4/16/2008
Philips Electronics recently released the final results of a survey conducted by Fazzi Associates of nearly 1,000 home care agencies in the United States. Results of the Philips National Study on the Future of Technology and Telehealth in Home Care show that nearly one third of large agencies are currently using a telehealth system and that industry use of telehealth is expected to double over the next two years, principally as a means of managing patients with chronic disease. In addition, over 88 percent of agencies report that telehealth services led to an increase in quality outcomes, as evidenced by a reduction in unplanned hospitalizations and ER visits, and over 71 percent report an improvement in patient satisfaction.
Co-sponsored by Philips, the National Association for Home Care & Hospice (NAHC), and Fazzi Associates, this first-of-its-kind study gathered insights about the use of home care technology from nearly 1,000 agencies across the U.S. The study represented all major segments of home care: large and small, rural and urban, free-standing and hospital-based, and for profit and not-for-profit.
"What makes this study so important is that it is the first representative sample study on technology and telehealth in home care that has ever been undertaken," said Val Halamandaris, president and CEO of NAHC. "We now have a much clearer sense of how specific segments of home care are responding to and using these technologies. One finding that is particularly significant is that the utilization of telehealth by home care agencies also correlates directly with providing the highest quality of care."
"Philips Home Healthcare Solutions was pleased to sponsor a study of this magnitude that could provide insights to advance the home care industry, as well as share these findings at no cost to the field," said Mike Lemnitzer, senior director, Philips Telehealth Solutions. "We believe that home health agencies will be a critical part of the solution to the U.S. healthcare crisis and ensure a continuum of care from the hospital to the home."
According to Dr. Robert Fazzi, project co-director, the Philips study was designed to address questions that are most on the minds of agency leaders about the role of four major home care technologies: human resources and billing systems, point of care systems, electronic medical records, and telehealth systems. Given the importance of telehealth to the future of home care and hospice agencies, much of the study focused on the various types of telehealth systems being used, the components of these systems, what agency leaders liked and disliked about their systems and most importantly, what leaders felt were the most significant impact of these systems on various aspects of quality and financial outcomes. Among the findings were:
- 17.1 percent of agencies use some type of telehealth system. A much higher percentage of large agencies (32.0%) report that they provide telehealth services.
- 88.6 percent report that telehealth led to an increase in quality outcomes:
- 76.6 percent report a reduction in unplanned hospitalizations
- 77.2 percent report a reduction in emergency room visits
- 71.3 percent report that telehealth services improved patient satisfaction. No agency reported that it reduced patient satisfaction.
- 83.9 percent state that less than one in ten patients refused a home telehealth system.
- 79.2 percent of patients or family members were reluctant to have the telemonitoring system removed.
- 42.8 percent report that telehealth led to a reduction in cost. A similar number reported it as cost-neutral.
- 63.5 percent report that telehealth had no impact on clinical caseloads. As more agencies use telehealth and move up the learning curve, clinical productivity measures may increase
- 49.7 percent report telehealth decreased on-site visits
- 45.2 percent report telehealth increased the number of referrals
- 56.9 percent report that their nurses were very receptive to having a telehealth service after one year as compared to 36.3 percent at the beginning of the program.
- 89.1 percent stated that given everything they know today, they would still have started their telehealth program.
To request a copy of the full report, please visit
www.philips.com/HomeCareStudy.
(Source: Philips Press Release, April 4, 2008)
4/16/2008
The Centers for Medicare & Medicaid Services (CMS) has published a new regulation establishing Part D e-prescribing standards for four types of information. The new rule will go into effect on April 1, 2009. According to HHS Secretary Mike Leavitt, establishing standards for e-prescribing under Medicare's prescription drug program will help pave the way for the widespread adoption of e-prescribing throughout the medical community.
This regulation applies to:
- Formulary and benefits: This standard will enable doctors and other prescribers to find out information on what drugs are covered by a Medicare eligible individual's prescription drug benefit plan
- Medication history: This standard will enable doctors, other providers, as well as dispensers to communicate about prescribed medications a beneficiary has taken or is taking including those prescribed by other providers
- Fill status notification: This standard will enable doctors and other providers to receive an electronic notice from the pharmacy or other dispenser telling them that a patient's prescription has been picked up, not picked up, or has been partially filled
- Provider identifier: The final rule requires providers, dispensers, and Part D sponsors to use the NPI to identify individual healthcare providers in Part D e-prescribing transactions.
For more information, please visit
www.cms.hhs.gov/EPrescribing.
(Source: Federal Telemedicine Update, April 7, 2008)
4/16/2008
The nation's ability to rein in future healthcare costs, which hospital executives fear could reach unsustainable levels within a decade, may depend in part on emerging technologies that are taking patient engagement to a higher level, especially in the home. Home health monitoring and telemedicine for post-discharge care are nothing new, particularly with cardiovascular care, but it is taking on added dimension as new technology permits.
William Petasnick, CEO of Froedtert Hospital, Milwaukee, said the next generation of home health monitoring, also called home telehealth, will take consumers beyond routine pacemaker monitoring and into total remote monitoring. The business value of this new direction goes beyond the desire to reduce hospitalization, and therefore cost, and extends to better resource utilization in an era of nursing and other workforce shortages, the need to better manage chronic diseases, and the desire for better patient service and outcomes.
The hospitals of today, Petasnick noted, are trying to become more highly intensive in terms of their care environments. "With less-acute patients, the more we can keep them out of an institutional setting, that's better for care and it's a more effective use of resources," he said.
Home telehealth, according to Jonathan Edwards, research vice president for Gartner and a lead analyst on telemedicine, is a concept that uses these technological developments to assist patients who suffer from chronic or long-term medical conditions that historically require frequent visits to the hospital. Monitoring for cardiac patients is popular with several types of portable devices, but the technology is also used for cancer or diabetes patients whose vital signs suddenly can fluctuate.video conferencing.
"For patients with expensive conditions, it makes sense to have these devices rather than being admitted into the hospital," Edwards said.
Joan Maro, vice president of home care and hospice and chief nurse executive at Aurora Health Care in Wisconsin, said the technology Aurora uses for patient monitoring collects chemical levels and vital signs, with specialization to meet the requirements of many conditions. Monitors can read heart rate, blood pressure, weight, oxygen saturation, and temperature, sending signals to the Aurora offices for review and (if necessary) response by a trained nurse.
Daily monitoring, Maro said, allows clinical professionals to both keep an eye on patients in the event of emergency and also plan ahead for any new developments in their condition. Depending on the issues surrounding patient privacy, it may one day be possible for a patient's family to access their information over a distance.
"It would be a wonderful offering for the families caring for loved ones from a distance," Maro said. "They would be able to see that their blood pressure was in line or that they had taken their medications - even monitor them via camera."
One barrier to the use of telemedicine, Edwards said, is not the devices themselves but transmittal of data from those devices, and the lack of an infrastructure to monitor and detect the data. Without an appropriate recording system, the information collected cannot be compared to normal health criteria and therefore is of limited use to doctors and other providers.
Developing these records systems can be a problem, since telemedicine is held back by the oldest issue in the medical field: money. Maro said that at this time reimbursement for in-home monitoring is limited, chiefly due to a lack of documentation to prove that home health monitoring is cost-effective and leads to improved outcomes.
Funds are limited for telemedicine, Edwards said, because insurance and payer companies have been slow to lend support for the technology. These limitations mean that, in many circumstances, patients have to cover their own costs, leading to circumstances where third-party vendors have to bypass primary care and therefore are not integrated with the physicians' medical records.
"The group is paid by activity, so they don't have any incentive to keep the patient at home," Edwards said of healthcare's profit mentality.
Telemedicine's success, Edwards added, will depend on the success of pilot projects and grant funding, which help develop interest and documentation in the field. One of the more encouraging investments has been made by the U.S. Veterans Health Administration, which has thousands of patients suffering from conditions such as diabetes and cardiac failure. The field also is driven by organizations such as the Continua Health Alliance, which unite device developers committed to improving technology for home health devices.
Device development will also play a role, as the three areas of telemedicine identified by Edwards - messaging systems to prompt and alert patients, devices to record vital signs, and tools for video conferencing - continue the trend of merging into one device. Unified devices like these would allow healthcare providers to consolidate operations, a move that also could lead to wider adoption by insurance companies.
Of course, the most important factor for home health monitoring will be for developers to remember who they are designing the technology for. "For anybody, the issue is creating a healthcare environment and creating it where services are needed," said Nina Antoniotti, director of telehealth for Marshfield Clinic. "It's what's efficient for providers and giving [patients] a good experience."
Telemedicine is expected to expand with the specter of "Baby Boomers" approaching retirement, a trend that will dramatically increase the elderly population. "The elderly patients are more likely to have chronic conditions, which are typically more expensive to manage," Edwards said. "Therefore, an elderly population will need more home health monitoring."
Not everyone believes the aging population will be the primary driver of future healthcare costs. Donna Friedsam, associate director for health policy with the University of Wisconsin-Madison Population Health Institute, cited recent U.S. Congressional Budget Office and Office of Management and Budget analyses that suggest the aging population is not the only culprit.
In challenging the conventional wisdom, the Congressional Budget Office has issued a series of reports on the growth in healthcare costs. In one analysis, it notes that the aging of the population is frequently cited as the major factor contributing to the large projected increase in federal spending on Medicare and Medicaid, but asserts that aging accounts for only a modest fraction of projected growth.
According to the CBO, the main factor is the extent to which the increase in healthcare spending exceeds the growth of the economy. The CBO also indicates that gains from higher spending are not clear, but there is substantial evidence that more expensive care does not always mean higher-quality care. "Consequently, embedded in the country's fiscal challenge are opportunities to reduce costs without impairing health outcomes overall," the CBO stated.
The Office of Management and Budget goes a step further, saying the long-term fiscal challenge is "almost entirely unrelated" to demographics and Social Security, but it is mostly confined to inefficiencies in the private and public healthcare system - inefficiencies that concepts like home telehealth would address.
(Source: Wisconsin Technology Network News, April 2, 2008)
4/16/2008
HRSA has issued a Sources Sought/Market Survey to locate firms with the capability to develop a model infant audiology diagnostic protocol using telemedicine. This will help professionals provide diagnostic services in rural areas. Audiology as a profession has been slow to adopt telemedicine, but it is now becoming necessary and more feasible to use telemedicine since inexpensive interactive video systems are now available.
Preliminary research suggests that telemedicine models might prove to be effective for audiologists to use to deliver hearing services to locations where no services now exist. This is vital because diagnostic audiology needs to occur between the ages of one to three months after a baby fails to pass a follow-up screening. However, only half of the infants referred are generally evaluated due to the shortage of pediatric audiologists and equipment. Data shows that an infant with a significant hearing impairment who receives intervention by six months of age will perform significantly better in language development than the infant who is identified after six months of age.
The goal is to place diagnostic equipment in a spoke site of an existing telemedicine network. Audiologists at the hub site would then observe the correct use of the equipment, interpret the results, and interact with the families.
The methodology, once demonstrated could be spread through the National Center for Hearing Assessment and Management. NCHAM has a regional network of pediatric audiologists operating throughout the U.S.
This Sources Sought notice is for information and planning purposes only and is not a solicitation announcement for proposals. For more information please see the Sources Sought announcement posted on
www.fbo.gov on April 11, 2008.
(Source: Federal Telemedicine Update, April 15, 2008)
4/16/2008
Next-generation patient monitoring systems earned an estimated $3.9 billion dollars for manufacturers in 2007, and this market could more than double in five years, according to a recently released market research study.
The report,
High-Tech Patient Monitoring Systems, by the life sciences research firm Kalorama Information, covers the new generation of patient monitoring devices as well as data processing and EMR interface software that are crucial to these systems.
The report claims that an aging population and a shortage of healthcare workers have driven the development of systems that can monitor patients remotely, process data and even alert a healthcare worker if there is a problem.
The care of patients with chronic diseases, such as asthma, congestive heart failure and diabetes, eats up a great deal of U.S. healthcare spending, but these conditions are also among those most amenable to patient monitoring. The Kalorama report notes that better patient monitoring systems mean patients can leave the hospital sooner, thus reducing costs.
Given this demand, device manufacturers like Honeywell, GE and Abbott have added wireless communication, data processing and Web interfacing features. These features enable the systems to gather, sort and drop data into a patient's electronic medical record for future review.
Kalorama says the most useful patient monitoring systems are "intelligent" ones that can read the data based on pre-programmed algorithms for a patient's specific condition and automatically report to a healthcare worker or physician when measurements are abnormal.
"Data is important, but if your system only gathers data, you are just increasing the burden on the workers who have to then interpret that data," said Melissa Elder, an analyst for Kalorama Information. "The smart PM systems know that when a pre-defined number is hit, it's time to call the doctor."
Elder said some systems can even take patient care a step further, incorporating built-in video and audio interfaces so that the patient and physician can speak.
(Source: Healthcare IT News, April 11, 2008)
The US-medical device manufacturer
Medtronic is planning to extend its presence as a telemedicine provider in Europe the company recently announced.
"The wave of telemedicine is now hitting the medical devices industry, and Medtronic will take a lead", said Peter Steinmann, vice president for distance monitoring at Medtronic Western Europe.
CareLink was introduced in Europe in 2007, but so far in pilot projects only. This will change in 2008, according to Medtronic's CEO Bill Hawkins. He recently said 2008 will be the year for Medtronic to get into Europe with its telemedicine solutions on a bigger scale: "We will launch an entire series of new products in Europe in 2008 that will all be tailored for remote monitoring."
The company presented its telemedicine plans at its European headquarters in Tolochenaz, Switzerland, on 1 April. At the heart of the company's telemedicine initiative is the CareLink platform, an internet-based solution for remote medical device monitoring and remote patient monitoring.
"In 2007 the number of CareLink users has more than doubled to a total of 230,000, mostly in the US", said Medtronic CEO Bill Hawkins.
CareLink has been available in the US since 2004. The platform is currently used for the remote monitoring of patients with implantable defibrillators (ICD) or pacemakers and for web-based continuous blood glucose-monitoring. In both cases, the physician can check patient or device data remotely via the internet.
The new product line-up includes new generation ICD- and pacemaker systems that are capable of wireless data transfer without the need of an antenna to collect the data.
The devices will also have an automatic alert function for pulmonary edema, which Medtronic refers to as 'OptiVol'. It measures electrical currents in the thorax and generates an e-mail or short message-alert for the physician in case a pulmonary edema is developing in the patient.
Wireless glucose sensors for diabetics and insulin pumps are also made compatible with the CareLink telemedicine platform so that a fully automatic transmission of blood glucose levels into the internet platform is possible.
Medtronic's patient management director for Western Europe, Keyne Monson, said that the main obstacle for a quick implementation of CareLink-based telemonitoring in Europe is reimbursement. "There is the question of who pays for the patient's equipment for data transmission. But even if Medtronic decided to give this away for free, there is still the issue of who pays for the remote diagnostic procedure."
Medtronic's vice president and deputy general counsel, Herb Riband, made it clear the huge differences in the reimbursement in different European countries. "Germany, the UK, and Portugal are heading the crowd. They do cover remote device checks for cardiac implants already or will do so soon. In general, though, there is a lack of incentives to use remote monitoring throughout Europe."
In France, for example, there is now a two-year-assessment of remote versus in-office device checks in 1600 patients from 30 cardiac centres underway. "The goal is to make the new technology broadly available in 2010. This is very straightforward, but, frankly, it will take more than two years to have the results," said Riband.
He added that the picture was also of cautious progress in Italy and Sweden: "In Italy, there is a government-backed project in the region of Lombardia, and in Sweden, too, there is a government-backed initiative." Most other European countries are far behind that, said Riband.
(Source: eHealth Europe, April 2, 2008)
REACH Call, a provider of web-based telehealth solutions, has added a general telemedicine module to its service offering. This new general telemedicine module facilitates faster treatment for patients in rural areas by connecting rural ER physicians with specialists who can remotely diagnose, evaluate and recommend treatment for a variety of medical conditions from anywhere in the world using a web browser.
"Our general telemedicine module enables a rural ER physician to remotely consult over the Internet with specialists in other hospitals, allowing them to virtually treat any condition—from a skin rash or burn to a broken bone or an aneurism—and everything in between," said Sandeep Agate, REACH President & CEO.
REACH developed the general telemedicine module in response to demand from current customers—hospitals that already use the company's remote stroke diagnosis and evaluation service. This 100 percent web-based service originally was designed to facilitate faster treatment for stroke patients in rural areas by enabling neurologists to remotely diagnose, evaluate and recommend treatment from anywhere in the world. These same hospitals realized the value of web-based telemedicine and asked REACH Call to design similar modules for other medical conditions.
"This move into general telemedicine expands REACH Call from a very specific use—stroke evaluation—to a very generic competency," Agate said. "Now that we have filled each end of the spectrum, there is a very large gap between our service capabilities and those of our competitors."
More than 50 hospitals have deployed REACH Call in a "Hub and Spoke" design, where a larger "Hub Hospital" provides physician-consulting services to smaller "Spoke Hospitals." Several Spokes are connected to the Hub and leverage the expertise of specialists at the Hub to provide care for patients in their own ERs. These Spokes use a mobile workstation to initiate a consultation request with a physician affiliated with the Hub. The workstation is an assembly of non-proprietary, off-the-shelf components including a laptop, LCD monitor, keyboard, mouse, and a camera. It is battery powered and is equipped with a wireless bridge for maximum mobility within an ER. Spoke Hospital ER staff can use the Web browser running on the laptop embedded in the workstation to register a patient and request a consult with a remote physician affiliated with the Hub.
"Although REACH started out in stroke care, we originally designed our platform for extensibility so that customers would not have to upgrade hardware or spend capital to increase their telemedicine capabilities in the future," Agate said. "Our existing customers can use the same components to expand their telemedicine offerings into other areas."
Since REACH is a 100 percent Web-based turnkey service, there is no hardware or software installed in the Hub Hospital. The consulting physician can use any laptop or PC, a standard off-the-shelf Web cam, and a broadband Internet connection to communicate with the Spoke and evaluate the patient. The physician, who can conduct the consultation from anywhere in the world with a broadband Internet connection, has complete control over the two-way audio and video communication and can view all patient data and DICOM images, such as CT Scans or X-rays, to efficiently and effectively evaluate the patient and recommend treatment.
(Source: REACH Call Press Release, April 3, 2008)
4/16/2008
The Charité University Hospital, part of Berlin University in Berlin,
Germany, has opened a center for cardiovascular telemedicine that will carry out research and provide services to patients. It is the first academic telemedicine center in Germany to support a full 24/7 call-center service.
Until now German telemedicine projects have mainly used the commercial call-centers of telemedicine providers, such as PHTS or Vitaphone. The new center will carry out clinical research on telemedicine for cardiovascular patients, and act as a telemedicine call-center for patients on home monitoring programs.
Located within one of the hospital's main buildings, the center initially has 15 employees, including five medical doctors.
"Charité is planning to become a leading academic player in the field of telemedicine", said the managing director of the university hospital, Detlev Ganten. e said that the hospital was already engaged in international telemedicine consultations, for example as the academic centre of excellence for the telepathology network of the International Union Against Cancer, and as a telemedicine partner of Shanghai University Hospital. To open its own call centre was the next logical step, said Ganten.
The first big project at the new centre began a few weeks ago with the 'Partnership for the Heart' project, a clinical study on telemonitoring for patients with chronic heart failure. "We managed to recruit 600 patients in three months", said Friedrich Köhler, a cardiologist and the medical director of the center.
The 'Partnership for the Heart' project aims to show a reduction in mortality rates and hospital admissions for heart failure patients, due to the assistance of telemedicine.
"Unlike other telemedicine studies in heart failure, this one is designed according to the criteria for an FDA approval. If successful, telemedicine in heart failure patients will finally be reimbursed on a regular basis within the German public insurance system", said Köhler. This would be a major breakthrough, since it would mean that every doctor with heart failure patients could issue a "prescription for telemedicine".
Long-term funding for the Charité telemedicine centers yet to be secured. Currently the center has 6m Euro, supplied by the ministry of economy and the three industrial backers of the 'Partnership for the Heart' project: ICW, Robert Bosch, and Aipermon. The money will last until 2009, when the 'Partnership for the Heart' project ends.
"Afterwards the centre will raise money from different sources", deputy-group leader Stephanie Lücke told E-Health Europe.
As the center will function as a call-centert can generate income from health insurance companies. On top of this, further clinical and technical research projects are in the pipeline, which would attract funding from industry, politics or other donors. Finally, Charité Hospital itself is paying the doctors and providing the location.
"One of the next projects will be a clinical study for telemonitoring in pregnant women with pre-eclampsia", said Köhler. These women need blood pressure and CTG monitoring. Using telemonitoring, most of this could be done at home with a neonatologist checking the data online.
Another field of interest is congenital heart disease. Effected children often need close monitoring in order to identify the best opportunity for a cardiac operation. Telemonitoring in diabetics, and in patients with arterial hypertension, is also on the agenda for the future.
(Source: eHealth Europe, April 9, 2008)
Doctors and nursing staff from several municipalities in
Greece - plus four specialists from the Athens Medical Centre - have been trained in the use of telemetric systems as part of an extension of the country's telemedicine program.
The municipalities are members of the Inter Municipality Health & Welfare Network OTA across Greece. The training course, organized and supported by Vodafone Greece, was conducted by instructors from Vidavo, following a pilot program in 2006.
As part of their training the medical teams were also given equipment used to record life signs and a PDA device. The equipment given to the doctors allows them to examine patients with chronic diseases.
For example they can now take a cardiograph or check respiratory function if asthma is suspected at any of the regional medical offices participating in the program and transfer those examinations to the Athens Medical Centre to a cardiology or pneumonology expert, who will examine them and send his opinion back in the same way.
Consequently, regional medical offices will now be able to offer specific specialist services in addition to primary health care. The Greek telemedicine system is based on mobile telecommunications technology and offers multiple benefits to all participants.
Patients can practice preventive medicine, while at the same time geographical limitations are abolished and the sense of security felt by patients is strengthened thanks to direct access to specialist doctors.
Doctors in the regions can better manage their patients since they can provide specialist health care services in remote areas where there is no direct access to a central hospital, while at the same time they also have the opportunity to communicate and work with the specialists from the Athens Medical Centre.
(Source: Vodafone Greece Press Release, March 28, 2008)
Dr Winston Davidson believes that if the Jamaican government can develop an effective system of health care at the community level, then this could significantly cut costs for
Jamaica. In addition, he says, over time, the administration will have to consider the use of technology and automated systems in the public health sector to further reduce costs.
Ruddy Spencer, the health minister, says s there will be further discussions with Cabinet in another two weeks to develop plans for the advancement of telemedicine technologies in the island.
Telemedicine allows for doctors to manage and monitor their patients from a geographical distance using audio, video or computer technology. It also enables doctors to collaborate on patient care, participate in diagnostic procedures and keep abreast of current practices.
"It basically involves a combination of information technology with the management of health information to allow for patient access at any time and any place," Dr Davidson, who heads the Telemedicine Research and Development Unit at the University of the West Indies, Mona, explained.
Dr Davidson says for primary health care to be effective, it must be based on several components which include maintaining a healthy lifestyle, protection against the risk of certain diseases such as malaria and early detection.
He also says the private sector will have to play a role in the development of the public health sector.
"You are going to give access to every individual to primary health-care facilities without cost and that is basic. But when you move now to a higher qualitative level at the hospital, you have to put in place the resources to not only maintain that quality, but to improve it and be part of a system of global delivery."
(Source: Jamaica Gleaner, March 31, 2008)
A one-year telemedicine pilot project launched in July 2007 connects hospitals in
Ethiopia with
India's leading cardiac institute in Hyderabad in an effort to boost health care in rural Ethiopian communities.
The $2.3 million project is part of a larger $135.6 million pan-African electronic network, a joint initiative between the African Union and India to improve Internet connections and communications.
The project uses fiber-optic technology to connect physicians at Black Lion Hospital in Addis Ababa, Ethiopia, with physicians at Care Group of Hospitals in Hyderabad, India. So far, Ethiopian physicians have used the system more than 50 times to consult with Indian doctors, according to Asfaw Atnafu, an Ethiopian physician.
The project also has linked Black Lion with Nekempte Hospital, which is 185 miles west of Addis Ababa. Care Group is in talks to expand the project into Nigeria and Libya.
Indian officials estimate that 100 African patients have benefited from the pan-African network, which is linked to 12 specialist hospitals in India. India plans to continue providing funding and training for five more years before handing over the project to African countries.
(Source: iHealth Beat, April 3, 2008)
Northern Ireland is racing ahead of the rest of the UK in the development of telehealth, said GPC Northern Ireland. But GPs fear it is increasing workload and is not evidence based.
Dr George O'Neil, of Eastern LMC, said $92 million USD was being spent monitoring long-term conditions. Northern Ireland's Department of Health, Social Services and Public Health (DHSSPS) has just established the European Centre for Connected Health (ECCH) to link telehealth systems across Europe.
It will roll out systems to monitor 5,000 patients at home in Northern Ireland in its first year. GPs at the Northern Ireland LMCs' conference said the process of reading print-outs from the night before was time-consuming and unresourced.
Others worried that eventually the worried that the well would be monitored at home too. GPC Northern Ireland chairman Dr Brian Dunn said that technology to monitor chronic illness at home was here whether GPs liked it or not.
'Either GPs get involved and develop it, or the trusts will,' he said.
(Source: Healthcare Republic, April 8, 2008)Premiere Issue of TeleHealth World Magazine Now Available as Free Download3/22/2008
TeleHealth World recently announced that their premiere Spring 2008 issue of is now available as a
free download [pdf]. Included in this issue, are feature articles on telehealth entering the mainstream, the business of telehealth, telecardiology cost savings and telehealth in pre-natal care.
TeleHealth World is a new print magazine serving the rapidly expanding fields of telehealth, telemedicine, and connected healthcare. It is a comprehensive news and analysis resource for healthcare providers and technology providers who are leading today’s revolution in remotely monitored and administered healthcare, medical treatment and fitness/wellness enhancement.
TeleHealth World helps professionals involved in telehealth, telemedicine and fitness/wellness keep abreast of the latest developments, innovations and market news, including new advancements and installations of telehealthcare and telemedicine systems. Learn how organizations are expanding their capabilities for remote diagnostics, patient monitoring, medical treatment, wellness programs and healthcare delivery.
Please visit
TeleHealth World website for more information including how to subscribe to the print version.
(Source: Telehealth World Press Release, March 20, 2008)
3/22/2008
A $15.5 million grant from the Federal Communications Commission to the Center for Telehealth and Cybermedicine Research at the Health Sciences Center will be used to design, build, operate and evaluate a
Southwest Telehealth Access Grid, a broadband network largely serving rural areas that typically lack such technology. The grant to increase the bandwidth will be a boon to New Mexico, said Gary Bauerschmidt, UNM's director for information technology services and co-chairman of the network design and modeling committee.
The grid of telehealth networks will support rural systems and connections to more than 500 sites, primarily in New Mexico and Arizona, along with several Indian Health Service sites in Colorado, California, Nevada, Texas and Utah.
"What this really means is a network of networks, a virtual electronic highway that allows you as a patient to access health care at a distance," Dr. Dale Alverson, medical director of the Center for Telehealth at the University of New Mexico's Health Sciences Center said.
Eventually, telemedicine could make virtual house calls, he said. With an aging population and a related increase in chronic disease, "the shift is more to getting the care to the patient where they live," Alverson said.
"The idea with the FCC is not only to support our region, but eventually to connect these regions for a national telehealth network," Alverson said. The Southwest initiative was one of 69 nationwide the FCC funded.
A grid would not only improve the network for patient care and training health professionals, it would also allow people to switch into emergency mode for disasters or emergencies such as a flu pandemic, he said.
Leonard Thomas, chief medical officer for the Albuquerque area Indian Health Service IHS) - which serves 86,000 largely rural residents from southern Colorado to El Paso, Texas - said the IHS is maxing out its current infrastructure for telemedicine.
A grid would let the Albuquerque area IHS offer more than the teleradiology, teleopthlamology and telepsychology it now has. There are about 60 telemedicine services the network could make available, Thomas said.
"I believe, in the end, telehealth will be part of doing business in the health field, just like we use the telephone," said Alverson, medical director of the Center for Telehealth at the University of New Mexico's Health Sciences Center. "It won't be looked at as something unique or special; it's just what we do. ... Just as for many of us now it's second nature to use the Internet and the Web for health information."
(Source: Associate Press, march 19, 2008)
Officials from Shriners Hospitals for Children in Spokane,
Washington, and the Deering Clinic in Billings,
Montana recently outlined plans for a telemedicine link so kids in Montana can get some of their consultations and follow-ups in Billings.
"The technology will allow patients to receive care more quickly and with fewer hard-to-travel trips," said Shriner Hal Slavens.
The Shriners Hospital currently holds outreach and screening clinics at the Deering Clinic, flying in a group of staff and doctors from Spokane to work with local staff.
Using the telemedicine plan, less travel would be required. Relying on technology would save travel money, both for health care providers and the financial assistance the Shrine provides to families in need of care. That's not the greatest savings, said Potentate Larry Tipton: It saves children, who are sometimes in pain, and their families from travel that can be arduous.
"Montana is lucky to have as many Shriners as it does because it means more children get care," said Gene Raynaud, administrator of the Spokane hospital. Sometimes that care begins when a Shriner sees a child in need and suggests that the family seek a medical consultation.
"The Spokane hospitals' board of governors selected Billings to be the first site for telemedicine clinics," Raynaud said.
Perry Howell, the chief financial officer at Deering, said that with the large area the clinic serves, telemedicine is a key part of its services. "Telemedicine, especially for Eastern Montana, is going to have to be the solution because there's no other way to do it," he said.
In addition to serving patients, Raynaud said he would like the telemedicine link to be available for surgeons and specialists in Spokane to give seminars to care providers in Billings. Although a specific startup date has not been set, Raynaud said he'd like to see it up and running this year.
(Source: Billings Gazette, March 22, 2008)
Arizona's largest health-care provider, Banner Health Systems, has installed cameras and monitoring devices that allow doctors and nurses to remotely watch over the most critically ill patients at nine hospitals in
Arizona and
Colorado.
"We are there as a second set of eyes and ears," says Kate Trenary, a former nurse and director of Banner's remote ICU system.
The telemedicine center, located at Banner's Desert Medical Center in Mesa, is a back-up system of sorts that aims to help doctors and nurses who are at the hospitals that treat critical patients.
Touted as the first such system used by a hospital in the Southwest, Banner named its remote program iCare ICU. Within two years, every Banner hospital will be equipped with the cameras and data-transmission equipment that allow doctors and nurses to help take care of patients from afar.
Banner officials say the remote system does not affect staffing levels at hospitals. Rather, its role is to support the hands-on work that hospital doctors and nurses perform. But not everybody is convinced.
The remote center resembles an air-traffic controller's room more than it does a wing of a hospital. At the center, nurses and doctors watch over a bank of screens that track patients' vital signs such as blood pressure or pulse. When the computer screen flicks on with color-coded alerts, the nurses can investigate further by checking the patient's vital signs, calling the patient's nurse or doctor at the hospital or turning on the camera and talking to the patient directly. They even have remote access to a patient's medical records or X-rays.
One factor behind Banner's decision to sink more than $8 million in the center is to ensure all emergency rooms have access to physicians who are experts in critical care.
Banner began the remote monitoring system, in part, due to a shortage of critical-care physicians. Not all community hospitals can recruit or hire specialty doctors such as "intensivists" and critical care specialists that improve emergency room care.
Sutter Health operates a similar system in the San Francisco Bay area and Sacramento. Several East Coast hospital groups use the technology, too.
The physician-shortage problem is especially acute during night shifts.
"The need is always greater at night," says Donna Long, a Banner iCare physician who works the overnight shift. "That is where a hospital's resources are lacking."
The iCare center employs specialty physicians from 7 p.m. to 7 a.m. when such doctors are least likely to be on duty at the hospital. The iCare center does not have physicians on duty during the day, but Banner eventually plans to have a physician on duty 24/7.
Long admits that the job of treating a patient remotely can be difficult. One challenge is gaining the trust of the hospital physician who may not know the iCare physician.
"There is always a bit of reluctance to turn you patient over to somebody you don't even know," Long said. "You have to prove yourself over time with either phone conversations or direct conversations over the camera."
Still, Long said the remote physician, who can write orders and advise nurses, can treat a patient before a hospital physician has time to do so. That quick intervention can be the difference between life and death for a patient whose heart has stopped or brain is not functioning.
Physicians such as Long are anxious to quantify the difference the remote center has made in patients lives.
Banner Health offers some measurements of the program's success.
During the remote system's first year of operations, participating hospitals treated 6,183 patients and reported mortality rates that were 42 percent better compared with industry standards, according to Banner.
Patients also spent nearly 2,000 fewer days in intensive care than industry standards.
Those figures are based on a hospital industry measurement, called Apache (Acute Physiology and Chronic Health Evaluation), that predicts outcomes of patients under similar circumstances.
"The data shows we have fewer patients dying with Banner," Trenary says.
Other reports suggest that such remote monitoring systems can save lives and money.
In 2001, Johns Hopkins University study found that linking intensivists to hospitals remotely saved lives, reduced patients' complications and decreased average length of hospital stays. A 2004 report in Critical Care Medicine also said such systems help save lives and shorten hospital stays.
Other examples are more mundane.
Julie Edwards, a Banner iCare registered nurse, said busy floor nurses routinely request her help monitoring patients. Edwards also contacts the floor nurse when she notices a patient with low blood pressure or a tangled IV.
Still, the remote-monitoring program is not without critics.
The California Nurses Association, which advocates minimum nurse-to-patient staffing levels, said that hospitals such as Banner should spend money on nurses and doctors instead of technology. The California Nurses Association backs a bill in the Arizona house that would require minimum nurse staffing ratios for hospitals. Intensive care units would require one nurse for every two patients.
"They should not spend money on technology and spend the money on more registered nurses at the bedside, especially in ICU," said Malinda Markowitz, president of the California Nurses Association's national organizing committee. "Nurses have to be there at the bedside to use the smell, the touch the feel that you can't get remotely."
Banner representatives stress that the technology does not replace the function of on-site nurses and doctors.
"For nurses and physicians who utilize this, they love it," Trenary said. "We help them. We help the nurses that can't physically be in two places at once."
(Source: Arizona Republic, March 22, 2008)
Idaho State University and The Hospital Cooperative are collaborating to improve the delivery of health education and health care in southeastern
Idaho. With $98,000 that Idaho State University received from the Rural Utilities Service of the U.S. Department of Agriculture, ISU Educational Technology Services and The Hospital Cooperative will be able to expand the Cooperative Telehealth Network to four or more rural communities.
The Hospital Cooperative, headquartered in Pocatello, is a network of 13 not-for-profit hospitals in southeastern Idaho and western Wyoming. With public and private support, THC operates the Cooperative Telehealth Network to deliver educational and clinical services to rural areas using state-of-the-art telenetworking technologies.
Plans include installing sophisticated video systems for education and telemedicine in local hospitals, and using this equipment to enhance access to classes and to health care.
Blake Beck, ISU Educational Technology Services manager, termed the opportunity "a win-win situation" for the university and the cooperative.
"The opportunity to utilize Idaho State University grant funds to assist The Hospital Cooperative in their efforts to provide telehealth services to rural southeastern Idaho strengthens our relationship with THC and demonstrates ISU’s commitment to further our health education mission," Beck said.
"This collaboration with Idaho State University will help us deliver telepsychiatry services to four or five communities where there are no psychiatrists," said Jon Smith, executive director of The Hospital Cooperative. "We also hope to collaborate with ISU in delivering educational programs to these areas."
3/22/2008
FasPsych, a provider of provides professional telemedicine services, recently launched one of the first open telepsychiatry networks designed to serve clients regardless of where they are located or with which agency they are affiliated.
Many existing telepsychiatry networks were developed as internal solutions for one local or regional entity. FasPsych is different in that their system, rather than being built to singular access to care issues, was designed to serve multiple states and even other countries.
FasPsych's model allows any individual practitioner, group practice, hospital, company or agency, from a rural mental health clinic to a busy urban clinic, to obtain psychiatric services via video teleconferencing technology. After only being in business for 3 months, FasPsych is successfully delivering services to several rural Arizona mental health clinics. FasPsych will soon also be delivering services to: - Rural Emergency Rooms
- Nursing Homes
- Jails and Prisons
- Military and their families
- Private patients in their homes
- Mental Health Clinics
- Native American Tribes
FasPsych has hired a group of highly talented doctors, nurse practitioners and a psychologist to ensure services can be delivered in areas where they were previously unable to access care. Services can also be provided in Spanish.
(Souce: FasPsych Press Releas, March 20, 2008)
AMD Telemedicine, a telemedicine equipment provider, recently announced that it had identified telemedicine eductional initiatives -- in the form of courses, clinical programs, and affiliated hospital networks -- affiliated with 23 U.S. colleges, universities and schools of medicine.
"Telemedicine initiatives that connect hospitals and learning institutions -- both those we've spotlighted and others that we were not able to identify as yet -- help to educate not only physicians, nurses and nurse practitioners, but also patients," said Steven Normandin, president of AMD. "Our online inquiries have netted some excellent examples of real telehealth/telemedicine educational programs in action. We hope to expand this list regularly to include more educational telemedicine projects going on in the U.S. and around the world."
Through this informal, online research project, AMD learned that within U.S. colleges and universities found on the Web, 14.6% offer telemedicine/telehealth courses; and 7% of those same U.S. colleges and universities include telemedicine/telehealth clinics, centers, programs, institutes, etc.
The 23 schools that make up that 14.6% include:- East Carolina University, Brody School of Medicine
- Howard University, College of Medicine
- Loma Linda University
- Medical College of Georgia
- Mount Aloysius College
- Mount Sinai, School of Medicine
- Oklahoma State University
- Southern Illinois University, School of Medicine
- Texas Tech University, Center for Telemedicine
- The University of Hawaii, Telehealth Research Institute
- The University of Vermont
- UCDavis School of Medicine
- University of Arizona, Arizona Telemedicine Program
- University of Colorado at Denver
- University of Florida
- University of Kansas, Center for Telemedicine and Telehealth
- University of Miami, Miller School of Medicine
- University of Missouri, Columbia School of Medicine
- University of Rochester, School of Medicine and Dentistry
- University of Tennessee, Health Science Center
- University of Texas Medical Branch, School of Nursing
- University of Utah, Health Sciences Center
- University of Virginia, Office of Telemedicine
Each school offers a different set of telemedicine/telehealth programs.
(Source: AMD Telemedicine Press Release, March 19, 2008)
Since the first, relatively rudimentary incarnations of electronic intensive care units (eICUs) were installed in U.S. hospitals just seven years ago, the technology and acceptance level have grown. As there is with most fundamental shifts in the way things are done, there was resistance to remote monitoring technology when it first became available around the turn of the century. Providers, patients and patients' family members were wary. But now, more than 200 hospitals in 28 states now use eICU technology.
Rising costs and a shortage of intensivists (critical care specialists) and critical care nurses have made it difficult for hospitals to staff ICUs adequately. Electronically monitoring patients from a central location allows one intensivist to care for many more patients than he or she would be able to in a traditional ICU setting. Doctors and nurses watch video displays and a set of monitors for medications, blood pressure, heart rate, oxygen levels and respiratory rate.
Although the technology has found its way into only a small percentage of U.S. hospitals (some estimate 12%-15%), those that have and use it are already looking around the next corner.
One company -- Visicu, based in Baltimore -- dominates the market for designing and installing eICUs in this country. It's now poised to deliver its patented technologies and processes to the rest of the world. Founded by two Johns Hopkins intensivists in 1998, Visicu was acquired this year by Royal Philips Electronics of the Netherlands in a deal reportedly worth more than $430 million.
The company's success is attributed to legal, as well as medical, acumen. When Visicu's founders Michael Breslow and Brian Rosenfeld, who managed adult critical care at Johns Hopkins Hospital for more than 25 years, began devising software and electronic systems to monitor patients, they took great care with the wording of patents.
"Visicu did a really good job in developing a very broad, robust method patent for their technology," Groves said.
Other companies have challenged different aspects of Visicu's patents, but so far the company is virtually alone in the marketplace. Visicu's dominance leads some industry insiders to worry that competitive pricing and new applications for the technology may be slower to develop. But hospitals where Visicu systems are in place are generally satisfied.
"They've been a very good steward of the technology," Groves said. "They solicit input and they listen and react very well.
"Obviously, Phillips is pretty bullish on them down the road," Groves added, "and I wouldn't be surprised to see the company start looking at other parts of the world."
(Source: iHealth Beat, March 12, 2008)
Healthanywhere, a Division of IgeaCare Systems, recently announced they have partnered with Canada's largest independently owned home care service provider, We Care Health Services (WCHS), to deliver a telehealth system that provides a comprehensive menu of services for those with chronic diseases and their caregivers.
WCHS will employ a combination of easy-to-use technology and traditional home care to monitor health and promote independence in one's home and integrates health promotion, symptom management and disease prevention to help clients stay on the targets set with their doctors. Patients with chronic diseases such as COPD, Coronary Artery Disease, post-coronary/stroke, arthritis, cancer, mental health/behavior disorders, diabetes and kidney or liver disorders will benefit from this program.
Healthanywhere is not meant to replace nursing visits, but it can significantly reduce the number of visits required, while the monitoring function has been shown to decrease the number of ER visits and hospital admittances for people using the system. As clients and their families learn more about their disease, their ability to identify problems earlier and to react in a proactive way promotes their independence and improves their quality of life. As clients enjoy daily monitoring of their condition, their peace of mind is increased, they do not feel they are "home alone" in a medical system that is overwhelmed with the demands placed on it.
(Source: IgeaCare Systems Press Release, March 7, 2008)
A new report by Global Industry Analysts, Inc predicts that the global market for PACS and teleradiology systems will reach US$4.4 billion by 2010. Factors such as increasing adoption of PACS across imaging centers and small hospitals, advancing communication and enterprise technologies, and ability of PACS systems to be integrated with other imaging modalities are expected to bolster the demand scenario.
Picture Archiving and Communication System or PACS is a technology centered upon leveraging computers and data communication technologies to collect, store, process, retrieve and disperse medical imaging data to hospitals and affiliated clinics geographically spread across the world. The technology is currently metamorphosing into a broad commercial application.
Despite all advantages and benefits offered by PACS and teleradiology, the transition to a digital information environment is fraught with various challenges and issues such as high cost of purchasing, installing and implementing a PACS system and uncertainty over security of patient data. Teleradiology represents one of the most advanced and widely reported application areas of telemedicine. Telemedicine is progressively gaining momentum as the medical society seeks to leverage telecommunications as a medium to enhance administration and performance of medicine.
According to the report, the United States, Europe, and Japan dominate the global PACS and teleradiology systems market, capturing more than 88% share of sales in 2006, as stated by Global Industry Analysts, Inc. PACS Systems represent the leading segment, accounting for about 64% share of the worldwide sales in 2007. In terms of PACS acceptance in diagnostic imaging, United States leads the world market.
The report, entitled "PACS and Teleradiology Systems: A Global Strategic Business Report" published by Global Industry Analysts, Inc., covers major market dynamics, trends, issues, and competition pertaining to the market. Analytical estimates and projections on market size have been presented in terms of dollar sales over the years 2000 through 2010, while long-term projections are provided over the time period 2011-2015.
(Source: Global Industry Analysts Press Release, March 15, 2008)
3/1/2008
A position paper validating the importance of telemedicine and the role of telephonic medical consults to improve access, lower costs and enhance the quality of healthcare was recently released by The Center for Health Transformation (CHT). The paper, entitled "Telephone Medical Consults Answer the Call for Accessible, Affordable and Convenient Healthcare," is available for free download from the CHT website [pdf].
Co-authored by Newt Gingrich, former Speaker of the U.S. House of Representatives and founder of CHT; Rick Boxer, M.D., healthcare policy analyst; and Byron Brooks, M.D., telemedicine expert, the white paper articulates the merits of telephonic communications between physicians and patients and substantiates the benefits for consumers, health plans, employers, government and other payers.
While physicians have relied upon telephone consults for decades as a means of connecting with patients, only recently has the concept been implemented on a national basis. Today, this model addresses illnesses that arise quickly and tend to run a brief course, typically 5-10 days. This approach is particularly effective for acute, routine, episodic, self-limited and minor illnesses. With the use of a freely available portable medical record, these telephonic patient encounters support continuity of patient care and the evolution of a patient's medical home.
"Telemedicine will play an increasingly central role in getting the right care at the right time to individuals and families. Federal, state, and local governments must facilitate the spread of this important option by tearing down barriers to its use," said Speaker Newt Gingrich.
TelaDoc Medical Services, which currently serves more than 1.2 million members, was used as a model for understanding the concept of telephonic medical consults. Success metrics for the telephonic medical consult model include: - Rapid access to a primary care physician via telephone.
- Telephonic cross coverage to handle acute, episodic, self-limited and minor illnesses
- Fully portable Electronic Health Record (EHR) for both patients and physicians,
- with fully CCR-compliant data structure.
- Availability to patients with pre-existing conditions
- Affordability and price transparency
The telephone cross-coverage model, whereby physicians "cover" for one another via the telephone on a round-the-clock basis, emerges as one of the best examples of the power of telemedicine to make medical care more accessible and convenient to patients while maintaining quality and reducing costs. It is a straightforward approach, one that relies upon simple technology -- the telephone: a mobile ubiquitous staple in nearly every household or office in both urban and rural communities and one that is familiar, easy-to-use, and can be widely utilized without special training or orientation.
Dr. Brooks stated, "It is my hope that this paper helps healthcare policy makers and corporate health care underwriters to understand what more than a million Americans and their physicians have come to know: telemedicine physician consults, in general, and telephonic physician consultations, in particular, are a valuable and needed addition to our strained healthcare delivery system."
(Source: Center for Health Transformation Press Release, February 29, 2008)
