Telehealth: Mining the Vault

Guest post by Jack Plotkin, CTO, Virtual Health.

As a concept, telehealth has always impressed physicians with its potential. The ability to capture time-critical health information regardless of a patient’s location empowers a level of preventive care and early diagnosis never before possible. A physician can only observe the symptoms exhibited by a patient during a visit, but what of the symptoms exhibited in the course of the hours, days, weeks and months between visits? Each day, patients are subject to changes in their health as a result of lifestyle choices, treatment compliance decisions and physiological processes. Telehealth makes it possible to continually monitor these changes and take immediate remediation measures rather than waiting until the disease has progressed to a point of no return.

The advent of wireless devices that may be unobtrusively worn or placed in the home to track everything from pulse rate to frequency of night-time bathroom usage has made the real-time collection of a broad range of biometric data a reality. Moreover, the cost of such devices has dropped significantly over the past several years while their convenience and capabilities have grown. Despite this progress, the healthcare industry has yet to fully adopt telehealth or realize its enormous potential.

Some point to the lack of reimbursement as the culprit. Although device costs may have dropped, the overall expense of initiating and maintaining a telehealth program, including the associated device, data, personnel and training costs, is significant. However, two trends are chipping away at the economic side of the equation. First, state Medicaid programs are continually increasing the scope of reimbursement for tele-visits and remote monitoring, and both Medicare and private insurers have also started to move in the same direction. Second, the shift from fee-for-service to capitation models are providing compelling financial incentives for managed care organizations to fund telehealth programs.

Arguably a more critical obstacle to the mainstream adoption of telehealth is the challenge of data integration. Telehealth systems have developed along a separate track from electronic medical record systems. As a result, the telehealth data resides in a separate, landlocked silo from the patient’s medical history. Thus, even though data is being captured regarding the patient between physician visits, the physician still only sees and records the data accessible during the visit. At the same time, the telehealth program nurse is only seeing the biometric data without the context of the patient’s overall health profile that is accessible to the physician. With the data in landlocked silos, different members of the patient’s care team are unable to see the entire picture or effectively collaborate.

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