Telemedicine is a hot topic in the news of late. I am receiving a lot of inquires asking the specifics, so I put together a quick reference article, reviewing the questions that I often receive.
Telemedicine and Telehealth are two words that overlapped all the time. Telemedicine is the remote diagnosis and treatment of patients by means of an electronic network to improve a patient’s health status. Telehealth is a broader use of healthcare information over a secure network. In addition to clinical services, it also refers to other remote healthcare services and includes diagnostic monitoring, supervision, professional education, counseling, disaster management etc.
Can you explain the different categories of Telemedicine?
- The most well-know is Teleconsultation. This is when there is a two-way consultation from a doctor to a patient. This is usually done by videoconferencing technology or it may also be just by storing an image and sending it to your doctor, with the doctor interpreting it and sending it back.
- Telementoring. This is when a doctor/clinician is mentored by another doctor/clinician. The mentor is usually a specialist and assists in helping manage a remote patient. An example that is close to my heart, happened 4 years ago. A friend’s 3 year old child sustained life-threatening injuries, after being run over by a ride-on lawn mower. The surgeon at the local ER also worked for Dupont hospital for children. She grabbed her iPad as she ran into do emergency surgery on a child that had less than 2% chance of survival. She connected with the pediatric GI surgeon, who watched and walked her through the surgery, thus enabling him to then be helivaced to Dupont. He is alive and well today thanks to technology!
- The third category is Telemonitoring. That is where you get data from a patient who is at home, connected to some kind of biosensor, such as: vital sign monitor, electronic scale, glucometer, optic, chemical, etc. The results of these devices are sent, via a secure network to the health care provider. Telemonitoring will see a significant rise in the near future, as more wearable devices are being developed and clinicians become more comfortable using them.
What are the Benefits of Telemedicine?
The are many benefits of telemedicine, but the number one would be:
- Increased access to a specialist. Not only will this help to save lives, but it will also prevent complicated medical issues. The telestroke program is one example of how having access to specialists, no matter where you live, can make a tremendous impact on preventing long-term, horrific complications. In speaking with small rural hospital staff at the 2016 ATA conference, I was astounded that many wanted to implement life-saving programs, but they have great difficulty finding specialists such as cardiologists to sign on. Those in remote areas understand and see the need for telemedicine before those in a metropolitan area, because we take for granted the numerous specialists so close to us.
- The next benefit would be the cost-savings, direct and indirect. Again, using the telestroke program as an example: Prevention of hemiplegia and other life-long conditions, not only saves on the medical expenses that will ensue to because of the complications (direct), but also enables the individual to stay in the workforce and provide for their family (indirect). Early access to a specialist, aides in cost reduction because it can prevent unnecessary medical procedures, such as unnecessary radiographic exams, drug prescriptions, surgeries, use of medical devices, etc.
- Convenience – this is what motivates the public and will be the factor that will drive telemedicine forward. People will pay for convenience and start to demand it. Right now, most of the public is still unaware or just not that familiar with telemedicine. But what we have seen, not only with use of our platform, but generally over the spectrum of telehealth, is that once one uses, they would prefer in the future. As the public gains familiarity with telehealth, they will search out providers that provide it, because of its convenience.
- Another benefit is that it improves health quality. Early access to specialists keeps people healthier. Specialists are able to provide a more specific diagnosis and treatment. This results in faster healing, a shorter duration of the ailment, quicker return to functional ability and prevention of worsening of symptoms.
- The last would be one that is not ever mentioned: increase aide in the health and well-being of third world countries. Operation smile is one example of a volunteer organization that has done wonders for so many. These volunteers give up weeks of their lives traveling to remote areas, where security and sanitation are limited. Many would love to give back and aide others in need, but we all have busy lives. Telemedicine will remove so many barriers and enable many that were unable in the past.
What do you see as the barriers to telemedicine?
The biggest barrier is clinicians. Usually you hear “difficulties with reimbursement” as the main reason for the slow expansion of telehealth. But if our doctors and clinicians were more aware of the lifesaving benefits, they would expand and educate their patients. Clinicians tend not to be as tech-savvy as the general public. I still have to fax reports to my physicians on a regular basis. How often does your physician group give you and e-mail address to send reports? That being said, I have seen a lot of progress with physicians/clinicians in the past year. A year ago, I would receive a lot of negativity if I brought up the topic to colleges and physicians. They felt that it would take away the quality of an in-person assessment. Now, those same colleges are coming to me, asking how to start their own program.
