Administrative Director Neurosciences, Bon Secours Richmond Health System; Dr. Stacey Epps, Executive Medical Director Bon Secours Virginia Neuroscience Institute.

The American Heart Association/American Stroke Association recognizes American Stroke Month by focusing on efforts to teach family, friends and coworkers how to recognize the signs of stroke.

This year The American Heart Association awarded Bon Secours Richmond Health System the Best Integrated Campaign Award for 2015. The fourth largest and only faith-based health system in Virginia, Bon Secours Virginia provides full range of services to thousands of Virginians through a network of hospitals, primary and specialty care practices, ambulatory care sites and continuing care facilities across the Commonwealth.

Bon Secours is accustomed to taking a leadership role in Neurological care, having established teleneurology initiatives more than five years ago with a goal to have all of its area hospitals joint commission certified. AcuteCare Telemedicine, the leading practice-based provider of Telemedicine services for hospitals seeking around-the-clock stroke and other urgent Neurological care is collaborating with Bon Secours Neuroscience Institute (BSNI), the neuroscience division at the not-for-profit Catholic health system sponsored by Bon Secours Ministries.

Dr. Keith Sanders, Partner, AcuteCare Telemedicine, comments, “ACT is aligned with Bon Secours and its ongoing commitment to utilizing the finest and latest technology for the treatment of stroke. This award is evidence of their outstanding efforts to promote a fully integrated stroke program that improves awareness of the dangers of stroke and provides the best in acute stroke care to the communities we serve.”



Rising Opportunities in Virtual Healthcare

While it may not be the .com bubble of the 90’s, telehealth and virtual healthcare initiatives are gaining popularity amidst investment communities across the globe. While some challenges still remain; individual state medical licensing reform, digital medical record keeping and some regional short-falls in technology infrastructure, a recent Wall Street Journal report on private equity firms investing in the health-care sector indicate increased investor interest in earlier stage opportunities. With the rising cost of healthcare, anticipated physician shortages and an increased demand for healthcare, virtual medical care is a way to solve the access and cost issues. Nirad Jain, a Bain partner and a co-author of Bain’s latest report on global health-care private equity, said “Health care is such an important part of the economy in the U.S. and globally, it impacts society in such a fundamental way that it is hard for a private equity firm of scale not to have some part of its portfolio in health care.” Private equity last year reached a three year high of $29.6 billion globally, nearly double the level recorded for 2013.

Telemedicine has been around for several decades but advances in digital infrastructure, software and the popularity of mobile devices by consumers is creating a tipping point for a budding virtual health industry. “Telemedicine is moving like lightning. We’re able to do so much more than before,” said Andrew Watson, Chief Medical Director of Telemedicine at University of Pittsburgh Medical Center.

Researchers at Mercom Capital Group estimated a 300% increase in funding flowing toward established and startup virtual-visit firms in 2014, and StartUp Health, a New York-based accelerator, and Rock Health, a San Francisco-based accelerator and seed fund, have independently reported that funding for new digital health ventures in the United States doubled last year. Rock Health estimates that $4.1 billion of new capital was invested in digital health in 2014, up from less than $1 billion in 2011.

“As practitioners in the telemedicine space, we’ve seen many technology platforms and telehealth delivery models enter the marketplace,” comments Dr. James Kiely, Partner, AcuteCare Telemedicine LLC.  “More consumers are embracing the convenience and lower costs of virtual visits and readily seeking routine and minor healthcare services through their smart phones, laptops and pads instead of face-to-face encounters with their doctors. As a result, healthcare organizations are moving quickly to implement telehealth initiatives across specialties such as neurology, cardiology, psychiatry, and other specialty programs.”

Whether or not virtual medicine and telehealth initiatives become the Facebook and Twitter of this decade remains to be seen. As investment dollars continue to rise, the future of telemedicine looks promising.



Patching the Current System Will Not Advance the Great Promise of Telehealth

The deliberate march towards meeting the Federation of State Medical Boards’ (FSMB) goal of streamlining medical licensing of physicians continues. The FSMB promises that a new compact of seven states will trigger changes that will ultimately help reduce redundant licensing requirements by creating one place where physicians submit basic information such as their education and credentials. Last month Idaho and Utah were the latest states electing to join Montana and West Virginia as this compact attempts to speed up the process of licensing doctors across state boundaries. While some question why only seven states are required for implementation of this compact, just three more states are now needed to initiate the process that promises to remove a formidable barrier to telemedicine growth nationwide.

Despite being one of the most promising technologies to improve patient care and lower the rising costs of healthcare, telehealth is surviving in a regulatory environment that was established during an era devoid of modern telecommunication devices and technology. State physician licensing is currently controlled by 50 state medical licensing boards, each with their own requirements, policies and credentialing criteria. The current licensing process is a substantial impediment to the advancement of telehealth across state lines, sparking an intense debate over the need for a traditionally unpopular nationalized licensing system.

In an attempt to ward off yet another federal intrusion into states affairs, last year the FSMB proposed a voluntary national compact on joint licensing for the states. The goal is to secure the cooperation of enough states to quiet any calls to replace state-based physician licensing with a national program. The reason for the compact is that the FSMB previously approved a telemedicine policy that defines the location of the practice of medicine as the state where the patient is located, not the physician. The model legislation calls for at least seven states to participate in the compact in order to form a governing commission made up of representatives from the participating states.

From the outset industry leaders and telemedicine supporters saw the effort as a weak attempt to stem the growing tide to replace an outdated and inefficient system. The FSMB compact does little to address the cost associated with acquiring a license in each state and in fact increases the costs by adding fees associated with handling and processing the information.

Washington Board of Osteopathic Medicine and Surgery Executive Director Blake Maresh says, “For some, the interstate compact offers a tested Constitutional precept that could creatively forestall federal intervention that might otherwise supplant the longstanding authority of state medical boards, for others the possibility of other state boards licensing physicians who practice in their states, coupled with the establishment of new governmental organizations, leaves them uneasy at best.”

It is certain that the authors of state and federal constitutions could not have envisioned the advance of modern technology and the impact of those advances on preserving and improving the lives of their constituents. Delivering the benefits of increased access to the latest and best medical care, improved patient outcomes and lower costs must trump preserving outdated constitutional precepts. We must intensify our focus on implementing new processes designed to advance the great promises of telemedicine.