4/30/2009
Unable to send stroke specialists to every emergency room, a growing number of medical centers that specialize in stroke are bringing their expertise to patients through telemedicine.
"People who have strokes in isolated areas are pretty much dead in the water. You need to give them a lifeline to stroke centers," said Dr. L. Nelson Hopkins III, chief of neurosurgery at Kaleida Health and chairman of neurosurgery at the University at Buffalo.
Based at Millard Fillmore Hospital, Hopkins leads the most advanced stroke telemedicine system in New York State, with connections to 10 smaller hospitals in the region.
Telemedicine isn't new, but applying it to stroke is.
Early evidence from Buffalo and elsewhere suggests that telemedicine links improve the chances that patients will survive a stroke and avoid paralysis and other major problems.
Carney believes that the telemedicine link played a part in her getting treated quickly enough to avoid devastating brain damage.
"I was eventually able to walk out of the hospital and am still able to speak," said Carney, whose left arm remains paralyzed.
New York started a telemedicine initiative in 2006 to address the lack of neurologists and neurosurgeons in rural areas. The program is modeled after a system at the Medical College of Georgia that uses a technology called REACH, or Remote Evaluation of Acute Ischemic Stroke, to establish connections between hospitals and evaluate patients' risks.
"The technology gives smaller hospitals access to neurologists, and can be used for other services like psychiatry and trauma," said Dr. John Morley, medical director in the state's office of health systems management.
Millard Fillmore, a state-designated stroke center, acts like a hub to 10 spoke hospitals, including Niagara Falls Memorial, Brooks Memorial in Dunkirk, Olean General, Medina Memorial and Wyoming County Memorial.
Other REACH systems in New York operate in Syracuse, Rochester and Cooperstown. In addition, the Catholic Health System last year established a telemedicine link between its stroke center hospitals and Mount St. Mary's Hospital in Lewiston.
"Telemedicine allows us to provide a higher level of care wherever the patients show up," said Holly C. Bowser, vice president of neurosciences at the Catholic Health System.
In many instances, patients who might have suffered a stroke first show up in smaller hospitals and then often get transferred to stroke centers too late to be treated with tPA, a clot-busting drug that stops the progression of a stroke. The drug must be given within three hours after symptoms start.
The faster a patient receives treatment the less chance that brain cells will die.
Carney, an assistant women's basketball coach at Geneseo State College at the time of her stroke last year, arrived at Olean General's emergency room in time to get tPA. But the drug, which does not work in every patient, didn't solve her problem.
Based on the telemedicine evaluation, she was quickly transferred to Millard Fillmore, which specializes in procedures to reopen blocked blood vessels. Doctors there inserted a tiny tubelike device called a stent in her brain to restore blood flow through a damaged artery.
"I'm a poster child for telemedicine," said Carney, who hopes to return to coaching if she regains movement in her arm with therapy. "There are so few stroke specialists in [Cattaraugus County]. It's really important to be able to get rapid access to that level of care."
Telemedicine for stroke remains a work in progress. It costs hospitals here about $25,000 for a three-year contract with Millard Fillmore. That may seem like a relatively minor amount, but it is a challenge for smaller facilities that may question whether telemedicine is that much more valuable than having emergency room doctors consult with stroke specialists by phone.
There are no standard national guidelines yet for stroke telemedicine. There is little research on its effectiveness, although studies indicate that the technology is worth pursuing.
In addition, private health insurance companies have yet to create separate reimbursements for telemedicine that can cover the cost of equipment and technical support.
"We believe telemedicine is cost-effective for stroke, but we also need to do the research to show it. We see many more patients getting tPA, and that's more cost-effective than caring for people who've suffered a stroke," said Dr. Bart M. Demaerschalk, a Phoenix neurologist who reviewed the state of the field in a recent issue of Mayo Clinic Proceedings.
Hopkins said that one of the biggest benefits of the program is that it is increasing awareness among patients and emergency room personnel about stroke and its treatments.
But he also argues for a reevaluation of the state's stroke center designation, which New York has given to 114 hospitals, saying the current practice of taking suspected stroke patients to the nearest stroke center doesn't always make sense. Instead, he advocates a higher designation for hospitals that can provide newer, interventions round-the-clock to restore blood flow in the brain.
With growing awareness of stroke, Hopkins said, there are more patients who are candidates for the interventions, and those patients should be transferred to hospitals that can provide the latest therapies in a timely manner.
(Source: Buffalo News, April 21, 2009)4/30/2009
The Federal Communications Commission (FCC) recently announced the approval of $35.6 million in funding under its Rural Health Care Pilot Program (RHCPP) for the build-out of five broadband telehealth networks that will link hospitals regionally in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Carolina, South Dakota, Wisconsin, and Wyoming. In addition, $10.4 million in funding has been approved for the design of a telehealth project in Alaska. Collectively, these projects are eligible to receive $46 million in reimbursement for the engineering and construction of their regional telehealth networks.
The FCC established the $417 million RHCPP to increase patient access to care via telemedicine and support the transfer of electronic medical records, which will improve the quality of care for patients. Nationwide, 67 projects are eligible to receive RHCPP funding for telehealth networks serving 6,000 health care facilities in 42 states and three U.S. territories, using broadband technology to bring state-of the-art medical practices to isolated rural communities. At this time, 29 of these projects have developed or posted requests for proposals to select vendors to build out their broadband networks, while the remaining projects are preparing their requests for proposals as part of the competitive bidding process.
"I am pleased with the progress that these rural health care initiatives are making to develop telemedicine programs, build highways for electronic medical records and, overall, increase patient access to health care in the regions they serve," Acting Chairman Michael J. Copps said. "There is great potential to improve health care for those communities that currently have limited access to primary, specialty and preventive care; as well as to enhance public safety by connecting health care providers, public health officials and first responders to these networks so that they can share crucial data during emergencies."
The following is an update on specific RHCPP projects:
- Health Information Exchange of Montana ($13.6 million) - In an area with no connections to Internet2 or National Lambda Rail - nationwide dedicated Internet backbones - a new fiber network will connect health care providers in Montana to enable distance consultation, electronic record keeping and exchange, disaster readiness, clinical research, and distance education services.
- Palmetto State Providers Network ($7.9 million) - This project will connect health care providers to a fiber optic backbone to enhance simulation training, remote intensive care unit monitoring, and medical education programs across South Carolina.
- Iowa Health System ($7.8 million) - This project will use new network connections to link health care providers in Iowa to an existing statewide, dedicated, broadband healthcare network, Internet2, and National LambdaRail.
- Heartland Unified Broadband Network ($4.7 million) - This project is expanding and enhancing an existing network to increase the use and quality of teleradiology and increase distance education activities throughout Iowa, Minnesota, Nebraska, North Dakota, South Dakota, and Wyoming.
- Rural Wisconsin Health Cooperative ($1.6 million) - This project has augmented an existing shared electronic health records project that will provide health care providers in Wisconsin with access to redundant connectivity and data centers, as well as higher speeds that will range from 10 to 100 Mbps.
- Alaska Native Tribal Health Consortium ($10.4 million) - The consortium's network, which will serve primarily rural health care practitioners, will unify and increase the capacity of disparate healthcare networks throughout Alaska, allowing them to connect with urban health centers and access services in the lower 48 states.
(Source: FCC Press Release, April 17, 2009)
4/30/2009
In a new study funded by NIH, educators overwhelmingly embrace
Behavior Imaging technology as a telemedicine tool for more effectively treating children with autism. Dr. Uwe Reischel, M.D., Ph.D, of Boise State University coordinated a study that examined not only the efficacy of "B.I. Capture" (a behavior imaging tool that captures and stores behavioral events via remote control video) in treating students with autism, but also looked at how easy it is for teachers and behavior specialists to use the technology.
"We are finding that autism educators are receptive to using telemedicine and specifically B.I. than we had originally expected," noted Reischl. "This is especially so for participants who not only want to use it for behavior analysis, but who also see it as a useful tool for assessing student skills, giving or receiving consultation, and for training students and staff."
Behavior Imaging was initially developed by the Georgia Institute of Technology and is now marketed by Caring Technologies/TalkAutism in Boise, ID. The system is able to capture on video, a child's behavioral episodes in educational, clinical, and home environments. Behavioral data is captured on video and then the video is used to characterize recognized aspects of behavior to assist in the diagnosis, treatment, and research of autism. The video can be viewed, annotated, and stored online, so that behavioral experts can guide students progress from anywhere in the world.
An earlier phase of the study demonstrated that the technology enabled a 43% reduction in errors when collecting data for the Functional Behavior Assessment program. Now in addition to more effective clinical diagnoses and treatment, behavior imaging can help qualified practitioners save time and money by not always observing autistic behavior in people in person.
"B.I Care" is another platform now used by professionals to diagnose, evaluate, treat, train, and provide remote consultation for autism, TBI, PTSD, and other conditions. The new system B.I. Care will be unveiled and exhibited at the ATA Annual Meeting in Las Vegas and complements B.I Capture.
For more information go to www.bicapture.
(Source: Federal Telemedicine News, April 22, 2009)
Wireless Cardiac telehealth systems are not only advancing care, they're turning into marketing tools that companies can use to sell surgeons on their pacemakers and other implanted cardiac devices (ICDs). The pitch? Home-monitored patients should have fewer health problems, but only those with compatible implants can sign up for each provider's service.
Medtronic dominates the cardiac telehealth market with its CareLink patient network. Launched in 2002, it boasts 350,000 patients in 20 countries, with 12,000 more enrolling each month. But the company's lead may narrow.
St. Jude Medical is now rolling out the latest update of its competing Merlin.net network. The new product should help St. Jude grab 5 to 7.5 percentage points of the global $6.5 billion ICD market over the next five years, projects UBS Securities (UBS) analyst Bruce Nudell.
Marketed as an all-in-one package, St. Jude's Merlin line includes several implanted devices that connect to Merlin.net, an Internet-based repository from which authorized doctors have access to patient information. The third version was approved by the U.S. Food & Drug Administration on Mar. 22.
The new software can combine hundreds of measurements taken from medical devices with other information stored in electronic health record databases such as Microsoft's Health Vault and Google Health to predict changes in a patient's health. St. Jude, based in St. Paul, Minn., says the system also has better doctor alerts and comes in more languages. The network is a free service to those with enabled devices.
St. Jude began selling the network across Western Europe in late April. Though Medtronic's CareLink is already on the market in Europe, St. Jude beat Boston Scientific (BSX). So far, the $4.36 billion company has signed on more than 40,000 patients and 1,200 clinics, with patient enrollment growing 17% month over month and clinic enrollment growing 19%. "St. Jude is continuing to advance toward the cutting edge of technology and should gain the most share in 2009," says Christopher Warren, an analyst at Caris & Co. in New York.
Medtronic, though, doesn't seem too worried about St. Jude's advance. The Minneapolis company had $13.52 billion in 2008 revenue and commands about 45% of the global ICD market, with the other 55% split almost evenly between St. Jude and Boston Scientific. Having Europe well covered, Medtronic plans to introduce CareLink to another 10 countries this year. (It's also free for patients with a Medtronic device.)
Medtronic says its head start and scale give CareLink an edge. Users have provided 4 trillion pieces of health data, enabling Medtronic to write better algorithms to keep watch on patient care. "There's always been someone coming after us, but we have been the leader and will continue to be," says Pat Mackin, Medtronic's senior vice-president of cardiac rhythm disease management.
(Source: Business Week, April 27, 2009
Tunstall Healthcare recently announced the launch of its RTX3371 telehealth monitor - an interactive telehealth device with in-built GSM/GPRS mobile phone technology that collects vital signs wirelessly from a range of external devices such as weight scales and blood pressure cuffs.
In addition, the RTX3371 telehealth monitor's spoken voice functionality allows it to collect subjective patient information from patient questionnaires, and to automatically transmit the data to a clinical backend software application based on an open architecture interface.
According to Anthony Taroni, Director of Sales at Tunstall: "The availability of GSM/GPRS cellular coverage in the USA and the rapid increase in the number of people replacing regular phone lines with wireless and mobile phones has set new standards for home hubs and the way they provide connectivity in order to ensure effective telehealth delivery. This wireless device offers service users the freedom to place the device anywhere in the home independent of phone plugs, increasing user satisfaction and acceptance."
SourceL Tunstall Press Release April 30, 2009
NuPhysicia recently launched their Medicine At Work service, which brings retained physician services to the workplace, using video telemedicine to connect board certified doctors and patients.
Medicine At Work delivers innovative medical instruments, telecommunications equipment, and, through its retained physicians, professional healthcare services directly to employees at their place of work. Using two-way video, the doctor providing services to Medicine At Work conducts examinations in real-time with the assistance of a specially trained on-site paramedic.
Melody Reid, NuPhysicia's Executive Director for Employee Health Services, said, " Industry research shows that on-site care enables employers to control healthcare costs, while giving employees convenient access to medical attention from physicians at work during business hours. Employees visit Medicine At Work clinics at the worksite for doctor visits, prescriptions when needed, one-on-one wellness coaching, and other healthcare needs, without the time away from work and expense normally associated with seeing a doctor."
Dr. Michael Davis, Senior Vice President of NuPhysicia, stated, "Through the physicians associated with this program, Medicine At Work(TM) offers a full-time medical presence in the workplace, blending high technology telemedicine and high touch. The doctors use innovative tools and equipment and secure electronic medical records (EMRs), and develop an old-fashioned doctor-patient relationship with the focus on improving employee health."
A Medicine At Work clinic is cost-effective and space-efficient to outfit, needing only a minimum of 12 X 12 feet of space, an electrical outlet, Internet connection and a door for privacy at the employer site. Medicine At Work provides all furnishings, equipment, clinic staff and medical care services for a fixed monthly cost per employee.
(Source: NuPhysicia Press Release, April 16, 2009)
3/26/2009
Some new low-cost services have popped up on the Internet with the aim of providing basic health-care consultations more cheaply and easily. In January,
American Well went live with a Web service that allows patients to communicate with doctors via online video, text chat or phone. The doctors can view patient personal health records through Microsoft Corp.'s HealthVault and even prescribe medication over the Web. The service is currently available only in Hawaii through the Hawaii Medical Service Association, the Blue Cross Blue Shield affiliate in Hawaii. HMSA-insured patients pay $10 for a 10-minute visit; uninsured or non-member patients pay $45 for a 10-minute consultation.
A similar service,
SwiftMD, launched in November and is now available in New York and New Jersey. For a one-time $18 registration fee and $9 a month, users can make an appointment at any time to speak with a doctor over the phone or through online video chat. Doctors call or connect on average within a half an hour of when the appointment was made, and patients pay $59 for the consultation.
And in Dallas,
TelaDoc. has a similar service that allows anyone to go online or pick up the phone and schedule phone consultations with physicians.
The services are the next step in "telehealth," or the delivery of health care through the telephone, Web or other telecommunications technologies. While some doctors communicate with their patients electronically, medical providers and insurance companies generally provide online services that allow patients only to manage personal health records, schedule appointments, refill prescriptions and request referrals.
The new services offer the convenience of online consultations, but they still have their drawbacks. Since physician-licensing regulations and health plans vary from state to state, the availability of electronic consultations is limited. And some patients may be reluctant to confide in a stranger -- even one with a medical degree -- or have concerns about the privacy and safekeeping of their records online.
Also, companies and doctors warn that online care isn't a replacement for health insurance or appropriate for every ailment, and that patients in emergency situations should go to the hospital. On its Web site, SwiftMD lists a number of ailments it treats such as allergies and rashes, fevers and the flu. The company says it treats only people between the ages of 3 and 69, and doesn't treat people with pregnancy-related problems or severe psychiatric disorders, such as schizophrenia, bipolar disorder and severe depression.
Randall Hagar, director of government affairs with the California Psychiatric Association, says that telepsychiatry can have benefits, but also limitations. With new patients, he says, there is an ethical obligation to do the initial meeting in person, in part because a doctor can better sense the patient's state of mind.
"Good clinicians use their intuition and you can sense things that you can't when you are dealing with a two dimensional screen," says Mr. Hagar.
On the availability question, American Well says it will launch in other states later this year, but declined to provide further details. SwiftMD says it will soon be operating in Alabama, Pennsylvania and Connecticut. And to vet its doctors, SwiftMD says it does background and reference checks on its physicians before they're hired. The company is also working to list doctors' credentials on the Web site.
Leah Light, an uninsured graduate student in New York, found out about SwiftMD's online service from her mother, who purchased a year's membership for her as a Christmas gift. In January, Ms. Light, who takes prescription medication for a chronic panic-attack disorder, signed onto SwiftMD's Web site to see if she could get her prescription refilled.
After some questions, the Web site immediately deemed her appropriate for care. Ms. Light scheduled a phone appointment for the following day to speak with a doctor, who wrote her the prescription. The conversation, which lasted roughly an hour, cost $55 (she received a discount for pre-paying for the year), much less than the $260 Ms. Light paid to see her previous doctor.
"I feel reassured by the fact that if I need to talk to a doctor, I can without having to blow my food budget for a month," says Ms. Light, 26 years old. "It definitely makes me feel a lot better."
Not surprisingly, the services appeal to uninsured patients, as well as millions of others hit by layoffs and the recession.
But health-insurance companies are reaching out to insured patients as well. Michael Stollar, vice president of marketing and communication for the Hawaii Medical Service Association, says online care can help reduce rising health-care costs by cutting down on unnecessary visits to the emergency room and making it easier for people to detect illnesses earlier and get the proper treatment sooner.
(Source: Wall Street Journal, March 5, 2009)
IBM, in collaboration with
Google and the Continua Health Alliance, recently announced new software that will enable personal medical devices used for patient monitoring, screening and routine evaluation to automatically stream data results into a patient's Google Health Account or other
personal health record (PHR). This breakthrough extends the value of PHRs to consumers and also helps to ensure that such records are current and accurate at all times. Once stored in a PHR, the data can also be shared with physicians and other members of the extended care network at a user's discretion.
Using IBM software to connect personal medical devices to Google Health and other health-record systems will allow patients to exchange vital health information with their doctors and other health services professionals more easily, and in real-time. As a result, health professionals can provide more timely feedback to patients on their conditions, suggest treatments, and help improve overall quality of life.
For example, a busy mom can receive daily electronic updates on the health status of an aging parent who lives alone, is suffering from high blood pressure, and is on multiple medications. A traveling businessperson, who is diabetic and training for a marathon, can have a real-time discussion about her blood sugar levels and heart rate with her coach hundreds of miles away.
Google Health allows users to store, manage, and share their medical records and personal health information securely online. Google Health was officially launched last May, and is free to users.
(Source: IBM Press Release, February 5, 2009)
Clients of Dallas based
TelaDoc use the internet or phone to request a consultation, and in less that three hours a board certified doctor will call them back. But when should they call TelaDoc? Company spokesperson Amanda Bates says when their primary doctor isn't available or when they have a cough, cold or other garden variety health issue and don't want to make a trip to the office or emergency room.
"All of these non emergency conditions that you don't want to miss a half a day from work these days just to be told you have a sinus infection. Well, I know I have a sinus infection."
Medical Ethicist Rob Tenery says the booming telemedicine business comes with some possible side effects.
"I think in this climate of cost constraints, patients are looking for less expensive ways to get health care, this is just one of the options. It is problematic, at least in certain circumstances and I think we have to be very careful."
Tenery is concerned about the long distance doctor-patient relationship. Karen Trotter was diagnosed with Multiple Scleroses nine years ago. The Navy veteran says she uses TelaDoc when her prescriptions from the veterans administration don't arrive in mail on time.
"You go without that stuff and symptoms start arising to that actually put you in the hospital and that is the last thing I want."
Karen has used TelaDoc for about a year. She says the doctors have access to her complete medical history and they always ask lots of questions. Company officials say it's doctors are available 24 hours a day all year long and in todays economic climate, a thirty-five dollar phone consultation is a bargain.
"And that's weather or not you have insurance." Says Amanda Bates. "So people without health coverage, especially right now, with so many unemployed, are still able to get fast access to a doctor when they need it.
Karen stills sees her personal physician twice a year, but a TelaDoc is always there if she needs one.
"It's a backup." Karen says. "If for some reason something happens where I don't get my medicine, I use TelaDoc."
TelaDoc started in 2004 and right now has more than a million clients. That number is expected to grow to ten million by the end of the year.
(Source: KDAF-TV, March 13, 2009)
3/26/2009
Australia's biggest telcom, Telstra, has waded into the debate over how the nation's health system should be reformed, describing Medicare and other payment structures for health workers as archaic and blaming them for holding back the adoption of more efficient, technology-based ways of working.
In a speech delivered to a conference in Sydney this week, Telstra's business division head Deena Shiff has called for a review of the basis on which doctors are paid and for the removal of existing barriers blocking the uptake of new technologies such as videoconferencing. Along with related facilities, such as the ability to transmit X-ray or other scan images over fast data connections, these allow patients in rural areas -- or their general practitioners -- to consult medical specialists hundreds or even thousands of kilometers away.
"The basis on which medical professionals are rewarded acts as a drag on innovation in delivering clinical services; it effectively deters them from making full use of the available technology," she says. "The basis on which doctors are remunerated ... needs to be reviewed to remove barriers to use of technology."
Under present Medicare rules, rebates are not payable for consultations where doctor and patient are not physically present in the same room. And, with only a few exceptions, Medicare will pay only for services provided by one doctor or health provider with the same patient at the same time, discouraging a rural GP or specialist from accompanying a patient to a telehealth consultation with a city-based specialist consultant.
In her address to the National Telemedicine Summit, Shiff said despite these restrictions the technology necessary was well-developed and remote diagnosis "is not a technology fantasy of the future, it is happening now".
One example is breast cancer, as mobile screening vans already transmit scan results to city-based radiologists for analysis.
In the Northern Territory, a doctor in the community of Oenpelli is planning to use a recently laid fibre-optic link to conduct consultations with specialists at the Royal Darwin Hospital for patients with traumatic injury, and will be able to transmit X-ray images and hold videoconferences with medical colleagues to discuss patient treatments.
Nurses on home visits can use e-health technologies to access patient records, while potential applications include using Bluetooth connections to a home monitor to measure blood sugar or send heart-rate measurements to a mobile phone.
Shiff says most private doctors are small businesspeople who cannot justify investing in equipment capable of enabling e-health consultations if payment mechanisms do not exist that will allow them to recoup outlay.
"In most cases the lack of a business model is impeding take-up," she says. "Home care requires someone to take responsibility for care co-ordination and to ensure that the data is correctly collected at the point of care. Even if this role is to be fulfilled at public expense or on a voluntary basis, it is difficult to build a business model around it."
Similar criticisms of Australia's slow uptake of modern communication tools in healthcare settings have been made previously by medical experts.
In a paper published in the Medical Journal of Australia in January, experts from the University of Queensland say the uptake of telemedicine has been "disappointingly slow" in light of its benefits, which include an "enormous potential to improve equity of access to health services in a cost-effective manner". Payment mechanisms need to be changed and new services should be integrated with existing outreach services and thoroughly evaluated to provide the evidence of their cost-effectiveness, they say.
Peter Brooks, executive dean of health sciences at the University of Queensland, said at the time that the barriers to greater uptake of telemedicine included the "lack of understanding and acceptance by the health professions and governments" about the potential for telehealth.
"Governments need to look at how these new technologies can help, and then play a co-ordinating or facilitatory role, encouraging partnerships between universities and health departments, but most of all ensuring that these services are funded properly with the creation of new Medicare rebates," Brooks said.
"We (also) need to educate the profession and, importantly, patients about opportunities that exist to make their lives easier and more connected, particularly in rural and remote Australia."
Shiff says the National Health and Hospitals Reform Commission had identified the problem in its recent interim report.
She says many commonly cited features -- including video consultations and transmission of electronic records -- already are possible on the company's existing broadband wireless network.
(Source: The Australian, March 21, 2009)
On April 1-3, 2009,
Luxembourg will be host again to the international
Med-e-Tel meeting. The 7th edition of the annual Med-e-Tel conference will focus on proven and tested telemedicine and e-health applications and provide evidence on clinical effectiveness and economic efficiency as well as on user aspects and satisfaction.
In its recent "Telemedicine Communication", the European Commission called for the provision and dissemination of scientific evidence of telemedicine effectiveness and cost effectiveness as one of the actions to increase confidence and acceptance of telemedicine services and subsequently to improve access for citizens and healthcare professionals to telemedicine and e-health services.
Also, the European Health Telematics Association's (EHTEL) Task Force on "Telemedicine & Chronic Disease Management" is currently working on building evidence about the impact and opportunities offered by sustainable telemedicine services in the context of the need for changing care processes and will contribute to the Med-e-Tel program with a workshop on "Tele-enabled Healthcare - The Voice from the Field".
Furthermore, EHTEL will be among one of the contributors in the opening session of this year's Med-e-Tel conference program. The opening session will be hosted by the International Society for Telemedicine & eHealth (ISfTeH), whose President, Prof. Dr. Michael Nerlich, will present on "Standard Operating Procedures in eHealth - Individualized Care or Health Mass Production?" and whose Executive Director, Dr. Yunkap Kwankam, will provide some background and his views on "The Rockefeller Foundation eHealth Initiative for the Global South: Harnessing ICTs to Improve Health Systems Performance". Additional contributors to the opening session include representatives from the European Commission, International Telecommunication Union, International Council of Nurses, Russian Telemedicine Association and Internet Society Belgium who will provide insights into current initiatives and future directions in telemedicine and ehealth.
Medifacts International, a global leader in cardiac safety monitoring services, will share their experience with "Telemedicine in Clinical Trials", together with partners from Novartis Pharma. The session will review key considerations for successful implementation of Telemonitoring Self Measured Blood Pressure (T-SMBP) within the clinical research environment, and provide some practical case study examples - contributing to the evidence base for telemedicine services.
Furthermore, Med-e-Tel 2009 will feature a workshop by the Telenursing Working Group that has been set up within the framework of the ISfTeH. The goal of the group is to bring telenursing experience to nurses worldwide and enhance networking with key industry stakeholders, by organizing sessions and meetings at existing events like Med-e-Tel.
The group was actually initiated at last year's Med-e-Tel and held an inaugural workshop at the joint Canadian Society of Telehealth / ISfTeH conference in Ottawa last October. The Telenursing Working Group is also collaborating with the International Council of Nurses, to get its message and experience across to a large nursing audience.
A regional (BeLux) hospital administrator seminar, endorsed by the CRP-Sant� (Public Research Centre for Health), will focus on "priorities, benefits and budgets for health IT in the 21st century".
A returning feature at the annual Med-e-Tel events, this seminar brings together representatives from all major hospitals and other industry stakeholders in Luxembourg as well as various Belgian healthcare institutions, and presents business cases from a number of industry leaders and their clients who draw from successful experiences.
This year, the seminar will reflect upon the short and medium term IT priorities and on making optimal choices for each individual hospital, each department and the healthcare system as a whole; the seminar will feature some of the most interesting experiences in the region and beyond, and show the benefits, as well as the conditions for success and the difficulties and resistance that can be met during implementation.
The three day Med-e-Tel conference program will include additional sessions and workshops on the topics of chronic disease management, open source software, ehealth in developing countries, elearning, mobile solutions, e-health integration in routine practice, environmental conditions and telehealth, national e-health programs and initiatives, Pan-Asian collaboration for evidence-based e-health adoption and application, and more.
The event also includes an expo and networking area which will feature companies and organizations such as Aerotel Medical System, Aipermon, Arpage, Austrian Research Centers, Card Guard, C-Consult Advice, Electro Security, Escrow Europe, European Commission, European Health Telematics Association, Honeywell HomMed, ICT, International Society for Telemedicine & eHealth and several of its national member organizations, Medifacts International, Medikidz International, medXchange, Vitalsys, Vitaphone, as well as various publications and online information services that will be featured in the event's media corner.
For further information and registration, please visit
www.medetel.edu.
(Source: Med-e-Tel Press Release, March 25, 2009)
2/27/2009
Technological advances rapidly are changing the way patients and doctors communicate. Video-conferencing with other physicians, remote patient monitoring and e-mail already are standard tools for many physicians across the country. One of the newest innovations, a platform that allows insurers to provide patients with real-time access to their doctors via webcam, launched in Hawaii in mid-January.
Proponents say "e-care" will help broaden access to health care, create savings for employer-sponsored health plans and help fight a growing shortage of physicians nationwide.
Others welcome technology but worry about reimbursement for e-care and the effectiveness of digital diagnoses.
"I don't see telehealth as ever replacing a personal relationship and direct one-on-one contact with your physician," said Dr. Michael Wulfers, president of the Missouri Academy of Family Physicians. "I just don't see how you're going to be able to ever accurately do a physical exam over the Internet."
Dr. Roy Schoenberg is working on that.
The Boston physician's health tech company, American Well, has developed a secure communication platform that connects doctors and patients for real-time consultations.
American Well's first customer, Hawaii's Blue-Cross-Blue Shield licensee, took the system live on Jan. 15. Consumers access the service by logging on through the insurer's website.
Patients can search for specific physicians or seek out specialists for 10-minute consultations through webcams or text chats. The sessions can be extended for a fee.
"Online care is a technology that allows us to extend the reach of the existing health care system so that it is much more available and in a way much more financially reachable," said Schoenberg, the company's president and chief executive. "It has tremendous promise."
The company did not release preliminary utilization figures from Hawaii.
Doctors can search through a patient's electronic medical records and write prescriptions. Health plan members pay $10 to access the platform. The uninsured or those on other plans pay $45 per session.
American Well receives transaction and licensing fees through its deal with the Hawaii Medical Service Association. Only physicians licensed in Hawaii can provide care, and they're covered under a blanket medical malpractice policy from AIG. Doctors are reimbursed automatically and electronically.
Of course, American Well doesn't bill itself as a cure-all. Patients experiencing chest pains or flare-ups of complex conditions should head straight to an emergency room, Schoenberg said.
Some physicians, including Wulfers, have raised concern about the potential hazards. Doctors can't feel a patient's abdomen or conduct a cavity exam through the screen.
"It seems to be just another (idea) along with urgent care or minute clinics, which will in the end lead to more fragmentation of care � and lower quality of health care," said Wulfers, a longtime family physician in Cape Girardeau. "It seems to me like it's a walk-in clinic over the Internet."
Still, many patients couldn't take advantage of "virtual house calls" if this service was suddenly available everywhere.
Only about 11 percent of U.S. Internet users have webcams connected to home computers, according to a recent study conducted for the California Healthcare Foundation. Meanwhile, about 65 percent of adult Americans have broadband or dial-up service, providing access to e-mail and the Web, according to a recent study by the Pew Internet & American Life Project.
Despite skepticism of the virtual house call, Wulfers e-mails some patients, adding that "in the future, I could do a lot of things by e-mail."
A survey by the California Healthcare Foundation also found increased use of e-mail between physicians and patients in the Golden State: 13 percent of Californians using the Internet reported getting medical advice via e-mail in 2007, up from 8 percent in 2004.
Starting March 1, Mercy Medical Group in St. Louis will test an online pilot program that gives secure Web access to a select group of patients. The patients will be able see lab results, get information about X-rays and schedule appointments through an interactive calendar.
Patients can take a picture of a suspicious rash and send the image in an e-mail. Doctors can respond to an e-mail question about high cholesterol with links to health-related websites.
Mercy plans to offer the Web portal to all patients by January, said Dr. Thomas H. Hale, president and chief executive.
Excited about the possibilities of the "electronic stethoscope," as he called the Internet, Hale also sounded a note of caution.
"What we don't want to do is to take that opportunity and say, 'Everything we've done in the past we need to throw away,'" Hale said.
"It has to be a clinical tool in the (arsenal) of physicians and caregivers."
(Source: St. Louis Post-Dispatch, February 25, 2009)
2/27/2009
Remote, home-based physiological monitoring of patients with congestive heart failure can save thousands of dollars per patient per year through fewer hospitalizations, according to a new report. The report authors estimate savings of $3,703 per patient per year for those with remote monitoring and disease management programs, and $5,034 for those with remote monitoring and standard care. Consequently, the technology has the potential to save $4.7 billion to $6.4 billion a year.
The New England Healthcare Institute, a Cambridge, Mass.-based independent research firm, has updated a report on remote physiological monitoring it published in 2004. The new data estimates an annual cost of $2,052 per patient for the monitoring technology. Add disease management software to the mix, and that price would go up to $2,802.
The return would come from a 60% reduction in hospital readmissions for patients that have standard care and remote monitoring, and a 50% cut in readmissions for patients that participate in a disease management program along with the monitoring, the report authors estimate.
The full report, entitled the
Research Update: Remote Physiological Monitoring is available for free download
here.
(Source: Health Data Management, January 28, 2009)
2/27/2009
The recently passed $787 billion economic stimulus package includes $19 billion for Health Information Technology (HIT).
The stimulus package will also provide $4.7 billion for NTIA's Broadband Technology Opportunities Program, $2.5 billion for USDA's Distance Learning, Telemedicine, and Broadband Program, $1.5 billion for HRSA to use to build or repair health centers and/or to purchase equipment, $1.1 billion to provide for research within AHRQ, NIH, and HHS, $85 million for health IT and telehealth technologies within the Indian Health Service, $500 million for SSA, and $50 million to provide IT within the Veterans Benefits Administration.
The HHS Office of the National Coordinator (ONC) will receive $2 billion to use to coordinate health IT policy and programs. Programs will be initiated by the Secretary but the National Coordinator will have the responsibility to move and expand the electronic movement of health information.
The ONC will be able to award grants to states or to Indian Tribes to use to establish a certified EHR Technology Loan Fund Program to help providers. Loans may be used by providers to purchase certified EHR technology, improve EHR technology, to train personal to use the new technology, and to improve the secure electronic exchange of health information. These loans won't be available until 2010.
The National Coordinator has the responsibility for standards and certification. New health IT Policy and HIT standards committees will be formed to serve as federal advisory committees and the committees will then forward their recommendations to the National Coordinator.
With this legislation, all health care providers and insurers plans that are providing services or products for the federal government will now be required to use only standards compliant health IT systems and products.
Incentive payments of $17.2 billion will be made through Medicare to go to health professionals and hospitals for certified EHR technology. Incentive payments will be made to physicians for the first five years from 2011-2015 if the use of EHR technology is demonstrated. The Medicare payment schedule for eligible professionals is $15,000 for the first year. However, if by 2015, a health professional does not demonstrate the use of EHR, then Medicare reimbursement payments will be reduced.
Hospitals will also receive incentive payments for the first five years for making use of EHR technology. If an eligible hospital does not make meaningful use of the EHR technology by 2015, their reimbursement payments will also be reduced.
According to the publication "Health Data Management", the Congressional Budget Office projects that health IT provisions in the stimulus package will result in 90% of doctors and 70% of hospitals using certified EHR systems by 2019.
The National Coordinator will be responsible for developing a health IT extension program to provide health IT assistance and to help providers adopt health technology. In addition, Regional Centers will be developed to provide technical assistance.
To enhance educational possibilities in the field of health IT, grants may be provided for demonstration projects to help move and integrate certified EHR technology into clinical education. In addition, assistance will be provided in consultation with the National Science Foundation to establish or expand medical health informatics programs in universities and colleges.
(Source: Federal Telemedicine News, February 19, 2009)
2/27/2009
Home Telehealth holds the potential of both improving care and saving money by reducing hospitalizations, visits to emergency departments and home health visits. It also could create a small industry.
Honeywell HomMed is among the companies that stands to benefit from the adoption of telehealth. The company, founded in 1999 and bought by Honeywell International Inc. in 2004, was among the pioneers in telehealth. It now has about 60,000 systems placed with customers.
Its monitors can remotely be programmed to ask 52 questions in 13 languages. They include general questions, such as whether a patient is feeling better today, as well as specific questions, such as whether a patient is experiencing swelling in his or her legs.
Honeywell HomMed, with revenue of roughly $25 million a year, is a minuscule business for its parent company, which has revenue of $36 billion a year. But the company expects telehealth to touch every part of the health care system within five years.
Several of the world's largest electronic companies - Philips Electronics, Robert Bosch North America, Panasonic Corp. - have bought or started telehealth companies. Intel Corp. recently entered the market.
A slew of small companies also hope to profit.
"It's definitely a growth market," said Paul Keckley, executive director of the Deloitte Center for Health Solutions. Customers include small home health care companies, national chains and health care systems. That's one of the challenges facing Honeywell HomMed and its competitors.
"It's a totally fragmented market," said Mike Benjamin, president of Honeywell HomMed. The biggest obstacle to wider use of the technology, however, is that Medicare and most commercial health plans don't pay for the service.
That gives home health care agencies little incentive to invest in the technology. If a remote monitor prevents a patient from being hospitalized, Medicare or a health plan saves money, but the home health care agency doesn't share in those savings.
(Source: Milwaukee Journal Sentinel, February 1, 2009)
A Utah man is working on a
voice-activated telemedicine system. Currently in contract with the Telemedicine and Advanced Technology Research Center, Dave Kadlec spends most days in a small office at Utah State University's Innovation Campus creating voice commands and writing computer code. The official name of the voice-activation process is the Augmented Instructional System.
"Say some poor guy got lost from his platoon with a wounded buddy," Kadlec says. "He can ask this program, 'What can I do?'" According to Kadlec, the computer could then send the soldier medical information about helping the wounded person.
Instead of being connected to the Internet, Kadlec says the government project he is working on has created a different type of interface. Basically, it means the technology does not have to be connected to the Internet to work. Not being connected to the Internet also means there is less fear of viruses and hackers messing with the system.
Being a hands-free device means helpful information can get to a soldier quicker than if the soldier had to write down a command, send it electronically or through radio signals, and wait for a written response. Now, the response comes in voice form.
"I want it to be able to say, 'Patient, 18 years old, 150 pounds, blown off right leg' and have it come back with proper procedure for that," Kadlec says.
The device may only require a wireless microphone and earpiece (to create the hands-free effect) to be hooked to a uniform. Kadlec is currently in phase two of the three-phase process.
Ray DeVito, director of USU's Technology Commercialization Office, says he first learned about Kadlec's product when Kadlec was an undergraduate student. DeVito says he and others saw the potential for commercialization so they tried to help Kadlec find some means to move the product forward. Since Kadlec's graduation, DeVito says he tries to keep in touch and offer advice when he can.
DeVito's son is an army medic and has been deployed to Iraq twice. When his son heard about the technology, DeVito says his son saw good possibilities for practical use.
"He knows what it is to sit there and to have easy access to information so he could see a lot of potential for training and for medics constantly going into the army," DeVito says.
For Kadlec, writing this kind of software seems strange today considering he didn't even know how to turn on a computer a few years ago. After hurting his back after working as a landscaper for 20 years, the 50-year-old decided to take a beginning computer class at Bridgerland Applied Technology College. Later, during a USU class, Kadlec created his initial voice-activated computer program for a school project. After showing it to the department head, Kadlec says things started rolling.
"He said, 'I want to help you with this,' and so I made an appointment with the USU research foundation office," Kadlec says.
Eventually, Kadlec wrote proposals to different organizations asking for grants. Halfway through Kadlec's doctorate program, a military grant for his voice-activated technology came through.
Initially, Kadlec thought his technology would be an education tool.
"The hardest thing has been keeping it simple," he says. "Most teaching tools are overly complicated."
Once he started working with the Telemedicine and Advanced Technology Research Center, however, his view shifted. Kadlec realized his technology could help the army in a more direct way, and possibly save soldiers' lives.
"The invention is just making pieces of software work together in a way they've never worked together," he says.
(Source: Logan Herald Journal, February 25, 2009)
AMD Global Telemedicine recently announced that with its recent shipment to France, AMD equipment is now installed in 74 countries. With the addition of the new site in France, AMD customer sites now total more than 5,200 worldwide.
Dan McCafferty, Vice President of Global Sales and Corporate Development at AMD Global Telemedicine stated, "Our recent success is a great accomplishment for AMD and proves how quickly telemedicine in general is growing. I firmly believe if you combine the new reimbursement laws, the telemedicine funding in the 2009 Stimulus Bill with AMD's new technology, telemedicine is on the rise. This is a very exciting time for AMD Global Telemedicine."
(Source: AMD Telemedicine Press Release, February 27, 2009)
PDS Health recently announced that it received a contract for the use of their proprietary hardware and online software to study telemedicine on certain types of patients in a major hospital system.
The study uses MDmonitor for analyzing the data submitted by the Telehealth monitor that is placed in each patient's home. The system does not require that the patient has a computer, so it's convenient and inexpensive. The study will continue until May 2009 clinical research study.
For this clinical study a Blood pressure monitor will be used, possibly together with a glucose monitor at a later stage. MDmonitor lets patient data be accessed online and keeps information updated, either by care giver's staff, the patient, or the patient's other health professionals. MDMonitor keeps medical data update, analyzes information and can remind patients to take medications.
(Source: PDS Health Press Release, Feb 25, 2009)
Honeywell HomMed recently announced that Terry Duesterhoeft has assumed the role of president of Honeywell HomMed, an industry leader in telehealth and remote patient monitoring, in addition to his current role of vice president of sales and marketing.
Since joining Honeywell HomMed in October 2006, Duesterhoeft has led marketing, product development and sales and has been the driving force in developing Honeywell HomMed's expanded vision and growth strategy. Prior to Honeywell HomMed, he held leadership roles in venture-backed startups, including co-founder and chief marketing officer of XStor Medical Systems in Mountain View, Calif., and vice president of strategic marketing at ZONARE Medical Systems. He also held several marketing and product development executive roles at GE Medical Systems, including global marketing manager with the ultrasound business during its exponential growth to a $1B business.
(Source: Honeywell HomMed Press Release, February 26, 2009)
1/28/2009
Bloch Consulting Group, publishers of the Federal Telemedicine News Update, has released a 2009 edition of their
Federal Agencies: Activities in Telehealth, Telemedicine, and Health Technologies report. With a new administration in Washington, the government is poised to make major changes in how it funds major research, operations, and grants in the telemedicine, telehealth and informatics sectors
Learn all about these activities at 24 major cabinet-level departments and independent agencies. The 200-page Federal Agencies report, a valuable resource for: anyone who needs to keep tabs on Federal activities in the telehealth field -- and zero in on the activities being funded -- should be reading this report right now. It will save you many hours of research time.
More information about the report can be found on the
Federal Telemedicine News website.
(Source: Federal Telemedicine News, January 2009
AT&T is developing a software tool and networking platform that will use wireless devices to record a patient's health measurements at home and send the data to the doctor. AT&T's system runs on both Wi-Fi -- enabling videoconferencing -- and a second wireless technology named ZigBee, which receives data from medical sensors. ZigBee consumes considerably less power than Wi-Fi, so monitoring devices, including thermometers, pill dispensers, blood-pressure monitors, and pulse oximeters, can use small batteries to transmit data over long periods of time.
Home-based monitoring services like AT&T's -- which is approaching the trial stage -- could transform how doctors interact with their patients. "The health-care industry is under a lot of stress," says Bob Miller, executive director of AT&T's communications-technology research department, "so there's a drive to explore ways of delivering better care at lower cost." And greater convenience for both doctor and patient: If a physician notices, for instance, that a blood-pressure medication isn't working, or if the patient isn't taking the drugs regularly, she'll be able to arrange a videoconference with the patient to discuss solutions.
AT&T isn't alone in exploring telemedicine technology, and the good news is that firms in this growing niche are banding together. AT&T is a member of the Continua Health Alliance -- the group also includes Bayer, Cisco, GE, IBM, and Novartis -- which is working to make medical-monitoring devices interoperable.
(Source: Fast Company, January 15, 2009
Health Hero Network recently said that the first large-scale, multi-year rollouts and evaluations of its Health Buddy System have shown success in helping improve the care of high-cost Medicare beneficiaries and veterans while reducing costs and hospitalizations.
The Centers for Medicare and Medicaid Services announced this month that it is extending and expanding Health Hero Network's Health Buddy Project, designed to show how doctors, nurses, and patients using telehealth technology can improve care and reduce hospitalizations associated with chronic conditions such as heart and lung disease and diabetes. The three-year project, which began in 2006 at medical groups in Wenatchee, Washington, and Bend, Oregon, has been extended to January 31, 2012. The project, being conducted in partnership with the American Medical Group Association, will also potentially be allowed to expand to one additional site in the second year of the extended program.
The announcement comes on the heels of the U.S. Department of Veterans Affairs' publication of four years of data showing a reduction of 19 percent in hospitalizations and 25 percent in bed days of care among a population of 17,025 veterans enrolled in the VA's Care Coordination and Home Telehealth (CCHT) Program. Health Hero Network has been the leading provider of telehealth technology to the CCHT program.
The company's Health Buddy System, the telehealth platform deployed extensively by the VA and used in the CMS Health Buddy Project, helps individuals with chronic conditions stay healthier while empowering their caregivers with knowledge to keep complications from worsening to the point where those individuals need to be hospitalized. Since late 2007, Health Hero Network has been a wholly owned subsidiary of Robert Bosch North America.
The Health Buddy System supports individuals with chronic conditions in self-care, while keeping them in daily contact with their caregivers. Individuals who use the system get support in self-care behaviors -- including medication compliance, diet, and exercise -- tailored to their unique conditions. Their caregivers get an actionable stream of knowledge to make targeted interventions at the first sign of symptoms or gaps in behavioral or knowledge that -- left unremediated -- could lead to a painful and expensive hospitalization.
The Health Buddy Project is being conducted under Medicare's Care Management for High-Cost Beneficiaries Demonstration. The project brings Health Hero Network together with the American Medical Group Association, as well as Wenatchee Valley Medical Center in Wenatchee, Washington, and Bend Memorial Clinic in Bend, Oregon. The program's design involves supporting physicians, nurses, and Medicare beneficiaries with the Health Buddy System in a relationship that keeps those beneficiaries healthier and out of the hospital through self-care and early detection of complications.
"The programs in the demonstration have had a positive impact on selected high-cost Medicare beneficiaries and have met and/or exceeded the savings target required in the demonstration agreement," the Centers for Medicare and Medicaid Services said in a news release announcing the extension of the Health Buddy Project, as well as two other Care Management for High-Cost Beneficiaries programs. "By extending the demonstration for another 3 years and frequently evaluating their financial status, each of the programs would have the opportunity to continue to impact their populations, maximize savings, and assist CMS in determining the replicability of the programs."
In a groundbreaking study published December 31 in The Journal of Telemedicine and e-Health, VA clinicians revealed the outcomes of the first multi-year evaluation at scale of the agency's Care Coordination Home Telehealth Program. Researchers reported that telehealth initiatives successfully reduced hospitalizations by up to 20 percent and improved the overall health conditions of patients who used the systems.
VA researchers praised telehealth systems for being able to provide daily contact with a patient base dispersed over wide geographies and for the behavioral improvements seen in patients who were presented with daily assessments through telehealth devices. The study also cited the program's modest cost of $1,600 per enrolled patient per year. The VA plans to rapidly expand the deployment of its telehealth program, forecasting more than 50,000 patients will be monitored on telehealth systems by 2011.
"The policy effects that result from the implementation of CCHT are profound," VA researchers said in the findings of their recent paper. "If 50% of patients requiring (non-institutional care) can ultimately be managed in a way that means they get improved access to care at lower cost and higher quality, then this represents an important advance. It means that a low cost and flexible solution will be available to deal with the large numbers of patients with chronic care conditions that health care systems know they need to serve."
Renowned for ease of use, the Health Buddy System empowers patients and the people who care for them by improving patient self-care and behavior while enabling care providers to access timely information and intervene before conditions become acute. The system's features start with the Health Buddy appliance and other licensee devices that allow patients to communicate with healthcare professionals by answering a small number of daily questions related to their medical condition and activities. The system offers analytics that then stratify and present this data -- through a secure Web-based interface called the Health Buddy Desktop -- to empower healthcare professionals to quickly identify problems and take corrective action.
The Health Buddy System features health management programs delivering personalized daily monitoring and patient education in order to promote positive behavior change and provide timely, relevant, and actionable information to care providers; many Health Hero Network programs are certified by the National Committee for Quality Assurance (NCQA). Health Hero Network customers are using programs, delivered on the Health Buddy System, that cover a wide range of conditions including heart failure, cardiovascular disease, diabetes, asthma, COPD, and mental health.
(Source: Health Hero Press Release, January 23, 2009)
Therapy Source, has developed a service, TheraWeb, which allows face to face therapy sessions to be replaced with Web, audio and video conferencing sessions. The service offers patients and doctors a secure place to have therapy sessions free from viruses or access by uninvited parties -thanks to robust encryption and unique identity authentication.
The TheraWeb offering is used specifically for speech and language therapy. And, according to the company's latest news release, the services has helped youngsters in particular, to have access to specialists they require simply by using the computer and an Internet connection. Not only are computers a very well known and popular tool among the younger generation, but screenings, assessments and other therapies can be conducted at more flexible times and even when weather issues arise.
In one scenario, the solution is making it possible for a 12 year-old student to easily sign into the Web-based therapy service and take part in an interactive speech and language session with his therapist, Lisa Brady, who is physically located hundreds of miles away.
"TheraWeb eliminates the hurdles normally associated with therapy sessions, such as scheduling, travel time, location, expense, and the ability to locate a qualified therapist who is near the patient," Brady said.
"In addition, the computerized approach can raise patient interest in the therapy, particularly in children, who are very computer savvy. This technology is completely natural for them."
Therapy Source offers qualified speech, occupational, physical, psychological and related therapy services to educational and healthcare organizations in Pennsylvania, New Jersey, Delaware and Ohio.
(Source: TMCnet Healthcare, January 27, 2008)
Research and Markets, an international market research and data firm, recently announced the publication of a "Telemedicine and E-Health Law" report.
When do Medicare and Medicaid requirements (including reimbursement and fraud and abuse provisions) apply to e-health transactions? What liabilities are associated with telemedicine? The use of the Internet and high-tech communications in health care has led to new approaches to medical treatment-and to challenging legal questions.
Telemedicine and E-Health Law includes topics from the licensing requirements for physicians who provide medical services electronically across state lines to the HIPAA privacy issues raised by the sharing of electronic health records across computer networks.
This book includes also includes chapters on tax, antitrust, intellectual property, and other aspects of e-health-all packed with expert advice that will help you steer clear of difficulties. The report is updated as needed, generally two times each year. More information can be found on
their website.
(Source: Research and Markets Press Release, January 16, 2009)
