Blog

The healthcare system has improved a lot in the last decade due to recent advances in network and wireless technologies that are connected with recent advances in ubiquitous and nanotechnologies computing systems. Telemedicine is used to describe the use of telecommunication technology in diagnosing health conditions, treatment, as well as taking care of patients.

This is aimed at offering expert-based healthcare especially to remote locations that are understaffed through the use of improved communication and telecommunication technologies. Telemedicine allows health services to be undertaken using an electronic network, something that has changed the healthcare sector.

There are three main categories of telemedicine; teleconsultation, telementoring, and telemonitoring.

Teleconsultation

This is one of the most widely known categories of telemedicine. It basically refers to the online visit where a consultation between the doctor and patient take place. It can be done through the use of videoconferencing technology or by simply storing a particular picture and forwarding it to the healthcare provider for further interpretations.

Telementoring

This is a situation where one medical practitioner gets mentorship from another, who could be more specialized to find ways of helping a patient. A good example is a doctor who has an autism patient in a rural location and is looking for help in managing that particular patient. The best thing to do is to connect to an established health institution who will have one of their mentors provide assistance online. That is telementoring.

Telemonitoring

This is a case where a doctor receives data from a patient at home while connected to a certain biosensor. It can be done by an electronic scale, a vital-sign monitor, a glucometer or any other any device that can effectively monitor bio-parameter. The doctor will then use the results they have obtained from the test to start administering treatment or prescribe drugs to the patient. This form of telemedicine allows a patient to be easily monitored from home, without having to travel to the health facility.

These are the three major categories of telemedicine.

A large number of established firms in the United States are turning to telemedicine services, launching workplace health centers and pursuing other ultramodern means to provide and pay for healthcare. However, according to recent surveys, there are no possible chances of physical provider visits and other technologies in telemedicine taking over the role of clinical laboratories when it comes to offering the kind of data needed for diagnosing and treating a disease.

But instead, anatomic pathology groups and laboratories are expected to witness changes in the manner in which samples are obtained from patients through the use of telemedicine. As access to telemedicine continues to improve, the laboratories are also expected to see changes on how test results from medical labs are reported.

What Might Happen In 2018

A survey done in May 2017 by the National Business Group on Health revealed that in 2018, 96% of averagely large companies and businesses would avail telehealth services in the states where it is permitted. Telemedicine technology has been divided into three distinct categories; provider-to-provider, remote patient monitoring; and the last one is patient-to-patient.

Using The Current Retail Setups To Promote Telemedicine To Patients

The only tool that can be used to enable consumers to leverage the options of telemedicine that are available to them is the use of small marketing. Providing just a video or telephone visits is not sufficient. An integrated delivery system should be excluded from the playbooks of the retailers.

A practical illustration is how retail giants like Walmart integrate the store experience and online shopping by providing side-to-side options that promote in-store pickup and the delivery of a product. That is the same way telemedicine options are supposed to be offered, in a manner that feels seamless and integrated to the consumer. Offering a simple link to a virtual visit to the network of the healthcare’s webpage for urgent care is one means of doing this.

Telehealth Could Increase Healthcare Spending

Whereas health plans have narrowed into telehealth as a means of driving down healthcare costs, practical visits to healthcare providers might not in any way reduce spending even if the health care access is improved.

What is Telemedicine?

Any type of medical monitoring involving a clinical diagnosis that is delivered with technology can fit within the scope of telemedicine.

For many healthcare practitioners, telemedicine is part of the future of the medical industry. Video conferences allow doctors, medical staff, and patients to efficiently and accurately transmit necessary information. This includes x-ray data, films, photos and remote patient monitoring.

Telemedicine is rapidly becoming the standard for diagnosing minute health issues, such as colds, flu, and infections, as well as handling patients with more serious long-term health conditions.

Telemedicine in Healthcare

According to the American Telemedicine Association, telemedicine is now being used in the majority of hospitals. In 2016, the number of telemedicine consultations was around 20 million. At the current pace, by 2020 there will be around 160 million. In fact, around one-third of all employer groups already factor telemedicine into their group planning.

Telemedicine has allowed physicians to now practice medicine across multiple states, should they meet the eligibility qualifications. The legal regulations have already been passed within the United States.

What Does this Mean?

As telemedicine practice standards, regulations and requirements are put into effect, doctors can now establish patient-physician relationships without in-person meetings. This is a huge step in the healthcare industry, as the issue of patient mobility had not been properly addressed in the past. Additionally, insurance companies are maneuvering to usher in telemedicine into their blanket of covered medical procedures and practices.

Legally speaking, telemedicine will have the same level of liability as face to face meetings with your physician. The standards of care with telemedicine consultations and diagnoses are held to the same level as any other doctor’s appointment. Although this is still a policy that isn’t cut and dry across all states in the U.S.

Of course, telemedicine is a relatively new form of practice, and the methods used are not foolproof. Miscommunication can occur, and diagnoses can go awry when the physician is examining a patient via video conference and not in person. Any malfunctions or problems arising from equipment could cause an error of judgment, or otherwise, mask signs of disease that could easily be noticed with an in-person appointment.

In regards to medical malpractice and telemedicine, we are still working out the issues.

None the less, these issues will be addressed in due time. Telemedicine is an emerging field, one that will ultimately be perfected as it makes a path in the future of healthcare.

Many insurance companies are deciding to leave ObamaCare, with Anthem being one of the largest health insurers in the United States determining that will not offer plans through the Affordable Care Act marketplace next year. Anthem joins Aetna, Humana, Minuteman Health, Harken Health Insurance, Molina Healthcare, and many others in what it seems to be an exodus of insurance company fearing the pains of increased costs stemming from the Affordable Care Act.

Why are so many insurance companies deciding to leave, and what are the factors that are contributing to this phenomenon?

The Factors That Come into Play

The Affordable Care Act is massively expensive to keep afloat. Its initial projections significantly overestimated enrollment data, as well as underestimated the cost per beneficiary. This has created a disaster where ObamaCare has become a bottomless money pit. Predictions also overestimated the revenues from various taxes imposed by law. It was projected that $70 billion would stem from Title VIII of the Affordable Care Act, with the CLASS Act being destined to fail even before it gained traction, whose projected revenue was based on accounting that would send private insurers to prison. Even the rhetoric of Medicaid expansion was surprisingly expensive.

Risk Corridor Payments and Statutory commitments. The Risk Corridor was designed to pay out insurers who lost money. However, when insurers made any capital, the Health and Human Services decided to dip into other operating funds to keep what may have looked like a sanctioned commitment. Instead of relieving this need by actually appropriating money from the Risk Corridor aspect of the Affordable Care Act, it was ultimately a bailout of the insurance industry. Now that insurers who relied on these payments just lost revenue altogether to a black hole in the system.

Insurance companies leaving due to high costs set a dangerous precedent. Large firms like Anthem are one of the country’s BlueCross BlueShield companies, which have long represented and serviced the individual market. For Anthem, it has been on the market for more than 70 years. Its exit has left whole regions like Arizona without any insurers.

When will ObamaCare be fixed?

Medical technology has made enormous advances in recent years, resulting in shorter patient stays and less invasive procedures. It is even used to keep patients from being admitted to the hospital. How? Through the use of telemedicine.

Telemedicine, or telemedical platforms, uses an audiovisual software platform for video chat between clinicians, nurses, and patients. With this, a physician or nurse practitioner can perform follow up visits with patients without the need for an in-person appointment. The patient gets the face to face time with the clinician and is able to show and tell any symptoms or improvements since the last clinic visit.

What are the benefits of this type of technology? Clearly, a video conference cannot replace physical exams or lab testing. What it can replace, however, are mandatory post-hospital visit checks, checks that are required by many insurance companies, and that doctors themselves desire, to ensure that the patient is healing correctly. For patients in assisted living, or without reliable transportation, these video appointments can make the difference in their quality of healthcare.

Under the current healthcare system, patients may be released from the hospital and then have to be readmitted because of a lack of post-acute follow-up care. With telemedicine, patients are able to be professionally evaluated, with at-home post-hospital care recommended. The repeat trips to the hospital can be even more unhealthy for the patient, and telemedicine removes that risk.

The need for transportation to and from the hospital, such as with an ambulance, is reduced, making those vehicles available more readily for acute emergencies. Providers from the clinic or hospital can evaluate patients around the clock, as long as the staff is available, and recommend at home care, rest, or that the patient is readmitted through the video conferencing. Best of all the telemedical platform is able to retain a patient history report, for easier access to the patient’s history if they access a different provider.

Technology has helped create a more efficient lifestyle in many ways. Now, it can create a more efficient medical system, also. Reducing the number of patients readmitted to hospitals can enhance both the patient wellbeing and streamline hospital treatment for other patients.

The second round of revisions to the Telemedicine rules released in 2016 (revision one was in July of 2017) occurred today in the District of Columbia. The rules from the District of Columbia Department of Health were revised after telehealth industry advocates submitted comments and amendments to the initial rules.

These changes were based in part on the above-mentioned comments, as well as Telemedicine Workgroup recommendations. The DC Board of Medicine made the changes in order to reduce barriers to care and clarify some aspects of the Telemedical Health ruling from 2016.

Several of the changes addressed the validity of doctor-patient privilege and clarified the circumstances under which this is valid. Currently, video and audio consultations will be considered treatment. The new rules also both established that a “real time” consultation would be considered treatment, as well as delineated the parameters of “real time.” Another change was replacing “face to face” with “in person” in order to define the relationship between doctor and patient.

Further, these rules established that if the patient seeking treatment is located in DC, the doctor must be licensed to practice medicine in DC.

Here are the key points for Telemedical Providers:

• Telemedicine has been redefined as care via remote technology
• The rules have flexibility, and video conferencing is not required
• A valid patient-provider relationship can be established remotely, without first requiring an in-person exam. The doctor may provide real-time treatment and exchange protected health information.
• Regulations regarding exams and patient evaluations were further defined. Specifically, the provider must establish diagnoses and identify underlying conditions or contraindications to recommended treatment options before providing treatment or prescribing medication for a patient.
• Regulations regarding informed consent, practitioner licensing, and standard of care were further clarified. Patients also must establish alternative forms of communication with the providers in urgent care cases.
• Rules regarding prescribing medications were established
• Medical record requirements were established

These rules and revisions are not exhaustive, or complete. Please be advised that more revisions may occur.

Telemedicine encapsulates the use of the different types of online communications by medical institutions and physicians. By employing technology, telemedicine makes it possible for healthcare providers to remotely care for patients either due to distance, convenience, or home location. It equips caregivers with the ability to transfer and collect essential medical data including photos, videos, and audio. A live Internet connection backs this transfer of information.

In the past couple of years, telemedicine has been a significant proponent in the field of cardiology, psychiatry, radiology, and oncology. Tele-surgery and patient indication are also possible thanks to video conferencing.

The History of Telemedicine

Even though the influence of the Internet is a relatively new phenomenon in the field of medicine, it has a unique history. For some, the advent of telemedicine goes all the way back to 1906, when Willem Einthoven first utilizes the electrocardiogram transmission over telephone lines. In the current day, telemedicine has become more immersive, with a few hospitals experimenting with telemedicine to reach patients who happen to live in remote locations. The potential for telemedicine has amplified as a tool to help alleviate healthcare shortages and to share medical consuls and healthcare records almost instantaneously.

Benefits of Telemedicine

Remote diagnosing. The majority of patients prefer easy access to services over in-person interactions. Telemedicine galvanizes practicality and convenience, allowing medical institutions to offer in-demand care without the wasted time and cost of in-person visitations.

Referrals and specialists. For the patient, they spend less time traveling to medical specialists. For doctors, some are charging less for the convenience of telemedicine consultation versus in-person evaluations.

Remote monitoring. Telemedicine allows physicians to be in tuned with vital signs, enabling them to notice if there is a change in health.

Remote health education. Telemedicine can also be used to convey messages. Since it is closely related to the videos and images – media that can express a lot of information in a compressed format – then it is expected to use telemedicine as a platform to deliver these messages.

Amazon has a secret health tech lab called 1492 which explores various areas such as telemedicine, medical record data and health apps for devices like Amazon Echo. The secret skunkworks is dedicated to opportunities in new areas in electronic medical reads and has a headquarter in Seattle. The project focuses on both software and hardware.

Amazon is increasing its interest in exploring new businesses in healthcare. For instance, it has another unit exploring the sale of pharmaceuticals. The new team is looking at opportunities involving pulling and pushing data from electronic medical record systems.

When the project is complete, Amazon will make information available to doctors and their patients. It is a means of building a platform for telemedicine which can make it easier for people to enjoy virtual consultations with their doctors.

The group is exploring other health applications for existing Amazon hardware such as Dash Wand and Echo. Most hospitals and doctors have already dabbled in developing skills for the voice assistant Alexa which is a great opportunity for e-commerce.

It remains unclear whether the company is building any new health devices. However, sources have already ruled out that option. Amazon has been advertising new roles for the stealth operation which people can search on the jobs websites under the keyword “a1.492.” some job posts have described the position as a special projects team or the Amazon grand challenge.

The unit has been posting ads for UX Design Manager for the new vertical and the machine learning director with healthcare IT experience, knowledge of electronic medical records and analytics. Some members of that team have an affiliation with a1.492 on LinkedIn. Some of the people already involved include two strategic initiative leads, two machine learning experts, and a UX designer. The experts are running projects in the group, eg. Cameron Charles and Kristen Helton.

Other teams are working in life and health sciences in Amazon. The cloud operation has a team of health experts to match Google and Microsoft for contracts with large pharmaceutical vendors and hospitals. Amazon has invested in startup companies like Grail that has a special interest in the cloud business.

The company is taking advantage of opportunities in the $3 trillion sectors and is directly involved in the sale of medical supplies for years. The market has many opportunities, and Amazon will capitalize on the efforts to digitize health operations.

The in-person care services telemedicine reimbursement bill aims to make telemedicine reimbursement equal to in-person care services. Senator Elder Vogel brought the bill to the Pennsylvania Senate on June 28, 2017 to define major components of telemedicine and to set telemedicine licensing requirements. Pennsylvania is bound to be the next state to allow complete telemedicine reimbursement equality for care services. The legislation requires all healthcare payers to provide telemedicine reimbursement if the same services are paid in person.

The bill will ensure that all telehealth services provide reimbursement under the ancillary service plans. The group or individual health insurance plans provide exclusive coverage for vision and dental services. The healthcare services a person purchases through the ancillary plans cannot be absent from the coverage because they were done through telemedicine.

Pennsylvania Department of Human Services will offer medical assistance for reimbursement of the fee for service, medical assistance and managed care programs or general healthcare done through telemedicine under Medicaid.

Healthcare providers must follow strict guidelines set to enable them to receive payments for telemedicine. Providers must establish a provider-patient relationship using appropriate diagnostic tests and virtual exams to give an accurate diagnosis. The provider can use an interactive audio without video IF after carefully reviewing the medical records of the patient.

The provider will give equivalent healthcare to the person. The bill also states that the provider must have an emergency action plan during the telemedicine consultation. Apart of the emergency action plan includes verifying the location of the patient and disclosing the identity of the providers. It also includes obtaining informed consent and establishing a diagnosis and treatment plan. The healthcare provider can create an EHR record using the records of the visit.

The legislation will enhance statewide care delivery using proper payment providers that include Hospital and Health system Association of Pennsylvania (HAP). HAP will ensure the technology provides greater access to quality care irrespective of where the patient is living in the commonwealth.

HAP supports telemedicine as a way of improving healthcare delivery and encourages other hospitals to support the bill so that telemedicine can become a viable care solution. Telemedicine reimbursement gives providers the financial support to enable them to pursue telemedicine care as a means of delivering care to under-served and remote communities in the state.

Similar legislation is before other state legislation and has been passed by other states as well to empower providers to consider telemedicine. The bill offers numerous benefits to patients across the country and strengthens the US Healthcare system.

When Hurricane Harvey caused flooding throughout Houston, it displaced hundreds of thousands of citizens. It is estimated that more than 27,000 homes were destroyed by the savage water, resulting in an extreme number of now-homeless people who lost access to vital prescriptions and medical treatments they need to stay healthy. The field of telemedicine provided displaced patients with the immediate care that they couldn’t get from their local physicians, in addition to medication and treatments for chronic conditions.

Displaced Houston residents with chronic or flood-related conditions can receive the medical care through technology-driven, virtual office visits provided at local disaster shelters through the cooperation of local hospitals such as Children’s Health. It is estimated that for every adult patient there are three children who need medical attention, and a shortage of pediatricians available for 24-hour care means some of these patients could not be treated without telemedicine services.

The use of telemedicine in the aftermath of Hurricane Harvey is made possible by the passage of SB 1107, a law passed in May that allowed Texas residents to see a doctor remotely without an initial visit in person. Texas is the last state in the country to implement this new law, and state physicians were still getting used to a higher influx of new patients even before Harvey struck.

They expect to see patients from Harvey who have been exposed to mold and bacterial infection from clean-up in addition to diagnosing new cases of anxiety or depression as families face an uncertain future. The use of telemedicine in post-disaster situations is relatively new. When Hurricane Katrina blasted through New Orleans in 2015, emergency personnel were often stretched to the limit with the constant traveling between office, hospital and shelters.

Telemedicine allows physicians to “see” dozens of patients a day using just a computer monitor and simple machines to measure vital signs. It is hoped that telemedicine can become the new normal for those who need medical treatment after going through a natural disaster.