Telemedicine and Telehealth News 11/26/2009
USDA announced that 111 projects for $34.9 million in grants will to go to 35 states to increase to expand access to healthcare services in rural areas. The funding will be provided through USDA's Rural Development's Distance Learning and Telemedicine Program (DTL). The program's goal is to help expand telecommunications, educational resources, and computer networks throughout rural communities. The funds are part of USDA's annual budget.
Some of the specific funding examples include:
Verizon has unveiled a new telehealth service that allows healthcare providers to see patients through video consultations. Verizon officials say the new offering, Telhealth Collaboration Services, allows healthcare providers to remotely consult with patients and other providers in real-time, allowing them to provide increased accessibility to specialty services, control costs of patient-provider encounters and more closely monitor patient health.
The service will also provide continuing medical education and training opportunities to medical professionals.
"Healthcare providers increasingly are tapping the power of IT, and our telehealth solutions offer an effective way to meet a wide range of challenges, including the expansion of access to care, speeding diagnoses and driving efficiency," said Rajeev Kapoor, global managing director of Verizon Connected Healthcare Solutions, the company's recently formed practice group.
According to experts, telehealth is gaining popularity in North America. Datamonitor, a provider of online database and analysis services, forecasts that annual spending on telehealth hardware, software and related services will nearly triple over the next three years, from the current $2.4 billion to $6.1 billion in 2012.
"These new IT capabilities will help hospitals, clinics and doctors' offices modernize the delivery of healthcare - a critical need throughout the U.S. healthcare system today," said Kapoor.
Verizon Business, a unit of Basking Ridge, N.J.-based Verizon Communications, has teamed up with San Jose Calif.-based Cisco to deliver the new service, which offers integrated audio, visual and video communication.
Source: Health IT News, November 23, 2009)
Northeast health insurer MVP Health Care will begin reimbursing its network of more than 22,000 physicians for Web-based consultations with patients covered through most of its benefit plans. The Schenectady, N.Y.-based payer covers more than 750,000 members in New York, Vermont and New Hampshire. The company is working with Mohawk Valley Medical Associates, an independent physician association in Schenectady, to identify 200 early adopter physicians in its service area. MPV Health Care also is seeking at least 50 additional early adopters in other markets.
The insurer will use the webVisit consultation software of the RelayHealth division of McKesson Corp., San Francisco. Further details, including the amount of reimbursement for online consultations, were not immediately disclosed.
(Source: Health Data Management, October 20, 2009)
The market for telemedicine devices and services will generate $3.6 billion in annual revenue within five years, a new study claims. The study by the Silver Spring, Md.-based research firm Pike & Fischer, says mobile-services companies, such as AT&T, Verizon, Sprint and Nextel, will take a sizeable chunk of the business. It predicts that smaller software and device manufacturers likely will be targets for acquisition.
The need to control health care costs, as well as advances in wireless broadband networks, smart phones and data compression technologies, will fuel telemedicine growth, the report states. Funding from the American Recovery and Reinvestment Act also will support a surge in broadband-enabled telemedicine services, such as remote patient monitoring and mobile access to electronic health records, it adds.
Wireless applications, devices and services will account for more than 70% of the telemedicine market within five years, according to the report.
(Source: Health Data Management, October 8th, 2009)
Healthcare services that offer online doctor visits are increasing. Earlier this year, the Hawaii Medical Service Association (HMSA) launched their online care program. The program offers patients online doctor visits which cost $10 for members and $45 for nonmembers The technology behind the HMSA program, created by American Well, a Boston company, is being picked up by other health insurance plans. Blue Cross & Blue Shield of Minnesota launched a pilot version this fall and plans to offer it to all members by mid-2010. A recent partnership between American Well and OptumHealth, a division of UnitedHealth Group, will take Online Care nationwide to all consumers, regardless of insurance provider. Then there is MDLiveCare, a national service with more than 100,000 members who may or may not be covered by a healthcare plan and who pay a flat $35 per online visit to consult with primary-care providers, specialists, and therapists in the network.
Some healthcare plans, such as Kaiser Permanente, already let members E-mail doctors, review lab tests, make appointments, and refill prescriptions online. But virtual doctor visits are in real time and don't have to adhere to office hours. In Hawaii, some of the most remote patients now have 24-7 access to basic healthcare.
About 10,000 individuals, most of them residents of the New York metropolitan area, can already get an online (or phone) emergency consultation with one of 34 ER physicians who have signed on with a company called SwiftMD.
Patients in Brooklyn, N.Y., who don't have health insurance (and physicians who don't want to deal with insurance claims) have the option of joining Hello Health. After an initial face-to-face visit, patients pay $100 to $200 an hour for each encounter, whether it's in person or online. In addition, the $35 monthly membership fee covers unlimited E-mail exchanges with Hello Health doctors. Online, patients can see their doctor's schedule and make their own appointments. If they run late, they can whip out a BlackBerry or iPhone and post a message on a Facebook-like "wall" on the physician's Web page. Hello Health internist Sean Khozin figures he spends as much as 40 percent of his time online - following up with chronic disease cases, for example, to coordinate care. Hello Health is in the process of rolling out nationally.
Such services offer more than convenience, however. An online encounter often is a substitute for an expensive trip to the ER. It's also likely to be cheaper than an office visit, plus it confers nearly instant access to a patient's choice of available doctors and - a boon for employers - may trim the number of workdays missed for minor maladies. Ninety-five percent of Harper's patients using the Hawaii service can be managed without a face-to-face visit, says the physician.
Many Americans are would-be prospects for online care. Half say they would be interested in using the Internet not only as an information source but to receive healthcare directly, according to a recent survey by an arm of PricewaterhouseCoopers. Consumers soon may be able to choose from a range of services.
(Source: US News and World Report, October 27, 2009)
Thanks to factors including a looming physician shortage, the health care reform debate and the increasing willingness of insurance companies to pay for the practice, telehealth is on the verge of becoming routine.
"More and more companies are seeing the benefits of telehealth," said Greg Billings, senior director at the nonprofit Center for Telehealth and E-Health Law in Washington. "If that doctor looking at that skin rash didn't diagnose it as skin cancer until later, the cost of treatment of that skin cancer is going to be a heck of a lot more."
Universities, technology companies and hospital systems, including the University of Maryland, have been experimenting with telehealth since the 1990s. A major insurance provider - UnitedHealthcare of Minnesota - recently announced a national push to persuade its network of professionals, including thousands here in Maryland, to adopt telehealth for their patients.
Remote consultation and diagnosis are ways for medicine to become more efficient even as physicians and other health professionals are increasingly in short supply, policy experts say. For patients living away from advanced hospitals in urban areas, they add, it's potentially lifesaving.
Telehealth systems can screen patients for diabetes, eye disease, kidney problems, nerve damage, vascular disease and complicated pregnancies. The technology is available and relatively inexpensive. It's the regulatory hurdles that present the challenge, experts say.
Because of licensing restrictions, specialists might have trouble treating and prescribing medicine for patients they are examining electronically across state lines. Also, only a handful of states require insurers to cover telehealth care - and Maryland isn't one of them.
"These are the thorny issues," said Dr. Elizabeth A. Krupinski, an assistant director in the radiology department at the University of Arizona and a past president of the American Telemedicine Association. "The nursing profession has done a lot more in that area than physicians in terms of cross-state licensure. The problem is that every state has their own twist on the regulations."
But telehealth is nevertheless growing. Johns Hopkins Medicine International has used telehealth technology to link its specialists with physicians and patients by videoconferencing in other countries, such as the United Arab Emirates, Lebanon, Panama, Singapore, Chile and Turkey.
Alex Nason, the telehealth program director at Hopkins, said the institution is exploring the possibility of applying telehealth approaches within Maryland. The hospital already has a partnership with Howard County General Hospital in which a robot with a video camera can act as a Hopkins doctor's eyes and ears during a patient consultation.
"Telehealth is not about geography; I really think it's about access," said Nason. "Whether you're 500 miles away or 5 miles away, if you can't get there, you can't get there."
UnitedHealthcare this summer kicked off a national tour that emphasizes the latest telehealth technologies. An 18-wheeler parked at a Cherry Hill school contained videoconferencing and digital diagnostic tools. UHC officials said the company, whose network includes 4,900 hospitals and covers 223,000 Marylanders, is building the first national telehealth network to help physicians cater to underserved areas, rural and urban.
"It's a fundamental new way to provide that connection" to specialist care, said James Cronin, chief executive of the Minnesota-based company's Mid-Atlantic division. Such technology isn't intended to replace patients' connection to a primary care physician, he said. Instead, it's meant to hook them up quickly to specialized care that's sometimes difficult to find.
Telehealth equipment can be installed in physicians' offices, small clinics, hospitals, and even workplaces for from $10,000 to $100,000. Hardware could include an electronic records system, digital diagnostic equipment, video monitors and cameras.
With federal subsidies toward incorporating the latest electronic systems, physicians and hospitals have at least some incentive to upgrade their computer networks.
Last year the Maryland Hospital Association found that the state is 16 percent below the national average for the number of doctors available for clinical practice. The shortage was greatest in Southern and Western Maryland and on the Eastern Shore.
(Source: Baltimore Sun, September 14, 2009)
by Michael Edwards, Maine Telemedicine Service News, Sept. 11, 2009
Both Maine and New Hampshire in the Summer of 2009 passed and obtained Governor signatures for laws which require insurance companies to pay for services delivered by telemedicine. Along with Oregon earlier this year, this brings the total to 12 for states with similar statutes (joining California, Colorado, Georgia, Hawaii, Kansas, Kentucky, Louisiana, Texas, and Oklahoma - see the Telemedicine Information Exchange). In the case of Maine, the new law supplements Medicaid reimbursement for telemedicine services delivered by interactive video sessions, whereas in New Hampshire, Medicaid does not cover telemedicine except in selected pilot waiver programs.
For the benefit of other states who may ponder such a step, we cover here some details about the similarities and differences in the laws and discuss some of what we know about how these laws got through the state legislatures.
Process Leading to Maine Law
The Maine Legislature passed the bill LD 1073, "An Act to Provide for Insurance Coverage of Telemedicine Services" on May 12, and Governor Baldacci signed it into law on June 11th. The law, Chapter 169 MRSA 4316, contains the following provisions:
The Health and Human Services Department recently indicated that it received no applications to operate the National Telehealth Resource Center. Because no one applied, HHS said it is extending funding for the existing operator of the National Telehealth Resource Center, the Center for Telehealth & E-Health Law (CTeL) until a new competition can be held in 2010, according to a Federal Register notice published Aug. 26. HHS is providing $225,000 in noncompetitive supplemental grants to the existing center for the year ending Aug. 31, 2010.
HHS' Health Resources and Services Administration (HRSA) is releasing the supplemental funding to the CTeL, which serves as the current National Telehealth Resource Center, so it can continue to provide technical assistance services to regional telehealth centers, the department said.
"HRSA received no applications for the National Telehealth Resource Center," the Federal Register notice states. "Since no organization applied to serve in the capacity as a NTRC, it is urgent that the Center for Telehealth & E-Health Law continue to provide its services until next year without disruption when HRSA can conduct a new competition for the provision of these services."
The Center for Telehealth and e-Health Law has been operating since 1995. It was selected as the National Telehealth Resource Center in 2006.
(Source: Federal Computer Week, August 27, 2009)
People suffering from depression should get counseling online to avoid long waiting times to see a doctor, according to new research. A UK study of almost 300 patients found that those given online cognitive behavioral therapy (CBT) were two-and-a-half times more likely to recover from their mental health problems that those who received standard care from a GP. One in six adults suffer from depression or chronic anxiety, and online CBT may offer an alternative to the growing problem.
Dr David Kessler, a senior primary care researcher at the University of Bristol and a part time GP, said: "The patients get up to ten one hour appointments which are carried out online by instant messenger.
"Maybe it is the writing things down that helps so much because you have to think more when you do this. It is like being in a chat room with your therapist.
"It would greatly improve access to therapists for people who are disabled, housebound or living in remote locations.
"And you don't have to be some whizzy computer geek to use it. Some of our patients were in their seventies although the average age of people with depression is surprisingly young � around the 30s and 40s mark."
In the study, patients aged from eighteen into their 70s were recruited from Bristol, London and Warwickshire and 149 were given online CBT along with the usual care while 148 got the customary GP sessions.
After a four month follow up completed by 113 patients in the intervention group and 97 in the control group, almost two fifths of those who got the online CBT recovered from depression compared with one in four of those who did not. After eight months the proportion grew further, according to the findings published in The Lancet.
"Cognitive behavioral therapy seems to be effective when delivered online in real time by a therapist, with benefits maintained over eight months. This method of delivery could broaden access to CBT in primary care," Dr Kessler said.
"The number of patients for whom online CBT is feasible and attractive will grow. It could be useful in areas where access to psychological treatment is scarce, and for patients whose first language is not English.
"It could make access to psychotherapies more equitable by providing a service to patients in areas or even countries where psychological treatment is not readily available."
(Source: The Telegraph, August 21, 2009)
Two corporate giants are cooperating in what they call an effort to expand the availability of telemedicine in both rural and urban areas that are medically underserved. UnitedHealth Group, the country's largest health plan by revenue, and Cisco, the Silicon Valley networking corporation, recently announced that they will cooperate on equipping a national network of doctors to care for patients via high-definition cameras and remote monitoring devices.
The project, called Connected Care, is expected to connect clinics, physician offices, workplace-based clinics, mobile clinics and even patients' homes, said Jim Woodburn, MD, vice president and medical director of telehealth for United.
The project kicked off a pilot program in New Mexico in collaboration with the Washington-based nonprofit Project HOPE, which works to expand access to medical care and education across the world.
"From the perspective of Project HOPE, this is a huge deal," said Rand Walton, a spokesman for the nonprofit.
The Connected Care network, meanwhile, will set up in multiple locations, including work sites, doctors' offices and mobile clinics, Dr. Woodburn said. He said United likely would build the Connected Care network beginning with primary care physicians in an effort to address the shortage of primary care in underserved areas.
United will pay for the telemedicine visits and expects the claims and payments to work in basically the same way face-to-face visits work, Dr. Woodburn said.
For United, which said in its announcement it would spend "tens of millions of dollars" on the project, the opportunity for savings is a part of the motivation to invest in telehealth, Dr. Woodburn said.
(Source: American Medical News, August 14, 2009)
Universal coverage could clog the healthcare system unless new care-delivery models are created, such as telehealth and online doctor appointments, according to a survey from PricewaterhouseCoopers. Fifty percent of consumers surveyed said they would be willing to seek healthcare through the internet or other computer technology instead of face-to-face, non-emergency visits. E-mail consultation was the top choice (76 percent), followed by telehealth, question-answer consults and an online forum monitored by a doctor.
The second alternative to access was retail and worksite clinics for patients. Of consumers surveyed, 37 percent said they would likely use a worksite clinic, and 36 percent said they would use a retail health clinic.
The third alternative was the use of telehealth technologies. This method could expand access to specialty physicians for patients in remote and underserved areas. Seventy-three percent of consumers said they would use biometric electronic remote monitoring services to track their condition and vital signs.
A fourth alternative is shared medical appointments (SMAs). Of consumers surveyed, 28 percent said they would be willing to participate in a shared medical appointment. This would consist of a 60- to 90-minute session that includes a private or personal exam, integrated with patient education and discussion with a group of 10-to-15 people. Instituting SMAs could increase patient access and a physician�s productivity by an additional six patients during a four-hour clinic session, according to PricewaterhouseCoopers.
(Source: Modern Medicine, August 27, 2009)
Nearly 10 percent of U.S. hospital intensive care unit beds use advanced telemonitoring, yet no one has studied how it affects cost and quality of care, according to a new report. In a study recently published in Health Affairs, researchers from the Center for Studying Health System Change found hospital clinical leaders hold strong views about the use of telemonitoring – or eICU – but they have little information to go on.
"The rapid diffusion of eICUs in hospitals across the country, which remains largely unstudied, illustrates the need for comparative effectiveness initiatives to include innovations in how we care for patients – not just specific drugs, devices and services," said HSC Senior Consulting Researcher Robert A. Berenson, MD.
"Proponents and detractors of eICUs feel strongly that their assessments are correct," Berenson said. "But without a rigorous assessment, who knows which side is right?"
The Health Affairs article, titled "Does Telemonitoring of Patients – The eICU – Improve Intensive Care?" was a follow-up study from HSC's 2007 site visits to 12 communities – Boston, Cleveland, Greenville, S.C., Indianapolis, Lansing, Mich., Little Rock, Ark., Miami, northern New Jersey, Orange County, Calif., Phoenix, Seattle and Syracuse, N.Y. HSC has been tracking these markets since 1995.
During the visits, HSC researchers learned that hospital systems in Indianapolis, Little Rock, Miami, Phoenix and Seattle had adopted eICU systems. In a follow-up study, researchers interviewed clinicians in the five hospital systems with an eICU, as well as those in 19 non-eICU hospitals in the other 12 markets and national experts on ICU staffing, quality and ICU telemedicine.
An eICU system combines telemedicine with software applications to manage ICU patients from a central monitoring station, usually located off-site from the actual ICU and staffed with physicians with advanced training in critical care (known as intensivists), critical care nurses and administrative personnel.
HSC researchers found that hospitals adopting eICUs generally were motivated by the potential to improve clinical quality and patient safety rather than expectations of cost savings from reduced complications and lengths of stay.
Among hospitals not adopting eICUs, there was general agreement that the limited potential benefits did not justify significant upfront and ongoing operating costs – estimated at $3 million to $5 million in startup costs for 100 ICU beds, along with ongoing annual operating and staff costs of $1.3 million to $2.3 million per 100 beds. Virtually all of the hospitals without eICUs believed their current on-site ICU staffing was adequate and preferable to off-site staff.
The lack of third-party reimbursement also was seen as an argument against adopting eICUs.
Despite the lack of specific payments or other incentives, most hospitals in the study, with and without eICUs, were working to improve ICU performance, primarily by adding more intensivists and adopting ICU-specific quality improvement tools to help prevent ventilator-associated pneumonia and central-line infections, the study showed.
In all but one of the five eICU hospitals, poor interoperability between the eICU software and the hospitals' enterprise-wide information technology systems created barriers to using the eICU's advanced monitoring and outcome analysis features, according to the study.
(Source: Healthcare IT News, August 19, 2009)
California State treasurer Bill Lockyer announced Tuesday the closure of a bond deal with the University of California system that will provide $35 million for a new telemedicine facility at University of California Davis.
According to the treasurer�s office, the facility will be a four-story facility of 50,000 square feet. The grant also provides equipment and research funds. Telemedicine is the exchange of medical information through electronic means.
The funding is part of a nearly $200 million bond deal for telemedicine projects throughout the University of California system. The university system purchased the general obligation bonds - typically offered to individual or institutional investors rather than public entities like universities.
The transaction is the latest of several deals with public entities Lockyer completed to keep funds flowing while the state copes with fiscal difficulties. The state will pay 3.183 percent interest.
(Source: Sacramento Business Journal, August 4th, 2009)
Rural health providers in Colorado will soon be able to have access to electronic medical records and other health information technology with the formation of a telehealth network.
The Colorado Health Association and Colorado Behavioral Healthcare Council said they will use Qwest Communications to develop the network. The network will connect 400 rural and urban hospitals, clinics and behavioral health providers in the state, the groups said in an announcement Aug. 14. The majority of eligible providers will be connected by the end of the year.
When it is complete, the Colorado Telehealth Network will let providers consult through video conference, send and view individual patient medical information and monitor patients� progress. The network will tackle some of the challenges faced by rural providers, including bandwidth, connectivity and information security. The two Colorado healthcare organizations combined two funding awards they received from the Federal Communications Commission to finance the telehealth network.
(Source: Government Health IT News, August 29, 2009)
A high-tech medical clinic pulled by an 18-wheel rig -- a collaboration of United Healthcare and Cisco Systems, the computer networking company -- recently visited Raleigh, North Carolina as part of a four-month, cross-country roadshow.
Allen Feezor, the state's deputy secretary for health services, toured the 80-foot long trailer with an eye toward finding solutions to the state's medical-care challenges: some counties don't have a single practicing physician, and many have a physician shortage.
The wired clinic allows a doctor to "see" a patient anywhere in the country via a video-conferencing system that also transmits a patient's vital signs and other medical data.
John Price, director of the state Office of Rural Health and Community Care, said telemedicine has tremendous potential. The technology could slash medical costs by preventing expensive treatments, he said.
"It makes a lot of sense if you put an asthmatic child on a management plan and keep that child from going to a hospital ER 10 times a year," Price said. "You could do that with congestive heart failure, uncontrolled diabetes and all these chronic diseases."
The costs of telemedicine ultimately would have to be shared by companies like United Healthcare, local hospitals, state agencies, employers and sites that would host remote clinics, such as shopping malls or pharmacies, United Healthcare spokesman Roger Rollman said.
The trailer has a reception area, waiting room and examination room with a two-way video screen. The cost of individual components ranges from $10,000 to $100,000, said Daryl Richard, another company spokesman.
The pieces don't have to ferried by truck. They could be set up at a drugstore, mall, school or library. Proponents say one day, chronically ill patients could have video screens and medical equipment in their homes.
In this state, telemedicine is in the early stages; one project connects rural doctors to specialists.
The Cisco and United Healthcare program is being tested using a bus in New Mexico and in clinics in Colorado. Soon it'll be offered to Cisco employees in RTP as a pilot project.
(Source: The Raleigh News and Observer, August 27, 2009)
Advance, a national magazine for health information professionals, in its August issue selected the collaborative effort of the Louisiana Rural Health Information Exchange, the Louisiana Rural Hospital Association and the LSUHSC-S as the nation's top health information technology project for the year. The system brings high-quality health care to patients in rural central and north Louisiana.
The idea was born of necessity in 2005 following Hurricane Katrina, said Dr. Donald Hines of Bunkie, executive director of LARHIX.
"When we started the project, health care in New Orleans was in a shambles," Hines said, and the LSU hospital in Shreveport was swamped with patients that normally were sent to New Orleans. Former LSUHSC-S Chancellor Dr. John McDonald "wanted to avoid unnecessary transfers, sending patients great distances for care."
But it wasn't until 2007 that the first funding was approved � $13 million to preserve health records, develop an Internet-based system so all patient records could be accessed by health care providers and patients, and develop a way so patients wouldn't have to travel long distances for treatment.
Initially, seven hospitals were equipped to enable them to electronically connect and exchange patient data with each other and the LSU hospital. Now, 14 hospitals are linked, and 23 have telemedicine and distance learning capabilities that allow rural doctors to communicate with those at the Shreveport hospital to get diagnostic and treatment advice and training. Fifteen of the hospitals are doing telemedicine consultations.
Currently, sharing medical records are hospitals in Bunkie, Homer, Bernice, Farmerville, Delhi, Ferriday, Winnsboro, Jena, Jonesboro, Pollock, Olla, Coushatta, Mansfield and Leesville.
(Source: Shreveport Times, August 23, 2009)
UnitedHealthcare recently reported that it will launch an telemedicine program in Colorado designed to give patients in rural areas access to physicians and specialists through audio and video technology. The insurer is partnering with the state of Colorado and the Colorado hospital system Centura Health on a program that gives rural residents a link to physicians and medical specialists when in-person visits are not possible.
Called Connected Care, the program will be built in several Centura Health facilities throughout the state as well as in federally qualified community health centers.
The program will connect patients with medical specialists located hundreds of miles away through high-definition video conferencing and other technologies to �create an experience remarkably similar to having the doctor in the same room with the patient,� according to an announcement from UnitedHealthcare.
Connected Care sites will be installed starting during the first quarter of 2010. The program will accommodate nearly 4,800 specialist visits per year in rural communities.
(Source: Denver Business Journal, August 17, 2009)
Sequoyah Memorial Hospital (SMG) in Sallisaw is the first hospital in eastern Oklahoma to use telemedicine for stroke treatment in the emergency room. The equipment obtained by Sequoyah Memorial will be used not only for stroke intervention and treatment, but also for other specialties and will provide critical medical support and access to specialists in urban areas. It has become the most important use of compressed video technology.
In addition, telemedicine has become a critical part of programs for staff training. Telemedicine allows a live connection to specialists who are not on site but may be in major medical centers in other cities.
Debbie Knoke, the hospital�s administrator, said that, �Many times the specialty services are needed for consultation in the treatment of patients at SMH.�
The first project for telemedicine utilization for Sequoyah Memorial was the stroke treatment program in conjunction with Dr. Tremwel, a neurologist affiliated with Sparks, and one of Arkansas� leading vascular neurological physicians. Prior to Sequoyah Memorial launching the telemedicine program, Dr. Tremwel conducted training with SMH staff. According to Knoke, at present, all nursing staff are certified in American Heart NIH Stroke Certification. A stroke team was identified and is made up of physicians, nurses, pharmacy technicians, and radiology technologists.
�Sequoyah Memorial is excited to continue to improve efficiency, optimize quality and safety, and improve patient care,� Knoke said. �This new service aligns directly with the mission of SMH in providing local access for services that enhance the individual health and well being of our patients.
�The scope of rural healthcare should not be underestimated,� Knoke said. �According to the Oklahoma Hospital Association, of the 124 hospitals in the state of Oklahoma, we are among the first to utilize telemedicine for stroke treatment in the emergency department. This is a crowning moment for our staff, patients, and community. Our stroke team has been working diligently with Dr. Tremwel and Sparks Regional Medical Center since last year to bring this service to our community.�
Sequoyah Memorial has endless potential with the skilled staff and the capabilities of telemedicine. The patient is Sequoyah Memorial�s main focus and also drives the hospital�s commitment to excellence.
The telemedicine service would not be possible without the Sequoyah Memorial Hospital Ladies� Auxiliary group. Their dedication to this cause was instrumental. Their donation of $15,000 following the spring fundraiser was paramount to Sequoyah Memorial securing the needed equipment to implement telemedicine.
The support of Oklahoma State University Center for Health Sciences Telemedicine program, through their donation of the telemedicine cart, was also very significant; their dedication to the health of rural Oklahoma is very evident through their mission, which is to provide specialty physicians and services to rural Oklahomans through Telemedicine.
Knoke said, �Sequoyah Memorial is very aware that our region ranks number one in the nation for the incidence of stroke among residents because the area is lumped into the Fort Smith metropolitan area. Arkansas ranks number one in the nation for stroke. It was this knowledge that drove Sequoyah Memorial to break into the field of telemedicine to provide residents with immediate access to life-saving healthcare.
(Source: Sequoyah County Times, August 18, 2009)
Twitter, the increasingly popular social networking tool that was at first merely a convenient way to stay in touch with friends and family, is emerging as a potentially valuable means of real-time, on-the-go communication of healthcare information and medical alerts, as described in latest issue of Telemedicine and e-Health.
Physician groups, hospitals, and healthcare organizations are discovering a range of beneficial applications for using Twitter to communicate timely information both within the medical community and to patients and the public. Short messages, or "tweets," delivered through Twitter go out from a sender to a group of recipients simultaneously, providing a fast and easy way to reach a lot of people in a short time. This has obvious advantages for sharing time-critical information such as disaster alerts and drug safety warnings, tracking disease outbreaks, or disseminating healthcare information. Twitter applications are available to help patients find out about clinical trials, for example, or to link brief news alerts from the Centers for Disease Control and Prevention (CDC) to reliable websites that provide more detailed information.
The use of social media and Internet-based outlets such as Twitter to communicate medical information requires a high degree of caution, however, to preserve confidentiality and patient privacy in the clinical care setting, and to ensure that information sources are accurate, reliable, and current.
"One way to look at Twitter is as a method of mass communication," says Joseph C. Kvedar, MD, Director of the Center for Connected Health (Partners Healthcare System, Boston, MA), who is quoted in the article. Twitter is real-time and was designed for mobility, notes Dr. Kvedar. It allows people to "text 30 people or 50 or 100 people, whatever the number is who are following you."
(Source: Telemedicine and e-Health Press Release, August 26, 2009)
A new stretcher-mounted telemedicine system features a touch-screen PC, a remotely controlled camera, microphone and electronic stethoscope. The TransportAV system, from Scottsdale, Ariz.-based GlobalMedia, is designed to link emergency responders in the field directly to a physician at a clinic or hospital where a patient is being transported. Hamilton Schwartz, M.D., director of emergency services at Cincinnati Children�s Hospital, invented the system. The hospital is the first user.
The 30-pound unit, which accommodates real-time audio and video connections, enables the remote doctor to control all aspects of the consult.
(Source: Health Data Management, August 25, 2009)
The Cleveland Clinic has set plans to develop a line of business around at an eICU service--in which the Clinic will provide remote guidance to ICUs at other hospitals--and also in remote home healthcare services.
These two sectors are among the more mature of the telemedicine markets, according to Clinic research. About 17 percent of home health agencies use telemedicine, and about one-third plan to buy one within the next two years, according to a 2008 survey.
The market for eICUs, meanwhile, already boasts several players, including Baltimore's Visicu, which claims 200 hospitals and 40 health systems in 28 states.
(Source: Fierce Health IT, August 25, 2009)
Dozens of large and small companies are turning to wireless technology to achieve a health-care system that keeps people healthier for less.
"Wireless applications have the potential to change every one of these areas," said Eric Topol, a cardiologist and genomics professor at Scripps Research Institute, at an industry event in San Diego last week.
Dr. Topol, who is also chief medical officer of the West Wireless Health Institute, a San Diego nonprofit research organization, cites a 2008 study that was distributed by a coalition of companies and organizations that support health-care reform. It put annual savings from remote monitoring at $10.1 billion for U.S. sufferers of congestive heart failure, $6.1 billion for diabetes and $4.9 billion for chronic obstructive pulmonary disease.
But claims about cost savings from new technology often don't pan out. There are "precious few" studies that back up such promises involving remote monitoring, says Mark Holland, managing director of System Research Services, an advisory firm focusing on health-care technology. And if reimbursements from Medicare or private insurers don't cover the cost of high-tech approaches, doctors and hospitals won't want to deploy them.
Using wireless technology has the potential to reduce costs in part because part of the infrastructure already is in place. With more than four billion cellphones sold to date, a large percentage of the world's population has access to devices and networks that can send medical data to doctors.
(Source: Wall Street Journal, August 4, 2009)
GPs at The Orchard Medical Centre in Bristol, UK have reported on the success of telehealth in improving care for patients with chronic heart failure (CHF), keeping them independent and out of emergency care, and promoting greater self-management.
The Bristol-based practice has successfully integrated telehealth into its CHF service, to provide more preventative support within the community setting, help avoid hospital admissions and reduce some of the burden on secondary care providers whilst providing a cost-effective model of care for the management of the condition.
GPs at the Orchard Medical Centre have liberated valuable additional resource and have reported reduced hospital admissions for some of the CHF patients since deploying the telehealth solutions.
In the case of one patient who had severe heart failure and a history of poor medication compliance, the telehealth monitor enabled GPs to view the direct link between poor medication compliance, weight gain and low oxygen saturation. This was remedied with the aid of telehealth as the patient could see for herself the importance of taking her medication. Telehealth also resulted in a dramatic improvement in another patient with severe heart failure who has not had to use out-of-hours health services in the 18 months since using the monitoring equipment, where previously she had been in and out of hospital four times in a nine-month period.
Clearly from this example telehealth has the potential to reduce costs, which is even more compelling when CHF is becoming an increasing burden in an aging population, and the annual cost to the NHS is 600m pounds. According to the British Heart Foundation, inpatient care accounts for 60% of heart failure care; with average admissions approaching two weeks, and so keeping patients out of hospital and supporting them within the home environment through telehealth has the potential to deliver significant resource and budgetary savings.
Telehealth has proven valuable in identifying trends such as change in body weight at an early stage to enable early intervention, and also in providing support to patients who find it difficult to visit the surgery. Patients have found the solutions easy to use, resulting in increased medication compliance and a resulting improvement in quality of life.
According to Dr Richard Berkley, clinical lead on the telehealth project: "Telehealth keeps people where they want to be, and that's at home with their family. Patient acceptance of telehealth is high; daily monitoring has enabled more accurate titration of patient medication, and also gives patients valuable reassurance, keeping them calm and reducing the risks of exacerbation and of hospital admission.
"Clinical contact with the district nursing team has actually increased as a result with patients taking greater interest and increased responsibility for their condition. The reassurance of self-monitoring has also helped to boost medication compliance, which in turn is thought to have helped to avoid unplanned emergency admissions and has helped to keep patients safe and well within the home environment."
The positive results reported by The Orchard Medical Centre reflect the growing acceptance of telehealth as a means of enabling trusts to support a greater number of patients, improving outcomes and making the best use of available resources.
The telehealth project was a joint venture between NHS South Gloucestershire and South Gloucestershire Council community care & housing department, and was funded by a technology grant from the council together with three years project support from Takeda UK Ltd. As a result of the success of the project, the Orchard Medical Centre is looking to expand the use of telehealth within Gloucestershire, through closer involvement and collaboration with other local GP practices.
(Source: eHealth News EU, August 21, 2009)
The German Medical Technology Association, BVMED, has published a ten point plan for advanced medical technology in patient care. The plan aims to provide a basis for health policy discussions in the run-up to the German general election this autumn.
The plan emphasizes the increasing need for telehealth and telecare across Germany, arguing that patients should not only have access to products but to comprehensive homecare treatment.
�Telehealth should be a part of regular care,� the plan says. �E-health, telemedicine and telemonitoring by means of medical technologies lead to better, safer, optimized and most cost effective care and must therefore become part of standard care.�
(Source: eHealth Europe, August 26, 2009)
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About the authors: Josie Henderson is the Director of the Telemedicine Research Center. Will Engle is the Executive Director of the Association of Telehealth Service Providers.
