8- TELEMEDECINE & TELEHEALTH by PHARMAGEEK

We’ve seen enormous changes in the healthcare industry in recent years, mostly relating to the more efficient storage and usage of patient data through blockchain technology and the digitisation of patient files.

 

In the past two decades, the growing penetration of technology in the industry has yielded new medical devices, automated treatments, and improved diagnostic processes, giving doctors, scientists and patients renewed hope for the treatment of diseases some of which, until now, have been largely untreatable.

 

Blockchain has enabled the seamless global exchange of patient information in real time with reduced transaction costs and fewer administrative delays, enabling much faster, more secure and more efficient exchanges of health records between medical personnel.

 

But technology isn’t only transforming the way patient information is handled; it is also revolutionising the way patients receive medical care.

 

Telemedicine -- the use of information technology to remotely diagnose, treat, or continuously monitor patients - has been hailed the ‘next disruptor’ of the healthcare industry.

 

In other words, the industry has at last recognised that waiting for hours at a doctor's office to ask a simple question or get a prescription can in some cases be so burdensome and frustrating that it can prevent patients from seeking medical help.

 

About time, too. If every other aspect of our lives has been digitised -- from job hunting, to online dating, to doing the groceries -- why haven’t we yet digitised the process of receiving medical care?

 

Often, a doctor’s check-up is so simple that all that is required is a quick verbal check of symptoms and a quick glance into the patient’s eyes.

 

If this could be done remotely through video technology in less than five minutes, it benefits both the physician -- who can in turn help more patients on average -- and the patient, who needn’t risk becoming even more sick by leaving home and sitting in a crowded waiting room with other ill people.

 

By empowering caregivers to remotely interact with their patients, telemedicine has the power to completely transform health care delivery, by making it far more affordable and available.

 

In fact, it has already begun to do this: in 2018, over 7 million patients used some sort of a telemedicine service in the U.S., and that number is only expected to rise over the next few years. Over half of America’s hospitals already use some sort of telemedicine, and there are more than 200 telemedicine networks in the US alone. Inevitably, with anticipated growth comes unprecedented industry investment - and the telemedicine industry is no exception.

 

There have been huge investments in the global telemedicine market in recent years, so much so that it is anticipated to grow from its current $38.3 billion valuation to an impressive $130.5 billion by 2025.

 

This encompasses value derived not only from the services provided through telemedicine but the devices and platforms that support service delivery. 

 

As healthcare companies look for ways to reduce costs and improve patient-centered care, more and more providers -- as well as investors -- are choosing to invest in shares in telehealth.

 

According to recent studies, 56 percent of healthcare executives say they have already integrated telemedicine - and more specifically, software as a service (SaaS) business models - into organisation, while another 24 percent are currently looking to invest in telemedicine solutions.

 

The remaining 20 percent are just beginning to become familiar with the opportunities presented by telehealth and telemedicine.

 

One particular platform - Colorado-based CirrusMD, which gives patients access to a board-certified physician in less than a minute on the app or on the web - has seen the largest investment to date in the telemedicine world, with a further US$15 million in funding having just been granted for the expansion of its telemedicine portfolio.

 

The money was raised through a series B funding round led by Drive Capital, bringing its total venture capital raised to $26 million altogether.

 

Founded in 2012 by an emergency physician, the platform is available across 50 states and differs from other telemedicine platforms in that members don’t pay upfront to physicians. Instead, it teams up with integrated delivery networks who pay doctors by the hour to deliver services via its platform.

 

CirrusMD is far from alone in the telemedicine sphere, mind you. It vies for the attention of patients alongside competitors Heal, Pager, Kry, HealthTap, Snap MD, Mfine, Pager, K Health, and Doctor on Demand, the latter of which just pulled in $50 million to continue expansion of its virtual doctor platform.

 

Maven - the first telemedicine platform made specifically for women - just launched with $2.2 million in seed funding, and Spruce just raised a further $15 million for its new platform which caters to people with dermatology conditions.

 

With 25 percent of consumers admitting they would willingly switch their primary care provider for one that offers more telehealth services, and with 75 percent of people saying they would be happy to attend a doctor’s appointment remotely, it's extremely likely that the telehealth and telemedicine industry will grow at an exponential rate in the next few years, paving the way for huge opportunities for those willing to invest in the digital infrastructure that supports it.

Telemedicine is one of the most notable advancements making waves in the digital transformation of healthcare. Telemedicine poses wins for healthcare organizations seeking to improve patient access while controlling costs, as well as healthcare consumers looking for more convenient ways to engage with providers.

 

With 71 percent of providers reporting the use of telehealthand telemedicine tools, it’s clear that the industry is sold on the benefits of virtualized care. Telemedicine market projectionssuggest that the industry will reach roughly $20 billion by 2025.

 

The patient and provider benefits of telemedicine are manifold—including reduced readmissions through remote patient monitoring, reduced costs via virtual access to specialists, and improved patient engagement—but barriers to adoption still linger. Here are five key challenges giving healthcare executives pause when it comes to telemedicine adoption and recommendations on how to successfully navigate those hurdles.

 

1) Understanding what comprises telemedicine. Due to varying state and federal definitions, as well as variance between Medicare, Medicaid, and commercial payer guidelines on what constitutes telemedicine, confusion still exists regarding what services will and won’t be reimbursed. Establishing a keen understanding of what virtual services qualify and how those services are reimbursed for each payer is vital. This will lay the foundation for quantifying the potential revenue impact of adoption.

 

2) Concerns around the cost to implement. Costs associated with telemedicine program adoption can include a myriad of factors, from video conferencing adoption to remote patient monitoring expansion. To mitigate the potential for expense sprawl, executives should identify key, phase-one telemedicine service offerings. Weigh earnings potential against anticipated program implementation and support costs to justify those telemedicine coverage areas.

 

3) Added data vulnerability. With healthcare security breaches on the rise, executive teams remain cautious of any patient data exposure risk. Many view virtual care delivery as an additional layer of potential threat. As with other IT implementations, thorough security protocols and routine audits should be put in place to guard against the real-time exposure of protected health information (PHI).

 

4) Potential for fraud and abuse. Telemedicine agreements can be subject to federal kickback laws, particularly in situations involving referrals for additional services. Providers must remain up-to-date on the regulations governing telemedicine services to ensure regulatory compliance and proper eligibility for reimbursement.

 

5) Patient awareness of and trust in virtual care offerings. Even with the proper broadband and internet resources in place to support patient adoption of telemedicine, providers may encounter patient reluctance to engage virtually. Healthcare organizations must cultivate trust by educating patients on offerings and what they can anticipate during virtual visits. Providers should also address security concerns with patients.

 

To ensure that engagement in telemedicine is a long-term trend as opposed to a short-term fad, healthcare providers will have to address and overcome these challenges. By implementing a telemedicine strategy that addresses these challenges head-on, providers can overcome barriers and rise to meet growing consumer demand for more convenient provider engagement options. As more healthcare organizations pivot to embrace new digital health platforms, telemedicine adoption, specifically, is quickly emerging as a key differentiator in an increasingly competitive landscape.

Telehealth has emerged as a critical tool in providing health care services. [1] The practice covers a broad range of medical technology and services that collectively define the discipline. Telehealth is especially beneficial for patients who live in rural communities and other remote areas where medical professionals use the Internet to gather and share information as well as monitor the health conditions of patients by using peripheral equipment and software such as video conferencing devices, store-and-forward imaging, and streaming media. The following information details important factors that are shaping this burgeoning field.

 

The Changing Face of Telehealth Law
Today’s competitive health care marketplace has created an environment where patients demand lower costs, higher service quality, and convenient access to services. [2] Telehealth is an innovative and valuable mechanism that provides patients with efficient access to quality services. Lowering costs and removing barriers to service access, are critical components in promoting patient wellness and population health. Convenience and cost-effectiveness are important commodities in the modern health care marketplace, as patients tend to avoid treatment that is difficult to access or too expensive. As a result, telehealth technology is emerging as a preferred choice among patients and providers. Telehealth has also attracted the attention of US legislators. They utilize this tool for improving the competitiveness of American health care services. This is especially important, seeing as health care represents 17 percent of the nation’s gross domestic product (GDP). In fact, the resource has helped to define the role that lawmakers play in ensuring that patients benefit in a competitive health care market.

 

Reimbursement for Services Delivered by Telehealth
The laws regarding reimbursements change regularly as more service providers incorporate telehealth technology into their practices. Reimbursement procedures can vary by state, practice, insurer, and service. [3] Care providers need to understand several facts, regulations, and laws to navigate Medicare telehealth reimbursements. They must first scrutinize whether the distance between the facility (the originating site) and the patient is far enough to qualify as a distant site. The location must also qualify as a Health Professional Shortage Area (HPSA) per Medicare guidelines. Additionally, the originating site must fall under Medicare’s classification as a legally authorized private practice, hospital, or critical access hospital (CAH). For instance, the Centers for Medicare and Medicaid Services ranks the Harvard Street Neighborhood Health Center as a top facility in need of physician services based on these criteria. Care providers must also use proper insurance coding to be reimbursed for hosting services that use telehealth technologies. For now, collecting reimbursements for telehealth services remains simpler for practitioners who limit the scope to which they apply the technology.

 

Telehealth or Telemedicine?
The term ‘telehealth’ is gaining popularity among medical professionals, compared to the original term, ‘telemedicine.’ [4] Some medical professionals use the names interchangeably. However, telemedicine is a term that may apply to the application of any technology in the clinical setting, while telehealth more distinctly describes the delivery of services to patients. Telemedicine is a familiar term, but telehealth more appropriately describes the latest trends in using technology to deliver treatments to patients. Depending on the organization, service providers may use a different definitions of telehealth. Although the basic premise remains similar, the context may change according to factors such as organizational objectives, and the needs of the patient population being served. Medical experts do agree on one point; telehealth is an innovative way of engaging patients, and it is highly beneficial for both providers and patients.

 

The Road Ahead
There are several areas where telehealth medicine could make a significant impact. It could be used as a tool to remotely monitor patients who have recently been discharged. It may also help treat individuals with behavioral health issues who might normally avoid treatment due to its high cost, or to avoid any perceived public stigma. [5] The largest area where technology could advance medicine is in treating the chronically ill. These patients usually require many visits with several specialists who may practice at different and distant originating sites. To move telehealth forward, organizational leaders must present evidence to peers and patients that the technology offers value. In addition, care providers must work to transition patients from using telehealth services only for minor conditions (for headaches, colds, etc.), to accepting the technology as a viable replacement for costly physician office visits. Advocates for telehealth medicine must also develop quality controls, so that this potentially transformational tool can maximize its problem solving capabilities and its service effectiveness. To harness the benefits of telehealth technology, America’s brightest medical professionals (both experienced and up-and-coming) must make a concerted effort to incorporate the tool into their practices and make it a regular service offering. Today’s medical students — as they enter a world where telehealth is becoming more pervasive — can take part in what might be a monumental change in the way health professionals think about medical treatment.

You can put the word "smart" in front of just about anything these days — including an entire city. But what does it actually mean?

 

The concept of smart cities is incredibly exciting. Cities have always been social, cultural and productive centers of society. But the city of the future will help us work and play even smarter, commute more quickly, and make use of more advanced and affordable products and public services. That includes health care.

As the world explores what smart cities are capable of, we're seeing more ways they'll impact the telemedicine industry and vice versa. Let's take a closer look.

 

A Holistic View of a City's Health 

 

Conducting a more proactive monitoring of public health is probably the most important part of a smart city's data-driven telemedicine system. Thanks to electronic health records, location technologies, and cheap and rugged remote sensors, public health officials have an easier time than ever studying disease patterns and profiles, tracking public health worries and outbreaks, communicating with the public about new issues and seasonal disease cycles, understanding and making changes to how people move about a city, and much more.

 

This brings us to one of the best features of smart cities: smart hospitals. A number of facilities across the U.S. are using more advanced devices and data-gathering systems to better understand changes, even in real-time, that concern citizens on a daily basis. These insights can cover any number of factors associated with city living, including air and water quality, the effects of weather and climate on health and even the relative stress and happiness in one city compared with another.

 

Better Access to Health Care Even in Rural Areas 

 

It's a long-running pattern, but residents of cities generally enjoy better access to health services and medical specialists. As a result, residents of rural areas, and those who live a little farther from city centers are more likely to suffer from chronic health problems and to have greater restrictions on their physical activities. Cities are known for their smog and pollution, but they offset some of the harm thanks to convenient access to health infrastructure.

 

Making cities even smarter seems at first glance like it might make health care inequality even worse. But it may actually do the opposite. Cities have more choices than rural areas when it comes to health care, but residents still face wait times and lines, often for issues that didn't require a visit in the first place.

 

To that end, we can expect that telemedicine will cut down on congestion in cities, plus make it far easier for rural residents to communicate with doctors and specialists with the same ease as rural citizens. With telemedicine and remote video consultations, distance from a metropolitan area is less likely to decide the quality of one's health care or their life.

 

More Efficient Public Institutions 

 

In the U.S. and elsewhere, it's a fact of life that countries must feed, clothe and shelter prison inmates and residents of correctional facilities. This portion of the population is frequently written off or forgotten about, but these are citizens too, and they deserve as quick and competent a response as anybody when they find themselves in poor health. 

 

Telemedicine can provide a vital function by making it easy for cities to see to inmates' health needs. New York City alone is home to around 55,000 residents of its correctional system, which means the already limited availability of specialist doctors isn't always able to answer the call. Instead, telemedicine makes it simpler for specialists to check in with patients when they can't be there in person while cutting down on the time and expense of transporting these individuals to appointments. 

 

Walkability and Self-Service Health Care 

 

Futuristic cities have long been depicted with swarms of flying cars, but that dream is still a little way off. In the meantime, we're busying ourselves rethinking our urban layouts, including making a push to install bike lanes and generally make our cities more walkable and more amenable to cleaner, healthier living. 

 

Smart technologies like internet-connected cars, plus city infrastructure that can talk to them, will make it easier than ever for pedestrians and cyclists to navigate intersections safely and quickly. Couple this with the fact that insurance companies increasingly turn to wearables to keep customers honest about -- and committed to -- healthy lifestyles. These wearables lend themselves to telehealth in a number of ways, from making remote data sharing simple, to automatically alerting emergency responders, for example, if an elderly resident falls in his or her apartment, or in a park, and can't signal for help themselves.

 

The truth is, we're only beginning to appreciate what's possible with telemedicine and smart cities. As more medical device manufacturers move into making devices for a connected world, while still maintaining the quality set in place by ISO 13485, it’s easy to see how the relationship between telemedicine and smart cities is just starting. 

 

The potential here is part of the reason why we will collectively activate some 36 billion internet-connected devices by the year 2021.  

 

By that time, we'll have even more robust industrial standards for helping public and private data systems work better together, and we'll have an even more thorough understanding of how the advancement of technology can improve how we live and how we pursue health care services. 

Practice EHR discusses net benefits of telemedicine for Urgent Care Centers.

 

Telemedicine is becoming the new norm for giving and receiving care. Today’s patients are more connected than ever before and 64 percent of Americans report they would seek care via telemedicine, according to an American Well telehealth survey.

 

In its early stages, telemedicine seemed like another on-demand solution taking patients away from urgent care centers (UCCs). Today, urgent cares are realizing the benefits of integrating telemedicine into their operations, such as better flexibility, accessibility and in some cases, better patient satisfaction and outcomes.

 

Fortunately, telemedicine also has financial advantages. Telemedicine empowers UCCs to provide a convenient and cost-effective service for patients, while at the same time improving revenue. Have you considered telemedicine for your urgent care? Read on to learn more about the financial benefits of telemedicine:

Net-Benefits of Telemedicine

1. Increase the number of patients you see each day.

Telemedicine helps you work more efficiently and see more patients in less time. A virtual visit takes less time than an in-person visit, allowing your urgent care to increase the number of patients seen in a day, without having to extend office hours. For example, a clinic with three providers that completes two virtual visits per day, at an average reimbursement of $50, will earn $109,500 in additional revenue in just one year.

 

For UCCs who do feel the need to provide extended office hours, telemedicine is a feasible and cost-effective solution when you have a cloud-based electronic health record (EHR) with integrated telemedicine capabilities. Consider virtual extended hours, where a patient can be seen via a virtual visit conducted by a remote on-call physician. This idea eliminates in-person visits during extended hours, which keeps costs low, drives revenue for your clinic and at the same time provides better accessibility for patients who may be in need during those off-hours

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2. Better allocate your resources.

Today, consumers have more options than ever before when it comes to their care. Long wait times can result in low patient satisfaction and fewer patients. If your clinic is experiencing long wait times, consider how you can incorporate telemedicine for services that don’t require an in-person visit, like for the flu or an emergency medication refill. Providing virtual visits for these scenarios is a much more efficient and cost-effective way for your patients and your clinic.

 

Telemedicine can also help multi-location UCCs balance their patient volumes and wait times, without having to spend money on additional resources. The Journal of Urgent Care Medicine cited an example of an urgent care that decreased patient wait times and increased patient satisfaction by equipping facilities with telemedicine capabilities in two locations. In other words, UCCs can leverage providers in lower-traffic locations to conduct virtual visits immediately and remotely for patients who are waiting to be seen at the busier location.

 

3. Reach more patients.

In addition to load balancing, telemedicine can easily enable UCCs to reach a larger pool of patients to generate more revenue. Urgent cares who use telemedicine can expand their services to reach patients across one state or multiple, instead of being limited to patients who only live within a 3-5 mile radius.

 

4. Achieve competitive advantage.

Research from Accenture indicates patients want a better healthcare experience and they are leveraging technology, such as telemedicine, to do so. However, the same research also suggests patient demands for virtual care options are outpacing what’s currently available. This provides a significant opportunity for urgent cares. UCCs were the catalysts for convenient, on-demand healthcare; those who continue to evolve with their patients will successfully differentiate themselves in today’s competitive healthcare market.

 

To continue to lead in the on-demand market, urgent care centers will need to adopt technology, like telemedicine to meet patient expectations. The good news is telemedicine is a smart investment that can result in improved efficiency, patient care, cost-savings, revenue and more. Incorporating telemedicine into your UCC isn’t difficult, and there are affordable, telemedicine solutions on the market today. UCCs that incorporate telemedicine, have a lot to gain and very little to lose.