Telemedicine popular with the young and chronically ill

“In 5 to 10 years, we’re not going to talk about telehealth, it’s just going to be health.” – John Kornak

LAS VEGAS — Barriers to telemedicine are persistent, but physician groups are looking for ways to push remote access forward, according to two speakers here at the Healthcare Information and Management Systems Society 2016 Conference.

Marcia Frellick, Medscape Medical News March 02, 2016

“Physicians are becoming more entrepreneurial,” said Robert Zimmerman, founder and chief executive officer of the Health Technology Access Foundation in Rockville, Maryland, which he created to provide education, solutions, and certification for small- and medium-sized healthcare providers.

“They are looking for ways to increase revenue by seeing more patients, increasing reimbursements, and improving quality,” he told Medscape Medical News. “They are starting their own telehealth networks with and without government or payer support.”

Telemedicine enables continuous care and to reach more patients, he explained.

It has proved particularly beneficial in monitoring patients with hypertension, congestive heart failure, diabetes, wound care, and chronic obstructive pulmonary disease. It also has been shown to increase patient satisfaction and reduce readmissions, according to the American College of Physicians, which, as reported by Medscape Medical News, has called for its expansion in primary care.

The baby boomers are the most resistant to telemedicine; younger patients and the chronically ill are the enthusiastic adopters, Zimmerman reported.

“The chronically ill are looking for any information, any way they can get monitored, any way to get help for their conditions,” he said.

“In 5 to 10 years, we’re not going to talk about telehealth, it’s just going to be health,” said John Kornak, director of telehealth at the University of Maryland Medical Center in Baltimore. Physicians will routinely ask their patients after a visit if they want do a telemedicine follow-up, he predicted.

Telemedicine has been in use for about 15 years at his institution. It started in psychiatry, but now tele-ICU services and remote support from critical care specialists to community hospitals are provided.

As part of his job, Kornak helps train and educate groups trying to start a telemedicine program.

To begin, “we recommend doing a thorough technology search to see what kind of IT devices you have on site that could ultimately enable a telemedicine program,” he explained.

Next, Kornak and his colleagues help develop a business plan, which spells out how the telemedicine program will be funded, such as whether the program leaders will apply for grants, and the hardware options available. They also determine whether or not patients with be provided with a device.

In addition, the team teaches telemedicine etiquette, which includes not opening a screen in a coffee shop or noisy place, turning off all electronic devices that could interrupt a session, and conducting the consultation away from a window that could cause glare.

Telemedicine Barriers

Some of the barriers to the implementation of telemedicine are resistance to change, hesitance on the part of top decision makers, a significant lack of understanding of the technology, regulatory hurdles, and a lack of training in nursing and medical schools, according to Zimmerman and Kornak. And in rural areas, lack of access to high-speed internet is an issue.

When it comes to telemedicine, there is a widespread lack of vendor compliance with the Health Insurance Portability and Accountability Act (HIPAA), Zimmerman explained. The focus has been on what the technology can do, not on privacy and regulatory issues. That likely started with an early perception that HIPAA was merely a privacy notice, he said.

Now, large health systems are demanding certification and proof that programs are compliant with HIPAA, he said. Progress is being held back, however, because a standard system of encryption is lacking.

The ‘uberization’ of healthcare is an opportunity that cannot be missed.

Medicine has lagged behind other industries that have seen new delivery models as demand changes, such as Uber’s entry in the taxicab space, said Satish Gattadahalli, principal for healthcare transformation at the technical and management consulting company of Whitney, Bradley & Brown in Reston, Virginia, who attended the session.

“We need to rethink the healthcare delivery business model in fundamental ways,” he told Medscape Medical News.

“Retail clinics, opening clinics after hours, etc., are all steps in the right direction for delivering primary care. What Uber, Lyft, and Airbnb offer us is a best practice where resources can be matched with supply on an on-demand basis, leading to on-demand medicine in some cases. The ‘uberization’ of healthcare is an opportunity that cannot be missed.”

Mr Zimmerman, Mr Kornak, and Mr Gattadahalli have disclosed no relevant financial relationships.

Source Medscape Medical News

References

Healthcare Information and Management Systems Society (HIMSS) 2016 Conference: Session 300. Presented March 1, 2016.

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