Dr. Sanjay Gupta recently authored an article on how telemedicine has been improving your current healthcare needs to date. This is an effective tool to see how exactly telemedicine has been contributing to your local doctor’s office and hospitals. With these services already being rendered at healthcare sites, bringing them in-home with AllyHealth can now save you both time and money. See the full article on EverydayHealth here.
From the article: Telemedicine is often referred to as the future of healthcare, but the reality is that it’s already happening. If you had an X-ray or MRI done recently, “chances are it was read by a radiologist at a distant site,” says Jonathan Linkous, CEO of the American Telemedicine Association (ATA). “If you had neurophysiologic monitoring during surgery, there’s a 90 percent chance it was done remotely.”
Derived from the Greek word for “afar,” telemedicine, or telehealth, is the use of technology to diagnose and treat patients remotely. While the concept has been around for decades, the use of telemedicine has become increasingly common in hospitals and physicians’ offices.
About 50 percent of hospitals now use telemedicine in some way, from remote emergency room consultations with specialists to monitoring heart rate and rhythm or blood sugar levels for a patient at home. “Add teleradiology [the electronic transmission of patient images to a radiologist at another location] . . . and the number jumps to 80 percent,” says Linkous. The ATA estimates that 100,000 stroke victims in 2014 were “seen” remotely by a neurologist.
Closing the Specialty Gap
Telemedicine especially benefits rural communities, where access to medical specialists can be very limited. In Arkansas, for instance, 73 of the state’s 75 counties are medically underserved.
Speaking at a national forum on telemedicine, Curtis Lowery, MD, chairperson of the obstetrics and gynecology department at the University of Arkansas for Medical Sciences (UAMS), told panelists: “I don’t think where you live should determine whether you live or die.”
Thanks largely to Dr. Lowery’s efforts, telemedicine services from the UAMS Center for Distance Health now reach 60 hospitals and community clinics in rural Arkansas.
In Milford, Nebraska (population 2,000), where family physician Robert L. Wergin, MD, practices, there isn’t enough demand to support a specialty like psychiatry. “Mental health issues are the most challenging for me,” says Dr. Wergin, who is president of the American Academy of Family Physicians. “If the problem exceeds my expertise, I have to tell the person to drive 60 miles to see a psychiatrist.”
Telepsychiatry, which can provide virtual at-home therapy, hasn’t yet reached Milford. But telemedicine is being used for the continuing medical education of local healthcare providers, and Wergin says connecting with a Critical Access Hospital (CAH) 15 miles away is being explored.
Second Opinions Made Easier
As the aging population grows and nationwide concerns about doctor-patient ratios continue, access to healthcare isn’t just a rural problem. In Reno, Nevada, for instance, local reports estimate that there is one doctor for every 450 residents and getting an appointment with a specialist can take at least two months. A recent study found that the state of Florida will be short nearly 7,000 doctors in the next decade, with cancer treatment, general surgery, and psychiatry among the largest areas of need.
Virtual consultation services are helping change that. Say your primary care doctor suspects that a mole on your cheek could be skin cancer. A digital snapshot can be transmitted to a consulting dermatologist to get a second opinion on what the lesion is and how to treat it.
“Last year, there were about 800,000 online consultations,” says Linkous. Online consulting services such as Specialist on Call provide neurology, psychiatry, and critical care specialists to more than 300 hospitals around the clock. The specialists are board-certified, U.S.-trained doctors licensed in the states they serve.
Virtual House Calls
Mobile apps like Doctor on Demand are putting a virtual spin on the house call by offering video visits with physicians and psychologists on smartphones and tablets. While a patient’s fee for a video visit may be lower than the cost of an in-person consultation, individual insurance coverage varies.
When Allie and Eric Neiman’s 5-year-old daughter developed a severely irritated eye, arranging a video visit with a pediatrician spared them a late-night trip to the ER or an urgent care center with their other child, a 5 month old, in tow.
The Neimans, who live in San Francisco, were able to schedule an appointment within 20 minutes and, using a smartphone camera, show the doctor their daughter’s eye. The diagnosis was conjunctivitis, and a prescription for antibiotic eye drops was phoned in to the couple’s local pharmacy. “A few days later, we got a follow-up email from the doctor, asking how she was doing,” says Eric.
Many states require that doctors practicing telemedicine directly with a patient be licensed where the patient resides. But state-by-state laws remain in flux. Thirty-five states had over 100 telemedicine-related bills on the table last month, regarding everything from licensure to coverage.
Telemedicine Concerns
Some physicians believe the greatest barrier to telemedicine’s widespread acceptance is the question of who pays for it.
Many private insurers and Medicaid currently reimburse some telehealth charges. Medicare, which Linkous says has been a slow adopter of telemedicine, will not cover remote monitoring but may reimburse for videoconferencing if the patient is in a rural area.
Linkous advises patients check with insurers before considering any telemedicine services.
Another major concern is safeguarding the security of personal health information that is being shared electronically. Wergin stresses that telemedicine should only be conducted over secure, encrypted portals compliant with privacy rules of the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Wergin points out that many physicians question whether telemedicine can ever take the place of an ongoing, doctor-patient relationship. Rather than a replacement for the family physician, he sees telemedicine as a tool for taking better care of more patients.
“Communication technology in medicine is going to grow,” Wergin says. “My hope is that telemedicine will be coordinated with a medical center, and if things don’t go well, you’ll still have a personal physician you can call.”
