Connected Nation (CN), through its state program Connected Nation Michigan (CN Michigan), released a study that examines the use and perceptions of telehealth in rural areas with a focus on Michigan counties.
Researchers found, among other things, the highest ratios in the country of patients per doctor, a lower-than-average life expectancy, and a higher-than-average number of preventable hospital stays in rural states with restrictive telehealth policies.
Ferree
“This study demonstrates why connecting rural America is critical,” said Tom Ferree, chairman & CEO, CN. “Connected Nation has worked for nearly two decades to identify innovative solutions for connecting every community, and in that time, we’ve seen firsthand that having access to high-speed internet impacts everything from the economy to educating our children. Now we have real data that shows it can also impact healthcare—and even life expectancies—among families and individuals in our rural communities and small towns through telehealth applications and programs.”
The more than six-month-long study was done in partnership with AARP and the Michigan Health Endowment Fund. Find the full report at http://bit.ly/2ThWBPX. The study looks at the opportunities and reasons for expanding telehealth as well as the obstacles for rural areas.
“Many older adults in Michigan, especially those who live in rural areas, do not have access to high-speed internet, and that’s a quality-of-life issue for them,” said Paula D. Cunningham, State Director of AARP Michigan. “That means they can’t take advantage of advances in telemedicine that at the very least could save them long trips to the doctor, and at the most could be lifesaving.”
“Our nonprofit has long been focused on connecting more families and communities to high-speed internet,” said Eric Frederick, executive director, CN Michigan. “In recent years, we’ve seen more talk about the ways telehealth could help fill the void in rural areas where there may not be hospitals or doctors for hundreds of miles. But, as we looked around for more detailed information on telehealth in Michigan, we soon learned there were a lot of unanswered questions at the intersection of telehealth and the digital divide that we decided to set out and answer—from how state policies impact the use of technology to whether people or providers even understand the many ways it can be used.”
CN Michigan’s researchers took a three-pronged approach to examine those issues. First, they reviewed the current telehealth policies in all 50 states to identify counties ripe for leveraging the benefits of telehealth. As part of this analysis, CN Michigan compared each county’s access to primary care physicians and health outcomes to determine how big of a role telehealth policies and the Digital Divide play in these metrics.
Second, the team conducted telephone surveys of 2,001 adult heads of households in five rural Michigan counties: Gladwin, Sanilac, Roscommon, Osceola, and Dickinson.
“We chose these five counties because they represent a cross-section of rural portions of the state,” said Chris McGovern, Director, Research Development, Connected Nation (CN). “They were selected due to their differences and representative nature in terms of geography, employment, and the prominence of non-related healthcare provision networks in each county. We focused our questions on current telehealth usage, savings experienced from accessing online healthcare, interest in future use of telehealth services, and barriers that prevent individuals from using the technology.”
The third facet of this study focused on healthcare providers. CN Michigan conducted extended interviews and focus groups with healthcare networks, including doctors, nurses, medical assistants, and others within the five counties identified for telephone surveys. Healthcare networks in these groups ranged from just beginning to experiment with telehealth to those with established and award-winning telehealth programs.
“Although our focus was primarily on the impact in rural Michigan, this data can help inform the development of telehealth services elsewhere and provide a starting point for additional studies in regions across the United States,” said Frederick. “Our hope is to build upon what we’ve learned in this study and help more people in both rural and urban areas save time and money through telehealth applications and expanding broadband access. Most importantly, we hope it will lead to innovations that can improve the quality of life for all Americans—no matter where they live.”
As the technology industry continues to experience continuous, rapid change and advancements, other industries are faced with the challenge of incorporating these new technologies, creating rules and regulations in order to ensure the safety and privacy of consumers and businesses. In 2020, technology will continue to lead to new developments in the healthcare industry, but will also leave room for new threats. In particular, telehealth will grow in popularity for both doctors and their patients, allowing for streamlined communication, more convenient consultations, an increase in treatment accuracy and the ability for patients to receive healthcare anywhere in the world.
As the health industry normalizes digitizing health data and providing telehealth services, we must also prepare for what lies in the year ahead for healthcare and data privacy – specifically as it relates to a rise in cyber threats, increase in regulations and the adoption of blockchain.
Protecting Privacy in the Wake of Cyber Threats
Today, telehealth is segmented, essentially meaning that “walls” exist in the network that protect data and act as a defense against hackers and cyber criminals. However, in the coming year, many networks will be streamlined and optimized into an end-to-end solution, likely under the umbrella of one vendor and cutting out third party applications. This has the potential to minimize costs, resources and time. However, accelerating digital health convergence in this way will open the door for network security vulnerabilities. Ultimately, this will provide hackers new avenues to access private patient data and find ways around pre-existing cyber defense mechanisms.
This increase in cyber threats due to the implementation of end-to-end solutions is something that the healthcare industry cannot be prepared for without proper regulation and a dedication to provider compliance.
Increasing and Reforming Regulations
As telehealth becomes a normalcy in patient-provider communication in 2020, we will see a rapidly evolving regulatory environment in order to combat the increase in cybersecurity threats and data breaches. This will lead to a need for additional regulatory compliance codes and demand for more security compliance assessments for healthcare providers and organizations engaging with personal health data.
The shortage of specialist physicians in the United States continues to receive a great deal of attention as an area of concern. However, a lesser-known compounding factor is the increase in referral rates. In a 2012 study, the National Ambulatory Medical Care Surveys found that between 1999 and 2009, the probability of receiving a specialist referral during an ambulatory patient visit increased from 4.8% to 9.3%, a 92% increase, nearly double. While this study is now several years old, we can surmise that this trend has continued due to the persistence of several factors contributing to the overall disparity between specialist referrals and the number of available specialist physicians.
The clear impact of these compounded problems is substantially increased wait times among patients with a physician referral for specialist appointment. In 15 major metro areas, a recent Merritt Hawkins study covering the medical specialties of cardiology, dermatology, orthopedic surgery, and obstetrics and gynecology, found appointment wait times increased 25% from 2014 to 2017. Wait times averaged 24.1 days across the study, with some extreme cases waiting 165 days for an appointment.
Long wait times impact patient outcomes and healthcare operations
On top of the anguish and emotional impact of waiting for care, diseases and illnesses can progress as patients sit in appointment queues for weeks or even months on end. As NEJM describes, “long waits before appointments, particularly specialist appointments, often contribute to the development of avoidable complications,” which cause more difficult health cases both for the patient and for the physicians caring for them.
There are notable effects on healthcare operations that add to the case for reducing patient wait times as a crucial avenue for improving healthcare overall. For example, long wait times for appointments increase the prevalence of no-shows, indicating that patients are either frustrated enough to not follow through on scheduled appointments or forget appointments altogether because of the long interim period. Sometimes appointments can even be moved around by specialist physicians at the last minute, leaving patients in limbo for even longer.
Additionally, long wait times frequently lead to patients receiving inefficient care. Firstly, extended waits often deter patients from seeking initial care. This shifts the healthcare industry away from proactive to reactive care, which is less effective and more costly for all parties involved. Secondly, the inability to access the care they need and when they need it, leads to patients seeking care within inappropriate settings. These patients are more likely to be admitted to EDs, as the 30-day rate of ED and inpatient usage was 8.7 times higher for patients awaiting a specialist appointment. A study by Truven Health Analytics noted that 71% emergency room visits are unnecessary and avoidable. Each of these issues alone make strong cases for reducing patient wait times; these issues combined suggest reducing patient wait times is a crucial goal that must be prioritized when it comes to streamlining healthcare delivery and improving quality of care.
In light of these concerning figures and effects, healthcare organization operations are turning their focus toward reducing wait times and improving patient outcomes. This fits well as part of an overall strategy to increase quality and efficiency of healthcare delivery. Below, we will focus on how telehealth platforms, specifically eConsults, combat multiple factors driving specialist appointment wait times, streamlining the physician referral process and thereby reducing patient wait times for happier and healthier patients.
Positive impacts of reducing patient wait times by accessing specialty care from within primary care
Increasingly, healthcare providers are entering into value-based payment arrangements. Telehealth solutions, and specifically eConsults, can support the drive toward more efficient care by increasing access to specialists while better optimizing time and place of care.
eConsults are is an electronic form of peer-to-peer collaboration, providing PCPs with a platform to consult with specialists on specific patient cases. eConsult interaction occurs using a secure, HIPAA-compliant messaging platform, where specialist guidance is received within 24 hours, drastically reducing the interim time between referral and treatment. eConsults can replace more than 70% of routine referrals with immediate, specialist-guided treatment from the PCP, without the wait and additional cost. Keeping lower acuity patients out of the specialist referral queue means faster access to face-to-face visits for the higher acuity patients, expediting care and improving outcomes for all.
One provider (and frequent user of AristaMD eConsults) at a Federally Qualified Healthcare Center describes the challenges of securing specialty care for the patients at her clinic: “Especially with MediCal patients, it usually takes at least four or five months for a patient to complete a referral. Very often, patients end up waiting three to five months, then receive notification their appointment has changed, the specialist has moved, or even that the specialist is no longer taking that patient’s insurance. Some of these patients are then in limbo for more than six to nine months. This is where the benefit of AristaMD’s eConsult platform comes in. AristaMD specialists provide guidance on patient care plans, for example diagnostic or medication recommendations, within 24 hours.”
Several studies have already noted demonstrable decreases in wait times once eConsults were introduced in large health systems. The San Francisco Department of Public Health saw dramatic improvements following the introduction of their eConsult program. The median wait time for a non-urgent appointment with a rheumatology specialist was drastically reduced from 126 days to 29 days. Additionally, patients visiting specialists needed fewer follow-up appointments as a result of a more extensive pre-visit workup made possible by this telehealth platform. Other similar successes have been observed in Los Angeles and the NYC Health + Hospitals System, with the latter finding that median wait times for high-urgency specialist visits decreased from 30 days to 16 days as a result of eConsult implementation.
Conclusion
eConsults are ideal for addressing the growing problem of lengthy patient wait times. They empower PCPs to deliver specialist-guided care to lower acuity patients in a timely manner while freeing up the capacity for in-person specialist visits for the more complex, higher acuity patients who need them most.
Over the past few years, there have been encouraging improvements in the realm of mental health care in the United States. Initiatives to improve mental health outcomes, such as the Affordable Care Act (2010), have been primarily aimed at requiring increased insurance coverage to encompass mental health services at levels comparable with physical medical care.
Despite these improvements, such policies do not address issues caused by access challenges within the referral system, and many of the one in five adults suffering from mental illness in the United States still are not accessing the mental health care they require and need. In particular, there exists a shortage of mental health providers across the country, and these health professionals are likely to be out-of-network for many patients. Further barriers preventing patients from obtaining care include travel, missed work time associated with appointments, and the social stigma of seeking mental health care.
Faced with these challenges, patients with mental health issues are resorting to emergency departments in search of mental health services. Hospital emergency departments lack access to psychiatric services and mental health resources. Further, as patients are improperly treated in urgent care settings, this can lead to reduced access to care for those with acute medical issues, which then results in poorer overall outcomes at the highest cost of care.
To address these multi-faceted challenges, value-based care models have placed particular importance on the role of primary care, as these organizations are uniquely positioned to promote innovation and efficiency through proactive and coordinated care. When it comes to mental health services, primary care providers (PCPs) serve at the front line of care and are positioned to be an excellent means of providing access to mental health care to a patient population in need. However, many PCPs lack adequate resources to treat these often complex and specialized issues.
Telehealth technologies, such as telepsychiatry and eConsults, can support primary care practices by creating networks to provide timely, documented, and standardized access to mental health professionals. This equips PCPs to more effectively manage patients with mental health concerns, reducing wait times and improving mental health outcomes.
AristaMD’s eConsult platform connects PCPs with adult and pediatric psychiatry, addiction medicine, and behavioral health specialists to provide care planning support and treatment recommendations. Ninety-one percent of AristaMD’s mental and behavioral health eConsults have been shown to include medication regimen guidance including initiation of treatments, diagnostic recommendations, and medication dosage adjustment, all of which can be managed within the primary care setting with the support of specialty insight.
As the U.S. population ages and the percentage of citizens over 65 continues to increase, healthcare consumers are taking advantage of a whole new generation of medical technology. Sociologists and anthropologists have been writing about that fact that millions of oldsters are delaying retirement until well past their seventies. Indeed, it’s not unusual for senior citizens to embark on new careers, sell insurance policies to life settlement companies for cash and basically reposition themselves for a completely new way of living.
The new year will usher in several new medical technologies that will help everyone live longer, healthier, happier lives. Forty might be the new 30, and 50 the new 40, but once 2020 rolls around the catchphrase might become, “70 is the new 50.” Here’s a peek at what senior citizens, and everyone else, will be dealing with next year and beyond:
Wearables
So-called “wearable technology devices” have been around for a while. They include items like blood-pressure cuffs, blood-sugar monitors and even brain-wave devices. They all have one major concept in common: real-time data is relayed back to medical professionals who can see important changes in the patient’s vital signs and other essential anatomical parameters.
In 2018 and 2019, the use of wearables exploded when cost for many devices came way down. Now, as 2020 approaches, the majority of healthcare consumers are becoming aware of what wearables are and what they can do. For heart patients, a wearable monitor can mean the early detection of trouble. Anyone who has suffered a stroke is a prime candidate for wearable technology. In practical terms, wearables are almost like having a doctor by your side every minute of the day but without the cost.
Voice Activation
Voice-activated everything is one of the fastest-growing trends in several fields, medicine included. Heart monitors no longer need to be reset by hand but can simply be commanded to “reset at base level and reset start date.” But that’s just the tip of the iceberg for seniors, millions of whom reside in care facilities. The beauty of voice activated devices means that oldsters need not know how to interface with keyboards and tablet screens. A simple word or phrase is all that’s needed to turn on lights, open secure doors and inform nurses that everything is okay.
Telemedicine
What was once a futuristic dream in 1960s television shows is now full-blown reality. You no longer need to travel to the clinic in order to “see” a doctor. Especially in rural areas, where long-distance drives are a burden for ailing and elderly patients, telemedicine has caught on. A standard Internet connection and a decent camera are all that’s needed for a virtual visit to the doctor. At fist only popular with psychiatrists and psychologists, tele-visits are now commonplace for routine physical checkups. Experts say that medical teleconferencing and tele-checkups will become the norm rather than the exception in 2020, as more health organizations look for ways to eliminate costly in-person patient interactions. The estimated cost of a telemedicine checkup is about one-third the cost of an in-person visit.
Born from a federal grant awarded to the University of Utah in the 1970s, “locum tenens” provided staffing services to health clinics and facilities in rural, under-served geographies in the Western United States. The notion of “freelance physicians” grew as the program proved successful for decades to follow.
Today, more than 50,000 physicians freelance, many in a downshift towards retirement to create more work-life balance, reduce practice management stress, and/or contribute to more flexible medical care nationwide. The advancement of telehealth technologies has also accelerated the freelance physician trend.
This trend, coupled with a currently disjointed and antiquated system for freelance healthcare staffing, fueled the creation of Hyr Medical, poised to disrupt the current status quo.
By transforming the way physicians and hospitals connect through a direct and transparent online platform, Hyr Medical enables reduced hiring cycle time for hospitals and increased pay for physicians.
Ahead of significant growth trends, Hyr Medical announces key additions to the leadership team including:
Dr. Sunil Pandya, MD, MBA, MHI, CPHIMS, chief strategy officer:
Sunil has over 15 years of clinical experience in nearly every aspect of hospital medicine. He has held leadership roles at the highest levels including Chief Medical Officer, Chief Strategy Officer, and National Medical Director. Additionally, Sunil has successfully created and sold five companies to various national physician management corporations.
Spencer Liebmann, chief operating officer:
Spencer has over 25 years of executive leadership experience in the healthcare industry. He has held executive leadership roles as both chief operating officer and president of hospital medicine. Spencer is an experienced entrepreneur who has built and sold four companies, as well as successfully led and managed large sales and customer service teams.
According to Manoj Jhaveri, co-founder and CEO of Hyr Medical, “Sunil and Spencer are truly special individuals. Their ability to define a vision, build and lead great teams, and execute is second to none. I feel so fortunate that they have decided to join Hyr as full-time executives to complete our c-suite.”
According to Jhaveri, Hyr Medical is blazing a new trail in healthcare staffing and technology as their dual-sided marketplace continues to expand. In the last 90 days alone, Hyr has received signed agreements from over a dozen major healthcare systems and medical groups. By the end of 2019, Hyr also expects to have over one-thousand physicians signed-up on its platform.
Artificial intelligence makes suggestions about what we should buy at the grocery store. If we need transportation to get to the grocery store, we can use ride-sharing applications. Swiping right on a dating app has become a new way to look for romance. Banking with your phone, without the need to physically visit a branch office, is common practice.
If, in the past, the public did not trust technology enough, nowadays, the convenience aspects of technology outweigh the risks.
But healthcare has always been a conservative industry when it comes to technology. For the most part, this is a good thing. I’m sure you wouldn’t have liked to be treated with a fairly new drug or piece of equipment, or to be diagnosed by a robot-doctor.
On the other hand, technology has come a long way and is now more reliable, stable and trustworthy than ever. It has already penetrated the health industry, which means you are going to see more and more of it. The combination of rising costs, Amazon’s promise to go into healthcare, and the government pressure for affordable care are pushing healthcare providers to embrace technology and adapt to all the risks and benefits it brings.
Technology at its core is being used to reduce overhead cost, provide better data analysis (to facilitate better decision-making), automate human tasks, and provide comfort and convenience in our day-to-day lives. When it comes to the health industry, what we all would like to see is (in no particular order):
Increased Access to Care – Access to care has been, and still is, a major concern throughout North America. When speaking of access to care, we oftentimes think of financial barriers to care. However, there are many other barriers that are as prevalent: Geography (distance and mobility to a healthcare provider), anxiety and even opening hours of a healthcare provider can be serious barriers for access to care.
Telehealth is quickly becoming a technological solution to resolve the above mentioned challenges and increase the ability for the general public to receive healthcare services in a way that is convenient for them. When we look at telehealth from the perspective of remote communities, it is the difference between seeing a healthcare provider and not seeing one at all.
Better Diagnostic – We look up to doctors and expect them to be able to identify our illnesses and prescribe the treatment that would enable us to overcome them. In reality, illnesses are becoming more complex and require interdisciplinary collaboration to diagnose with better accuracy and prescribe an effective treatment. There is no way of achieving this without the use of technology.
A centralized database that will store all health information from all practitioners is the only way to provide doctors the information they need, when they need it. Having information from all healthcare providers you have visited provides a better picture of habits, complaints and parallel treatments already prescribed (without the need for the patient to remember and be able to verbalize correctly). This is crucial to be able to treat you more effectively.
Technology has evolved, and it has positively affected all areas of our lives. When it comes to technological advances and innovations in medical technology, it can be said that life has been made easier for us.
With new medical technology, we are assured of longer life span with credits to various medical innovations in medical technology. It would interest you to know that technological advances are basically medical innovations in medical practices which are aimed at giving life a better meaning.
Hence, the basic aim of these evolving technologies in the field of medicine is basically an increase in the lifespan and ensuring our overall state of health is improved.
Below are the most recent technological advances used in medicine:
CRISPR stands for Clustered Regularly Interspaced Short Palindromic Repeats, and it is a new medical technology, which is at the highest level of advancement when it comes to gene-editing technology. CRISPR functions by tapping into the natural mechanisms that are found in the immune systems of bacterial cells, and it lacerates the DNA strands that have been infected.
The cutting ability of the CRISPR has the capacity to modify the conventional way of disease treatment. When some genes are modified, some diseases such as HIV and cancer could possibly be totally defeated in few years. Although, when you read most medical essays with an essay plagiarism checker, an essay check or an essay corrector, you will discover that there are still further inquiries into the full capacities of the CRISPR and the unknown benefits to the human race.
This is another new medical technology which fits into this technologically guided world. It basically means a form of promptly evolving technology which enables patients to access medical care via their medical devices, rather than go to the hospital for appointments with their doctor.
Currently, there are some highly-functional personalized applications that are developed for the purpose of allowing patients to interact virtually with medical professionals and get prompt medical advice and diagnosis.
Telehealth makes full provision for all patients to have various access means to healthcare the moment it is needed. It also comes in handy for those who have chronic health problems because it makes health care available at a regular, convenient and affordable means.
3. Virtual reality
Virtual reality has been in existence for quite a while, and there are medical advances that are being integrated into exploring the full capacities of this modern technology. With medical virtual reality, medical students have been afforded the opportunity of accessing close to real-life experience using this technology.
There are top modernized tools which aid them in gaining the experience needed by memorizing and practicing procedures as well as and producing a visual knowledge of the entire connection of the human anatomy.
If you check legit medical essays with an essay corrector or an essay checker, you will discover that virtual reality devices are a profound help for patients, providing diagnosis help, treatment schedule and making procedures available for them. They are also essential in patients’ rehabilitation recuperation.
Medical technology is advancing, and it becomes more personalized to patients individually. One of the benefits which precision medicine comes with is, it enables physicians to choose therapies and medicines for disease treatment, which includes cancer hinged on the genetic make-up of the patient.
This form of personalized medicine is way more effective than other forms of treatment, as it effectively treats tumors using the specific proteins and genes of the patient as the basis. This then causes gene mutations and makes it more effortlessly annihilated by cancer medicine.
In addition, precision medicine can also be used for rheumatoid arthritis treatment. It employs a mechanism of combating the vulnerable genes of the disease, in a bid to weaken it and lessen the symptoms and damage to the joint.
As the technology industry continues to experience continuous, rapid change and advancements, other industries are faced with the challenge of incorporating these new technologies, creating rules and regulations in order to ensure the safety and privacy of consumers and businesses. In 2020, technology will continue to lead to new developments in the healthcare industry, but will also leave room for new threats. In particular, telehealth will grow in popularity for both doctors and their patients, allowing for streamlined communication, more convenient consultations, an increase in treatment accuracy and the ability for patients to receive healthcare anywhere in the world.
As the U.S. population ages and the percentage of citizens over 65 continues to increase, healthcare consumers are taking advantage of a whole new generation of medical technology. Sociologists and anthropologists have been writing about that fact that millions of oldsters are delaying retirement until well past their seventies. Indeed, it’s not unusual for senior citizens to embark on new careers, sell 
Born from a federal grant awarded to the University of Utah in the 1970s, “locum tenens” provided staffing services to health clinics and facilities in rural, under-served geographies in the Western United States. The notion of “freelance physicians” grew as the program proved successful for decades to follow.
Technology is changing everything that we know.
Technology has evolved, and it has positively affected all areas of our lives. When it comes to technological advances and innovations in medical technology, it can be said that life has been made easier for us.