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What Telemedicine Promises Doctors and Patients
November 29th, 2017

What Telemedicine Promises Doctors and Patients

Ian Linton

Telemedicine uses video conferencing and other telecommunication tools to deliver healthcare at a distance. It promises patients greater convenience and time saved. For medical centers and hospitals,...

Telemedicine uses video conferencing and other telecommunication tools to deliver healthcare at a distance. It promises patients greater convenience and time saved. For medical centers and hospitals, it delivers time, money, and resource savings. In rural areas with fewer medical facilities, telemedicine promises better healthcare for residents.

Telemedicine provides access to healthcare information and records, enables access to specialists, improves communication between doctors and patients, and helps professionals gather and share important health data. According to SNS Research, the market reached $13 billion in 2015 with growth forecasted at approximately 40 percent over the next six years.

While technology supports telemedicine, legal concerns surrounding patient data privacy and unestablished standards for quality remote care are unresolved. Additionally, insurance companies and state medical boards vary in their opinion and support for telemedicine.

Technology supports telemedicine

A number of technologies make telemedicine a practical reality. Video conferencing plays a key role, together with secure, low-cost mobile communications that support real-time collaboration through tablets and smartphones.

Video conferencing is available on mobile devices with a high-speed Internet connection and softphone, a software application. Because video conferencing reach any location with Internet access, a mobile collaboration between doctors and colleagues or doctors and patients can occur inside hospitals, medical centers, and anywhere in the country, even remote rural areas.

Healthcare professionals transmit data such as electronic records and other documentation securely. In addition to real-time video collaboration, doctors use recorded video content to support patient education, aftercare, and wellness programs in the community.

Improving collaboration within hospitals

In hospitals, doctors and nurses frequently move between wards, visiting patients. To seek advice or collaborate with specialists, they connect and share patient information via the hospital’s internal wireless networks using smartphones or tablets.

Hospitals in the St Vincent Health System use a video content management solution to enable greater multidisciplinary collaboration to improve patient treatment. Teams of doctors now collaborate remotely during their rounds, exchanging observations, recommendations and patient information to improve and accelerate patient care. The rounds are recorded, archived, and published for other professionals to view on-demand as part of their continuing medical education.

The hospital also supports a weekly tumor board conference. Oncologists with a variety of specialties review malignant tumors to determine the best course of treatment, giving patients the benefit of having a team of experts examining their medical records.

Increasing access to specialists

Orlando Health, based in Florida, is using video conferencing to support its telestroke program, which reduces treatment time and improves outcomes for stroke victims.
The group’s nine hospitals are leading providers of stroke treatment, including the innovative tissue plasminogen activator (tPA) protocol. This treatment is most effective when delivered immediately after the onset of a stroke. To accelerate the assessment and treatment of stroke patients, Orlando Health uses a video collaboration solution.
The solution enables neurologists to see and assess a patient over live video within minutes of arrival at the hospital. The faster a patient receives stroke treatment, the better chances they will recover without permanent disability. Video collaboration is accelerating ‘door to needle’ treatment by minutes, sometimes even hours, time-saving that could change a person’s life forever.

In the Netherlands, doctors treating patients with pancreatic cancer draw on the skills, guidance, and expert opinion of leading specialists in the field. To treat patients effectively, health administrators centralized pancreatic surgery to a small number of hospitals. So, this leaves doctors at smaller hospitals without an on-site expertise to provide the most informed diagnosis and treatment.

The Dutch Pancreatic Cancer Group (DPCG) set up an expert panel of 12 specialists available to hospitals throughout the country. Members of the expert panel review patient scans from local hospitals and provide feedback, generally within five working days. In 53 percent of the cases, doctors provided different treatment because of the panel’s insight.

Changing the pattern of patient visits

As an alternative to a home visit, doctors may video or Web conference with patients with less mobile or medically unable to visit a health center. Doctors discuss the patient’s condition and recommend medication or treatment.

Remote monitoring systems grant access to critical patient data, like those with heart conditions or diabetes. This reduces home visits for routine assessments and provides timely alerts of changes in patients’ conditions that may require urgent attention.

A study by a team at the Harvard Medical School found, for patients, a visit to the doctor can take several hours when factoring travel and wait time. Only 20 minutes, on average, is spent face-to-face with the doctor. For patients with chronic conditions, doctors appointments are not only inconvenient, they may be difficult or impossible.
The team calculated, in the United States, doctor visits total around 2.4 billion hours annually, each visit costing the patient an average of $32. For insurance companies, the cost-per-visit is approximately $250.

Reducing hospital readmissions

Many hospitals find that readmissions put further pressure on their already limited resources. Although patients receive aftercare instructions before being discharged, when problems occur, patients are readmitted for further treatment or support. There are five areas that frequently lead to hospital readmissions:

  • Hospitals creation and implementation of effective discharge plans.
  • Patient non-compliance with medication and care instructions.
  • Compromised follow-up care due to poor collaboration.
  • Family caregivers not connected or informed to assist with care.
  • Patient condition deteriorates and necessary care not accessed.

Video collaboration and content management solutions help hospitals to deal with these challenges.

To improve patient discharge plans, hospitals can offer live, collaborative video at the time of discharge. A live conversation ensures patients, caregivers, and family members participate in the creation of a discharge plan and fully understand what action to take as the patient returns home.

Hospitals may also create a video recording explaining the discharge plan for the patient and family. The information explains what to expect in a normal recovery, compared to symptoms that represent a risk to the patient.

If patients forget the care instructions or have difficulty with their medication, the hospital sends reminders via real-time video collaboration or a pre-recorded video library. This makes reviewing patient care easy.

As part of the recovery process, patients and caregivers benefit from the support of their assigned healthcare providers. They can have virtual access to their primary care physician, case manager, or other professionals via live video. These video follow-ups help long-term patients benefit from feeling connected to their continued care.

Video collaboration assists the patients’ family who may live outside the area but want to participate in the care process. Family members can participate in video calls to create home care plans, learn to recognize risks, and assist with communication.

If a long-term patient’s condition changes or deteriorates, video collaboration enables access to their care team without resorting to readmission. Real-time video interaction helps case managers, nutritionists, physical therapists, primary care physicians, and others adapt treatment plans as changes occur in health and behavior.

Ed Spencer, Director of Telepsychiatry Consultation for the South Carolina Department of Mental Health, said video collaboration “enhances the treatment experience for patients and their families, and it provides significant cost savings for taxpayers by shifting more treatment to outpatient care. Polycom video solutions help us achieve our emphasis on community-based care and our ongoing efforts to reduce re-hospitalizations.”

Improving access to rural healthcare

In remote areas with limited medical resources, telemedicine provides local doctors a higher standard of care for their patients. Besides the opportunity for virtual home visits, telemedicine gives local professionals access to specialists anywhere in the country.

Local doctors gain insight into cases and procedures beyond their own experience or skills. It assists the diagnosis of complex cases, even allowing surgeons to conduct complex procedures with live video under the direction of a remote expert.

In California, Clinicians Telemed’s team of physicians and healthcare professionals help healthcare organizations expand access to specialist medical care and improve operational efficiency.

The group provides telemedicine services in a wide area of specialties to 56 locations.

Many of the sites are hundreds of miles away from medical specialists. These areas typically have difficulty attracting and retaining physician specialists. The group solves the problem by providing physician specialists to any location for the length of time needed. The teams utilize an electronic medical record system to provide all the records required by physicians, such as x-rays, lab reports, medical history, and physician notes.

Supporting preventative care in the community

Telemedicine is playing an important role in preventative medicine. As part of the National Prevention Strategy, video conferencing enables hospitals, clinics, health departments, community health centers, community colleges, and facilities like rehab centers and skilled nursing facilities to collaborate and provide community-based services that contribute to the health and wellness of the public.

In smoking cessation programs or alcohol and drug abuse prevention, community teams utilize pre-recorded educational content or hold live interactive video sessions. They hear from experts in the field and discuss issues with doctors and nurses as well as peers in the community who struggle with similar problems.

Delivering successful outcomes

A 2015 study, ‘Interactive telemedicine: effects on professional practice and health care outcomes,’ found telemedicine outcomes equivalent to, or in some cases, better than conventional face-to-face care.

Additionally, telemedicine gives medical professionals vast amounts of data to proactively analyze local or regional health trends and build better patient profiles to develop treatment plans.

Changing attitudes

Despite the promise and recent accomplishments of telemedicine, barriers to its wider adoption remain. A study by The Economist Intelligence Unit found 49 percent of respondents believe patients would be concerned about the risk of data breaches.

Although video collaboration is capable of providing benefits throughout the healthcare industry, professionals must be aware of privacy issues. Healthcare organizations must comply with the requirements of the Healthcare Information Portability and Accountability Act (HIPAA), which protects the privacy of individually identifiable health information. Any organization providing doctors, nurses, and other workers with remote access to patient data must ensure the security of data transmitted by video or other communication channels.

Some insurers refuse to support telemedicine due to increased costs for fewer perceived health benefits. And, State medical boards impose differing telemedicine laws and restrictions on doctors. Procedures for telemedical treatment are not standardized across State lines.

Looking to the future, telemedicine has the potential to transform the way doctors deliver care, promising improved treatment, and saving more than time and money.


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