8- TELEMEDECINE & TELEHEALTH by PHARMAGEEK

Using telehealth technology still requires good bedside manners - just call it your screen side or website manners. So what do providers need to know that is different between an in-person encounter compared to a telehealth encounter? 

 

The space involved with making that first impression via telehealth is significantly smaller than meeting in-person in a clinical setting.  Besides being two-dimensional, your space is limited to the size and quality of the monitor projecting your image on the other end of the connection. 

 

You only get one chance to make a first impression – so make it good.

 

Important factors to consider to help develop and maintain a positive patient-provider relationship:

 

Prior to encounter – being prepared is always the best practice.

• Equipment – understand how to use and test; know who to contact to troubleshoot; ensure good placement of the camera, microphone, and speakers
• Physical space – clear of distractions; good lighting; private and secure (HIPAA)
• Provider Appearance – professional; solid, non-distracting (preferably light blue) colors
• Preparation – review patient history chart/file

 

During the encounter – a little extra explanation can go a long way to foster relationships.

 

• Confirm connection quality (hear/see) and security of space (HIPAA)
• Introduce self (and others), organization/location
• Have patient introduce self and any others in the room
• Explain the process of taking notes, and only briefly looking away from the camera as necessary, otherwise maintain eye contact
• Periodically ask the patient if he/she has any questions or anything to say
• Reiterate any instructions or follow-up procedures for a patient prior to disconnecting

 

Developing your screen-side manners in today’s telehealth world is just as essential as developing good bedside manners. 

 

Patients still need to feel they are being heard and understood by their provider whether in-person or via video connection. The tasks that happen during an in-person visit, (e.g., jotting down notes, or looking at an image), are seen directly by the patient.

 

These same actions may not be as visible via video, and require some explanation to keep the patient engaged. The patient still needs your full attention.

 

Empathy is no less important in telemedicine. Being prepared, clearly communicating, and focusing on your patient will help foster a positive patient-provider relationship.

 

 You can still make meaningful eye contact via telehealth, but the trick is looking directly at the actual camera, and not the projected image of the patient on your screen.

 

Body language can speak louder than words, but telehealth creates a situation where not all body language is actually visible. 

 

While a thoughtful hand to the chin while thinking maybe commonplace, on video the same action might communicate disinterest. 

 

Controlling reactionary movements is vital for telehealth. While standing bedside, a simple action like shifting weight from one leg to another has minimal visual impact compared to being on video and then seeming to shift out of the view of the camera.

 

Similar to developing a good bedside manner, a good screen-side manner takes practice.  Telehealth is unique in that you can record yourself and review the video before ever connecting with a patient.

 

By examining your recording, you can get a better understanding of the patient’s perspective of the telehealth connection. This process allows you to make adjustments that might not happen otherwise, creating the best patient encounter possible.

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.

In developed countries like the United States, stroke is still the third leading cause of death. In fact, each year stroke occurs in more than 700,000 patients, leaving many with disabilities and unable to resume a normal life.

 

When a stroke occurs, every second counts. The sooner a stroke victim is treated with medication that breaks up blood clots and restores blood flow to the brain, the less chance the patient will suffer permanent damage such as the loss of muscle control, mobility, or the ability to speak.

 

According to the American Stroke Association, ‘time lost is brain lost.’ That’s because every minute that passes before a stroke patient is treated, means the death of millions of brain cells.

 

Unfortunately, less than 30% of stroke victims receive clot-dissolving medication inside a recommended window of an hour or less for maximum effectiveness, according to information from Healthcare delivery network Kaiser Permanente.

 

But the same study reveals how telemedicine – or a telestroke system to be precise – can be a vital tool in getting stroke victims faster treatment – and thereby limiting the debilitating effects of the attack.

 

A Race Against Time

Basically, a telestroke system requires a neurologist and attending nurse to have a high-speed Internet connection and videoconferencing capabilities on a laptop, tablet or desktop computer.  The purpose is for the consulting neurologist to be able to talk to the patient or an emergency response team about what symptoms the patient is experiencing, evaluating the patient’s motor skills, viewing a computed tomography (CT) scan, making a diagnosis and prescribing treatment.

 

Data gathered from 300 stroke patients being treated in 21 Kaiser emergency rooms in Northern California shows that those who were diagnosed as having a stroke via a telehealth consultation received clot-busting medication intravenously much faster than the 60-minute guidelines from the American Heart Association and American Stroke Association.

 

The Kaiser emergency rooms were equipped with telestroke carts, which included a video camera and access to patients’ electronic scans and test results. When emergency room staff contacted a staff neurologist and a radiologist via a telestroke cart, patients received anti-blood clot medicine in an average of 34 minutes. Eighty-seven percent of stroke patients received the intravenous medication in 60 minutes or less, 73% in 45 minutes or sooner and 41% in 30 minutes or less.

 

A Clear Priority

According to the American Stroke Association, American Heart Association, and the American Telemedicine Association, telestroke services could save thousands of lives each year and cut costs by $1.2 billion over the next decade.

 

The reason is because processes that used to happen sequentially during a stroke alert are now happening at the same time. That allows medical staff to provide evaluation and treatment to stroke patients more quickly, safely, and confidently, to avoid further brain damage.

 

The addition of specialized stroke services helps hospitals improve patient outcomes, decrease patient disability related to stroke, and reduce costs, while keeping patients in the community. Providing expert stroke consults remotely via telemedicine allows prompt care close to home for these patients, making a priority for health care providers nationwide.

 

If you are interested in bridging the gap of care for patients in need, whether they be in remote areas or unable to leave home, telemedicine can help provide quality care to more people in need. Contact TeleMed2U today, at (855) 446-TM2U (8628).

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. 

For medical students with the University of Arizona College of Medicine – Tucson, weeks of suspense will end on March 15. Otherwise known as Match Day, it’s the day the students will learn where they will go for their residency training, in their chosen medical field, after they graduate from medical school in May.

 

Sarah Joy Ring, who has completed the College of Medicine – Tucson’s Rural Health Professions Program and a 16-week Rural Health Distinction Track, is hoping for a residency focused on both pediatrics and emergency medicine, potentially in a rural location.  Her “capstone” paper, an in-depth research project that all Distinction Track students are expected to complete, carries the impressive title of “A Survey of Rural Emergency Medicine and the Discrepancy of Care for Pediatric Patients that Present to Rural Emergency Departments.”

 

During her training, she had opportunities to see how important telemedicine can be in rural communities.

 

“I was at sites that had telemedicine capabilities and spent some time chatting with the physicians about them. "I can specifically remember two experiences, one while on my family medicine rotation in Tuba City (in northern Arizona, where students learn about American Indian healthcare) and one during my RHPP summer in Flagstaff” (also in northern Arizona).

“Tuba City experiences a significant shortage of mental health providers in general, and specifically for children and adolescents," Sarah says.

“As such, they found using telemedicine helpful to connect the children of that region with services that they would otherwise struggle to receive, due to having to travel large distances to receive help, which incurs financial and time burdens for families.

“Moreover, a point that I found particularly enlightening when learning about this service, was with regard to what it means to live in a small population where it is quite likely you know most people living in the region," Sarah says.

“The physicians found that because of this, many adolescents experiencing difficulties often felt uncomfortable sharing with people who lived in the region, out of fear that they may tell someone, or that they were themselves a relative or family friend, which can be a common experience. Having someone to share with who lived out of the region and was not specifically invested in the region and an integral member of the community made many of these adolescents more comfortable with disclosing their experiences.  

“I also worked on writing about how telemedicine can be used to augment pediatric services in rural emergency departments for part of my "capstone" project and found some very positive results from multiple studies. For critically ill patients, one study found that in particular, telemedicine consults improved the access to critical care specialists, resulting in a reduced frequency of physician-related medication errors. Moreover, another study found that parent satisfaction was higher with telemedicine consults than with phone consults, which is a particularly important outcome when caring for pediatric patients and their family. Many of these same findings also translated to the pre-hospital environment, where ambulances that utilized telemedicine resulted in better assessments, more interventions in the pre-hospital environment, and improved outcomes for pediatric patients in pre-hospital care. 

“Overall," Sarah says, I think that we will continue to find that telemedicine is an excellent resource for rural providers that allows patients to have clinically significant access to additional resources and care that would otherwise be difficult or unavailable to the region."