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ATA’s Jon Linkous and the “Telemedicine Advantage”


By  of US News & World Report:

You could say telemedicine keeps patients at a distance – but Jonathan Linkous prefers to say it keeps them close. During “The Telemedicine Advantage,” part of the U.S. News Hospital of Tomorrow forum, Linkous, chief executive officer of the American Telemedicine Association, described the myriad ways telemedicine is extending the reach of health care, particularly for people in rural areas who don’t have easy access to high-quality care.

More than half of U.S. hospitals use telemedicine to engage with patients remotely – from monitoring vital signs to full-fledged consultations at a distance. Just the flash of a webcam, for example, allows critically ill patients, perhaps in an eICU, access to a world-class team of physicians who could be anywhere from miles to states away.

Patients’ doctor visits of the future will, in many cases, involve facing a screen – and “in some emergency rooms in San Francisco, you can walk into a kiosk, answer a set of questions and your course of care will be decided by an algorithm in a computer,” said moderator Steven Sternberg, U.S. News’ deputy health rankings editor. “There’s a lot of ferment in the field,” and real obstacles along with benefits. Among the highlights of the discussion, which explored both:

  • Linkous said telemedicine has been around 20 to 30 years “depending how you define it.” Perhaps the greatest example: radiologists, who don’t need to be in the same hospital or even city as a patient to examine digital images. Telemedicine is in place in 100 to 200 networks around the country, and close to 1 million patients will receive consultations online via webcam this year. “And that’s just the small tip of the iceberg,” Linkous said. He added that remote monitoring – for stroke patients, for example – has “huge potential” and can lead to a lower cost of care, coupled with higher quality. “It’s somewhat controversial, but the truth is, consumers want it,” Linkous said. There’s evidence in studies, he added, which suggest that patients overwhelmingly accept telemedicine, and recognize that it’s a step to receiving better care.
  • Steven A. Fuhrman, eICU medical director at Sentara Healthcare – the first remote critical care facility in the nation – said that when his clinic launched in 2000, caring remotely for a critically ill patient was “met with big question marks on people’s faces.” But it’s led to more efficient decision making and has allowed staff to become more efficient in dealing with complex cases. It also promotes proactive care. So why was the ICU one of the first places to have a population-management approach to telehealth? Because it’s such a data-rich environment – and monitoring sends data to centralized location, where it can be interpreted. If you can’t picture an eICU, “We’re not a security camera-based operation,” Fuhrman said, adding that there aren’t hundreds of screens plastered across the hospital’s walls. While physician care revolves around video access, and the ICU staff is not present in the ICU where the patient is, there is bedside staff who helps facilitate care.
  • Robert L. Satcher Jr., an assistant professor of orthopaedic oncology at The University of Texas MD Anderson Cancer Center, said cancer will become the most common cause of death in the coming decades. And because of insufficient primary physicians and specialists to meet the demand for cancer care, especially in rural areas, MD Anderson says telemedicine will play an increasing role. “Many patients live a long way from Houston and are looking for ways to receive care without traveling to Houston,” Satcher said. “The demand for teleoncology is from both patients and physicians.” He added that patients are typically satisfied with the “convenient” experience. Videoconferencing can lead to effective communication between physician and patient, he said, but it remains to be seen how that communication compares to a face-to-face meeting. Meanwhile, telemedicine has appeared at MD Anderson in a number of ways, from telementoring to telesurgery – a limited number of surgical procedures have involved robotic systems. Still, there are concerns, including the high cost of robotic systems, billing issues, safety and infrastructure (for example, a delay in the transfer of information from one site to another). While telemedicine is “not an ell-encompassing panacea,” Satcher said, he described its tremendous potential in meeting patient and clinician needs and enhancing cancer care to underserved regions.
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C3O Telemedicine News

Posted on:
October 7th, 2014

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