McKinley County, New Mexico, is the namesake of the assassinated 25 U.S. President William McKinley. Many locals, particularly those Native Americans of Navajo decent living on reservations, have also been the victim of assassination, but in character in addition to physical attacks. Three decades ago Gallup, New Mexico, which borders on the Navajo Reservation, was known as “Drunk Town, USA.”
For many years Northwest New Mexico’s Gallup ranked number one nationally in the number of alcohol-related deaths. This reputation also killed many resident’s spirits, contributing to addiction, joblessness and homelessness, further highlighting the need for behavioral health care in this region. Native American youth have the highest rates of alcoholism of any racial group in the country, according to the National Institutes of Health.
McKinley County Is One of Poorest in U.S.
There are many stories like this. Addiction’s partner is the adjunct poverty of McKinley County, one of the poorest counties in the U.S. In Gallup there is a large population of Navajo and Na’nizhoozhi Indians. It is the most populous city in the county with 22,670 residents and is situated between Albuquerque and Flagstaff with 61 percent living below the federal poverty line and unemployment at 8.4 percent.
The Indian Health Service (IHS), an operating division within the U.S. Department of Health and Human Services (HHS) is the principal federal health care provider for Indians. Its mission is to raise their health status to the highest possible level. However, there are still issues such as the life expectancy for Indians being approximately 4.5 years less than the general population of the United States, 73.7 years versus 78.1 years.
Data from a 2014 National Emergency Department Inventory survey also showed that only 85% of the 34 IHS respondents had continuous physician coverage. Of these 34 sites surveyed, only four sites utilized telemedicine while a median of just 13 percent of physicians were board certified in emergency medicine. Another behavioral health related disease afflicting the territory is diabetes. In 2016, diabetes was the sixth leading cause of death for New Mexicans and the seventh leading cause in the U.S.
RMCHCS Hospital Fights Addiction with Behavioral Health Apps
Despite the drumbeat of bad news and discouraging statistics, organizations such as Gallup’s Na’ Nihzhoozhi Center Inc.’s (NCI) has 26,000 admissions every year and is the nation’s busiest treatment center with many repeat customers. The detox center was the result of an effort 30 years ago which began when more than 5,000 people marched from Gallup to Santa Fe to demand assistance from state lawmakers and received a $400,000 for a study to build a detoxification center. The hospital then received two-million-dollar ongoing yearly federal grant out of which NCI was born.
When he became CEO of RMCHS a few years ago, he took a financially failing hospital and turned it around with the help of William Kiefer, Ph. D who is the hospital’s chief operating officer. Recognizing the root cause of the region’s health problem was addiction, Conejo revitalized a former rehab building on the hospital’s grounds and with some fundraising he launched the Behavioral Health Treatment Center.
The center is operated by Ophelia Reeder, a long-time healthcare advocate for the Navajo Nation and a board member of the Gallup Indian Medical Center. Bill Camorata, a former addict, is the behavioral special projects director. He opened “Bill’s Place,” an outdoor facility where he and hospital volunteers treated the homeless with meals, clothing and medical triage as part of Gallup’s Immediate Action Group that he founded and serves as president. The center has treated more than 200 addicted residents since the center opened in 2015 and has a staff of 30 who manage resident’s case work, provide behavioral health services and are certified in peer support.
Medical innovators can’t come up with ways to implement 3D printing into categories of healthcare fast enough. With so many practical applications, 3D printing is quickly becoming a technology realized for its untapped potential and seemingly limitless possibility to transform healthcare.
3D printing alone has many applications across a wide range of industries — for one example, advancements in health data are benefiting nursing and patient care. As 3D printing continues to be combined with the innovations in health data, it will further revolutionize patient care, lower healthcare costs, expand the field of nursing, and improve modern medicine as we know it. How will 3D printing and health data do this?
Below is an extensive look at how innovations in health data are changing healthcare fields, and how 3D printing will further reform these sectors, allowing for advancements in both medical practice and patient care.
Home healthcare benefits patients who would like personal care in the comfort of their own home. Elderly and disabled patients don’t have to travel to have minor care done, and patients who have such diseases as HIV and are worried about discrimination or bias can have their privacy. Home-based care allows for specialized care for the patient, rehabilitation, and the close monitoring of vital signs for health and wellness, without the trouble of an in-person office visit. This convenient transfer of data through new technology makes it increasingly easier for caregivers, whether it be family members or professionals, to care for patients on their terms.
ASU reports, “75.2 percent of nurses agree that telemedicine makes their job easier.” Telemedicine is another sector of healthcare made possible by the accessibility of telecommunication technologies such as videoconferencing. Through videoconferencing, a professional is able to listen to a patient’s concerns and diagnose illness or injury from a remote location. This gives the patient another level of privacy and both parties freedom and independence. Telemedicine cuts healthcare costs, as a physician doesn’t need to physically travel to a patient every time a minor checkup is needed.
EHRs and CPOEs
Electronic health records, or EHRs, are just that: electronic patient health documents that provide real-time information. Medical history, treatments, and diagnoses can be constantly updated along with other details such as allergies and current medications. An infographic by Duquesne University highlights the increased reliance on EHRs while illustrating patient data in the age of technology.
CPOEs, or computerized provider/physician order entries, are a better way to order medication and control the dosage and frequency at which the medication is administered. This efficient method of ordering pharmaceuticals reduces error and abuse, and therefore diminishes illness and injury. As Scott Rupp writes, CPOEs are “foundational for meaningful use. Make sure it’s easy to use and intuitive.”
Involvement of 3D Printing
In its infant stages, 3D printing is being utilized to make hearing aids, prosthesis, skin for burn victim patients, heart and airway splints, and much more. Showing potential for almost every aspect of healthcare, 3D printing, combined with the innovations in health data above, will transform these fields for even more accessible, affordable, and convenient healthcare.
3D printing can be applied to home health care, telecommunications, EHRs and CPOE in a number of ways. A professional can diagnose the atrophy of a leg, order the rehabilitation of walking, 3D print a prosthetic, and monitor the progress all while a patient is at home. In another instance, home healthcare and telemedicine can diagnose that a patient is ill, EHRs and CPOEs will allow for a better determination of what medication to order, and 3D printing can be used to print the medication for a patient
More accessible healthcare means more easily affordable healthcare, and with the involvement of 3D printing home-based care, telemedicine, EHRs, and CPOEs, healthcare will be transformed and turned on its ear. Patients who desire privacy, or are not mobile, will be able to get the care they need at home, while professionals will be able to stay in the office to help people with more immediate and urgent matters.
As mentioned above, 3D printing is in its infancy stages for many of these processes. An argument can be made that 3D printing will make home care, telemedicine, EHRs, and CPOEs more expensive — and that’s true, but only for now. As 3D printing becomes more of a norm in the medical field, and it will with its promising applications, the cost will decrease. As 3D printing becomes a normal process in these fields, it will increase patient care and make healthcare more accessible and more easily affordable.
By James Smith, blogger and researcher of latest technological trends in the fields of health and lifestyle. He has his work published on various authoritative blogs and is currently working on a telemedicine project at Mend Family. For all the updates follow him on Twitter @JamesSmith1609.
E-Heath, telehealth, telemedicine are different approaches towards accessible healthcare in remote areas or over a long distance. Technology has come a long way, opening new gateways for communication and transmission of information. To a certain extent, it has helped healthcare become more accessible, especially in remote areas.
Because of a lack of infrastructure, facilities, equipment and other factors, it is not always possible to offer quality healthcare in specific remote regions. Opening a healthcare facility requires time and resources, which would be challenging to amass in the remote areas due to lack of infrastructural development, lack of talent, lack of investors and so forth. However, due to efforts to make healthcare accessible to all, which is also a major Sustainable Development Program (SDG) objective, technology is used.
Healthcare service delivery has improved over the last few decades by adapting to new technologies. Terminologies such as e-health, telemedicine, and telehealth are all formulations of healthcare delivery, combined with communications technology. The initiatives taken towards developing the health service delivery is phenomenal. However, it is essential to establish an understanding of the differences in e-health, telehealth, and telemedicine. Most people would confuse them to be the same; however, they are quite different.
In simpler terms, telemedicine refers to the use of electronic communications channel/mediums, as well as information technology to deliver clinical services to remote patients. While telemedicine is a part of telehealth, it is more concentrated towards the use of technology for clinical service delivery. The service delivery is the same as medical practice. However, the critical difference is that it is used towards reaching out to patients in remote destinations via electronic platforms. This usually works when a patient and medical practitioner interact using video/voice conferencing to offer professional advice on medication and clinical services.
Telehealth is a broader spectrum of delivering quality health care via online mediums. The primary aim of telehealth is to provide healthcare services in remote areas with lack of healthcare services. Telehealth operates on the same principals of traditional healthcare practice with the use of technology. Because of the practitioners’ inability to be physically present in the area, they rely on telecommunications, internet and other communication platforms to interact with the patient and offer professional guidance.
According to the Health Resources and Services Administration (HRSA), United States, telehealth is used to promote and support long-distance clinical health care. The use of telehealth helps with delivering professionalized clinical healthcare remotely. Furthermore, it also helps with developing and improving health-related education, health administration, and improving general public health.
Telemedicine can be delivered using various technologies, including the internet, still imaging, video conferencing, streaming media, wireless communications, etc. This means that it can be used in more than one way. For example, a patient can acquire professional consulting and diagnosis remotely.
Similarly, it can be used for educational purposes, for delivering quality healthcare education on recent discoveries, prognosis, diagnosis, and other evaluations. Telehealth is the primary method of providing quality clinical health care in underdeveloped regions. It is widely present in the African region and helps in offering quality clinical care to long-distance patients. In most cases, the practitioner would conduct examination using imaging devices, live video conferences, and by obtaining patient’s medical history. Moreover, doctors use telehealth to seek second-opinion or expert advice on complex medical cases.
Telemedicine has already proven its effectiveness in traditional acute care hospitals, providing consistent coverage in areas where physicians are hard to come by, guiding clinical teams and leading specialty programs. Now telemedicine is making inroads into a new model of care—micro-hospitals. The growth of micro-hospitals, where small neighborhood hospitals offer care tailored to the specific needs of a community, is dramatic—and telemedicine is helping drive it.
Communities in 19 states have micro-hospitals today, and the numbers are climbing. Cited as a new trend in healthcare by U.S. News & World Report, micro-hospitals typically have eight to 10 short-stay beds and a small ED. They can provide the imaging and lab services performed in larger hospitals, but they are geared toward moderately ill patients who don’t require the intensive care and longer stays required by patients in traditional hospitals.
Because of this patient profile, micro-hospitals can hire fewer physicians—a plus given today’s physician shortage—and can rely more heavily on nurse practitioners (NPs) and physician assistants (PAs)—whose numbers are growing—to assume key leadership roles, make daily rounds and provide hands-on coverage.
A Perfect Environment for Telemedicine
Telemedicine teams offer a cost-effective way to provide on-the-spot, expert guidance to NPs and PAs via web videoconferencing, telephone and secure texting. One could argue that the emergence and growing public acceptance of telemedicine has made the physician-lean, micro-hospital model possible, helping bring cheaper, faster care to moderately ill patients. To illustrate, one company we are working with plans to place 70 micro-hospitals across the country over the next four to five years, and telemedicine will play a key role in all of them.
A Range of Specialized Care
In micro-hospitals, telemedicine serves a function that is similar to the model for many critical access hospitals, where NPs manage hands-on coverage of patients with guidance from telemedicine teams. A videoconferencing cart or “robot” delivers expert physicians to patient bedsides, where the physicians can converse with staff and patients. With the help of the onsite nursing team, they can access diagnostic equipment on the cart to examine patients and make a diagnosis. The telemedicine physicians also work with ED physicians to admit patients, examine them once they have a bed, and develop a plan of care to be carried out by NPs and nursing staff.
The telemedicine physicians might be in the same state and time zone; they might be across the country or, in some instances, halfway around the world, but they must be licensed in the state and credentialed by the hospital in which they are practicing. If they see that a specialist’s care is called for, they can contact a team of specialists—cardiologists or neurologists, for example—who are under contract to examine the patient via telemedicine and provide a diagnosis and treatment.
Given the growing shortage of specialists in the United States—the Association of American Medical Colleges (AAMC) projects a deficit of up to 61,800 specialist physicians by 2030—being able to contact a remote team immediately via telemedicine is another plus for micro-hospitals. For example, teleneurology specialists typically achieve an average response time of 3.5 minutes (a fraction of the time it typically takes for a local neurologist to get in the car and drive to the hospital), and an average diagnosis and treatment time of 21.8 minutes.
As we launch into 2018, questions remain about the healthcare policy environment and how it can impact many healthcare initiatives. As Yogi Berra said, “It’s difficult to make predictions – especially about the future.” I feel confident, however, about some fundamental trends in the healthcare landscape. These include a steady shift toward value-based care, an increased focus on data and analytics as a core enabler for digital transformation, and the all-consuming focus on the patient experience.
Here are my four key predictions for the healthcare IT trends that will transform the industry in 2018:
Patient Satisfaction Takes Center Stage
The era of healthcare consumerism is here. Patients are bearing increasing financial responsibility for healthcare costs, and seek improved experiences as a part of the value-for-money equation. In response, providers are taking a 360-degree view of patients, employing better analytics to leverage patient data such as demographic information, lifestyles and individual preferences, to personalize interactions and treatment.
Artificial Intelligence (AI) Becomes Entrenched in Clinical Settings
Despite the overuse of the term AI to describe many types of technology-enabled solutions, the adoption of AI has been steadily gaining ground in a wide range of settings. Deep learning algorithms will increasingly be used in clinical settings to support medical diagnosis and treatment decisions, predict the likelihood of patient re-admissions and help providers better leverage the data that has been accumulating in electronic health records. According to the 2017 Internet Trends Report by venture capital firm Kleiner Perkins, medical knowledge is doubling every three years, and the average hospital is generating more than 40 petabytes of data every year.
While all this accumulated information empowers more informed physicians, the growing range of data and knowledge sources creates a challenge as well, since physicians and clinicians must manage and stay on top of this information on specific conditions, especially in fields such as oncology. AI technologies are enabling time-constrained and overworked physicians to make sense of the vast amounts of data, helping them uncover hidden insights and supporting their medical diagnoses and decisions with timely and relevant input at the point of care.
Open Source Finally Takes Hold
Healthcare organizations have been conservative when it comes to open source technologies, largely due to concerns about data security and privacy. With the growing adoption of cloud-enabled solutions and a gradual shift of enterprise IT workloads to the cloud, they no longer have to worry about risks to the IT environment and can rely on mature cloud service providers, such as Amazon Web Services (AWS) or Microsoft Azure. And, open source architecture can now incorporate robust technology components with rich functionality. Our current collaboration with Partners Healthcare to build a digital platform for clinical care is based on an open source architecture. As the industry shifts rapidly to value-based care, cost pressures will force healthcare enterprises to transform their technology strategies, turning to open source solutions to rapidly build new solutions cost-effectively.
The need of Telemedicine AHA Report shows that 20 percent of US citizens are located in the rural areas and do not have access to the healthcare professionals and their services. The industry, though, has found a way out in form of telemedicine.
Telemedicineis defined by American Telemedicine Association as the process of medical data exchange from one site to another via electronic devices in order to improve patient clinical health status, electronic devices meaning emali, applications, video, wireless gadgets, smartphones, etc.
Telemedicine notion includes three main modalities: real-time, store-and-forward, and remote patient monitoring. The first modality means doctor-patient interaction with the help of audiovisual technology. The second — transmission of patient data and her history via secured electronic channels to a healthcare specialist. The third — collection of the patient data with the help of special devices (like wearables) and its transmission to a healthcare provider.
Foley predicts that by 2020, telemedicine will grow to 36.2 billion US dollars at CAGR (compound annual growth rate) of 14.3 percent. In 2014, it was 14.3 billion US dollars. Currently, there are around 200 healthcare academic centers in the US that provide video consultations worldwide, according to American Telemedicine Association.
Foley has also reported that 90 percent of healthcare top minders have already begun telemedicine integration. Nearly 70 percent of employers are going to offer telemedicine services as perks for their employees. 42 states in the US have already created more than 200 legislative acts about telemedicine.
US patients are not opposed to the idea of telemedicine, too. According to American Well, 64 percent of them would attend a meeting with their doctor via telecommunication means; forecasts that there will be 7 billion telemedicine users worldwide.
Types of Telemedicine
Telemedicine deals with many spheres of healthcare: telestroke (remote data transferred to the emergency specialists on site), teleradiology (images and media transfer), tele-ICU (systems and networks connected to the critical medical specialists), telemental health (distant mental health treatment), cybersurgery (operations held by surgeons remotely with the help of telecommunication and robotic instruments), and telepharmacy.
Importance of Telepharmacy
As stated by Centers for Disease Control and Prevention, 74.2 percent of physician visits involve drug therapy. During hospital outpatient department visits, there were 329.2 million drugs ordered or provided. These numbers demonstrate the potential hidden in the telepharmacy. Moreover, the number of independent pharmacies is steadily decreasing from 2011.
Telepharmacy was originally introduced for the rural areas that lack the resources to supply existing demands in the pharmacy. However, it’s now being actively used by healthcare systems, regardless of the location, due to its ability to meet medication needs 24/7.
A vivid example of telepharmacy success, Comprehensive Pharmacy Services, has launched telepharmacy project, CPS Telepharmacy, that works 24/7 the whole year round. It has been reported to detect and improve 1,300 medical errors per year and to have reduced around 45 percent of costs, with improved quality.
CPS Telepharmacy can process nearly 3 million medication events a year and involves with 200 medication orders a day (73,000 cases a year). Averagely, errors occur 3.6 times per day. Those can be wrong patient, wrong dose, or wrong medication.
CPS Telepharmacy has brought substantial improvements in form of reduced costs, lowered adverse drug events, and improved clinical outcomes.
PiplineRX, another leader in the industry, has recently announced its round funding at $9.1 million U.S. dollars by McKesson Ventures, Mitsui & Co Inc., and AMN Healthcare. Currently, the system is available in around 200 hospitals.
Many reports have been issued emphasizing the importance of the control of antibiotics prescription, namely ASP (antimicrobial stewardship program) to prevent emerging antibiotic resistance. Advanced technologies are to help reduce costs on drug by finding cheaper alternatives or preventing over prescribing of medications.
To sum up, telemedicine, as well as telepharmacy, have great perspectives. The number of their supporters in the healthcare industry is increasing from day to day and is not going to stop.
Guest post by Kate Jester-Brod, vice president of client success, EoScene.
Since Hurricane Katrina, the healthcare industry has been pushing towards maintaining comprehensive EHRs. The concept of an EHR combined with the concepts of the health information exchange (HIE) creates a means for patients and providers to always have a 30,000-foot view of the patient’s health. Which then begs the question, ‘what about the actual healthcare facilities?’ What does their 30,000-foot view look like? Are facility and staff doing their part to support exceptional and safe patient care?
In the most basic of explanations, enterprise risk covers the overall opinion of others towards your organization. It can affect revenue, staff retention, grant funding, and much more. In the healthcare industry, the enterprise is at risk at many levels. Drug safety, staff and patient safety, clinical outcomes, facilities maintenance, public relations, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores are some but not all of the components of enterprise risk.
Moreover, reducing enterprise risk in any industry includes reducing not only overhead and operational costs but also consumer costs. In healthcare reducing costs for consumers can increase patient satisfaction, which is an obvious connection. More interesting, however, are recent news stories reporting on suits against major hospital systems for frauds and schemes—or applauding them for lowering healthcare costs.
While telemedicine and home health are increasingly major components of healthcare, much of healthcare operates in a facility like a hospital or clinic. Facilities, along with structural integrities and heating, ventilation, and air (HVA) systems, also include patient equipment and a state of cleanliness. All of these components comprise the environment of patient care and healing, and the enterprise. By taking control of these areas a hospital or healthcare facility becomes one step closer to protecting the enterprise.
The best way to protect it is to predict and manage risk before problems happen. This is even more critical as the healthcare industry works towards the Institute for Healthcare Improvement’s Triple Aim as a means to optimize care. The three components of the Triple Aim complement and overlap the need to reduce enterprise risk.
Fundamentally, the Triple Aim works towards creating system-level metrics to measure success. Enterprise risk is at the center of these metrics that ultimately drive decision making. Understanding the policies and procedures that make up facilities management, patient safety, accreditation, and the overall health of the system can significantly reduce enterprise risk while supporting more effective decision making.
Taking control of facilities management can directly impact the reduction of enterprise risk. Facilities Management holds many different responsibilities in a healthcare system, including emergency management, fire safety, patient and staff safety, infection prevention, environmental services, utilities and equipment, accreditation, and many others.
Improving patient-centered care with consideration for facility compliance results in tangible ways to improve the Triple Aim. The electronics health record is assumed to document all the components of the Triple Aim, but this clinically based monitoring system focuses on provider-patient experience and overlooks other components of the healthcare environment.
Utilizing facilities information technology plays a critical role in establishing the foundation necessary to achieve positive results in achieving the Triple Aim. Recent innovation in health facilities IT has resulted in quality improvement and measurement from the ground up and has the potential to address an often overlooked component of that we all strive for in Triple Aim.
We put a lot of faith in health technology: to make us better, to save our systems, to revolutionize healthcare. We may be looking at it from the wrong side entirely.
The social determinants of health matter more than our ability to deploy doctors or provide insurance; physical and mental, health is always more social than clinical.
But most of our health tech that is supposed to be revolutionary is aimed at clinical factors, rather than the social determinants of health. Yes, telehealth can increase reach, but it is still just a matter of touchpoints, not a fundamental change to the lifestyles and cultures that determine health.
Same with all our EHR systems creating more ways to record information, more ways to quantify patients, to put more emphasis on engagement and quality-based reimbursement. Even genomics and personalized medicine are taking a backseat to soliciting reviews and trying to turn the patient experience into a number. It all puts greater focus on the clinical encounters, on how patients “feel” broadly about each minute aspect of their time in the medical facility.
A Digital Disease
As politicians trade blows on minimum wages and the ACA, the likelihood grows that insurance benefits and livable incomes (and lifestyles) will get pushed further out of reach for more people.
Modern work is tech-centric, which means lots of sitting, and manages to facilitate increased snacking without being particularly physical, a double-whammy that prevents employment or higher incomes from leading to healthier choices. For the less-skilled, normally accessible jobs are in the sights of automation and disruption. While tech is taking over medicine and opening up new possibilities, it is also transforming the labor market and closing countless doors to workers.
By extension, technology is changing the social framework that determines public health. Income inequality is growing, wage growth is stagnant, and no amount of awareness can change these front-of-mind concerns for people who may well want to eat better and exercise more, or even commit to seeing the doctor more often and following his or her advice to the letter.
Poor people can’t necessarily eat better as a simple matter of choice or doctor’s orders. Planning meals and purchasing healthful foods is a tax on limited resources–time as well as money. Working three jobs to pay the bills, many lower income individuals also don’t necessarily have time to exercise. And more likely than not, those working even high-paying jobs are sitting all day, sapping their bodies of energy and resilience, undoing the good of their intentions and smart devices alike through attrition.
In the current era, it is important to understand the role technology plays in different industrial sectors. The different verticals of the medical industry have adopted technology and identified the benefits associated to it. Healthcare and other medical services can be easily accessed with the help of a smart phone. It has become more convenient to track, regulate, and monitor several medical cycles such as medicine intake, therapy, and treatment. The communication gap between the patients and doctors has reduced over the years owing to advancements in technology. Progressive Markets recently added a market report that offers useful insights related to the global telemedicine market such as market share, size, and growth. The digitalization in medical field is set to facilitate enhanced healthcare and medical services in the coming years.
Technology has revolutionized several industries worldwide over the last two decades. The onset of innovative and modern technological advancements have made a notable difference in the medical field and has made telemedicine a game-changing way to serve people throughout the world. The adoption of telemedicine has increased significantly in the last decade although there are a few concerns regarding its reliability and precision. Approximately more than 70 percent urgent illness conditions can be taken care of with the help of telemedicine according to the American Telemedicine Association. A simple physician training enables providers to diagnose and treat minor problems such as pharyngitis, sinusitis and upper respiratory illnesses with the help of video chat.
General awareness related to telemedicine technology is growing
Telemedicine technology has not flourished largely yet as it is still in the nascent stage. However, as awareness related to the telemedicine is growing, the adoption rates are set to grow. The benefits associated to telemedicine are gradually making a mark in the medical industry. Telemedicine has largely helped to save time. With the help of telemedicine, a patient does not have to travel to the provider and save time.
Further, telemedicine eliminates any chances of transmitting infectious diseases from a patient to the health care professional. Telemedicine saves time and offers time-efficient solutions. However, there are additional benefits associated to it. It reduces costs significantly. The most important aspect of telemedicine is its ability to cater to the needs of the patients from any place at any given time. This is highly beneficial for occupational medicine. Telemedicine helps to formulate an efficient and reliable healthcare plan.
Benefits of telemedicine
Telemedicine is making its mark worldwide and it is important to realize that the technological advancement does not eliminate visits to traditional doctors. There are a few medical conditions that cannot be diagnosed without the presence of the patient. However, with data such as medical history of the patient, visual exam and an interview with the patient along with the providers training of pattern recognition, it is convenient to treat patients without them being physically present in the room.
As developers of electronic health record (EHR) software, my company gets into a lot of conversations with providers about their expectations for the future. This information helps us make decisions about what to build next. Here are three trends we’re hearing from our customers right now:
Low-tech beats high-tech in telemedicine
Unlike the way it was imagined decades ago by science fiction writers, telemedicine does not necessarily mean holographic images or live video conferencing with a physician half a continent away. Patients would rather receive “low tech” remote care from their primary care physician who has a full picture of their health status.
This form of telemedicine happens whenever an EHR system adds to a patient’s clinical chart the messages, pictures, or videos sent securely via smartphone. It happens whenever a smartphone connects to a remote health monitoring device for collection of real-time data such as blood pressure, oxygen levels, and heart rate.
The new rules allowing reimbursement of telemedicine and other non-face-to-face services will encourage physicians to bill for these remote care activities. Medicare’s recently expanded set of billing codes for Chronic Care Management (CCM) is a good example of how the future of value-based care goes beyond the office visit to keep patients out of hospitals and emergency rooms. The ability to securely and rapidly receive and answer a patient’s questions via text, and then capture those activities in the patient’s permanent clinical record is a critical step in that direction.
Primary care providers are trying new types of practices
Primary care physicians are frustrated with the hassle and expense of dealing with insurance companies. The new Medicare fee-for-value quality payment program is creating uncertainty about future reimbursement levels and requires additional reporting. Also, there is an acute level of burnout with “corporate medicine,” which has providers booked for dozens of daily appointments, only to spend less than 15 minutes with each patient.
In order to remain independent, a small but growing group of primary care practitioners are becoming more financially creative and experimenting with new models of practice. One example is direct care, in which a financial relationship is established directly between patient and provider, cutting out insurance altogether. This model includes concierge and direct primary care (DPC), where patients become “members” of a practice and pay a fixed monthly fee for unlimited primary care – similar to a gym membership, but for healthcare. Another example of direct care is the cash-only practice that sees walk-in patients for urgent care.
EHR interoperability will catch FHIR
Physicians and their patients are frustrated with the lack of interoperability in health IT. The concept of having a patient’s medical records accessible to any authorized provider at any time is still a rare occurrence. When a patient switches primary care physicians, the first office typically prints out and faxes their medical records to the second office, which introduces the possibility of errors, HIPAA violations, and others.