8/4/2008
Select Houston-area Wal-Marts will offer telemedicine clinics thanks to a partnership between Houston-based companies My Healthy Access and NuPhysicia. The companies will operate under the trade name "Walk-in Telemedicine Health Care."
The program is one of the service lines of NuPhysicia, which operates telemedicine methods developed by the University of Texas Medical Branch.
Glenn G. Hammack, NuPhysicia's president, said the program replaces the care typically provided by nurse practitioners at retail clinics.
"Our alliance takes that care a step further, bringing new levels of service, convenience and value to the retail health-care setting through interactive physician visits."
"In keeping with our mission to continually search for the best approaches to retail healthcare, we began evaluating proven telemedicine methods, and this led us to NuPhysicia," said My Healthy Access's president, Kathleen Delaney. "Our partnership with NuPhysicia will no doubt enhance services in our retail clinics to better serve our patients and offer us even greater potential for new business strategies in the future."
Under the agreement, physicians will use NuPhysicia's remote telemedicine through paramedics who will examine patients under the physician's direct supervision.
A two-way video communication is initiated during the patient visit, using split-screen technology. The patient can see and speak directly to the physician and see exactly what he/she is seeing on the screen. Electronic medical devices will allow the physician to visually examine the patient and even listen to his or her heart and lung sounds. The on-site paramedic acts as the physician's hands and carries out the treatment instructions.
"Simply put, the paramedic serves as the 'hands' of the physician, who uses medical devices such as an electronic stethoscope to listen to the heart, or other scopes that can see down the throat or in the ears - and the physician sees and hears everything live and in real time," said Hammack. "The physician performs the exam as if he or she was in the room with the patient."
"Our telemedicine methods have served hundreds of thousands of patients from Texas to as far away as the South Pole," continued Hammack." Similar live-video technology is now monitoring the most critically ill in ICUs across the nation," he added. "Now we can offer the residents of Houston access to convenient, high-quality health care."
(Healthcare IT News, July 21, 2008)8/4/2008
After more than four years in the mainstream in Florida and a few states, online doctor consultations are catching on, although not like many had hoped. Only a fraction of doctors offer the service, and a small number of their patients take advantage. However, proponents of e-consults said the number has jumped since Aetna, Cigna and other insurers began paying for them nationwide in January. They predict the practice will one day become a prime option for patients dealing with simple health issues.
"It's really convenient for the patients and great for the doctors, too," said Dr. Maureen Whelihan, a West Palm Beach obstetrician who has consulted online for 15 months.
Blue Cross Blue Shield of Florida began offering online physician contacts in 2004 as a way to improve patient satisfaction, ease office burdens on doctors and save a little money, said Lynn Monson, the insurer's director of health information technology.
A few thousand of the insurer's 28,000 doctors belong to the various online systems, and the number is growing. From all those Florida doctors, Blue Cross pays for a dozen e-consults per month on average, although many more may be using the system for free contacts, Monson said.
"I would love to see it take off like hotcakes, but it hasn't," Monson said. "It's something that's going to come of age."
Surveys show patients like the idea of contacting doctors by e-mail. But in California, only 4 percent of people reported doing so last year.
"The reality is that most patients unfortunately are not tuning in yet," said Dr. Nigel Spier, a Hollywood OB/GYN who answers patient e-mails daily and late at night. "Younger patients are catching on. But certainly the reflex is that if people have a question, they pick up the phone, they don't go to their computer."
To contact a doctor online, patients go to a password-protected Web site to find forms requesting lab results, prescription refills, appointments and office matters. Typically these are free and fielded by the office staff.
To initiate an e-consult about medical issues, patients answer a series of questions about their illness and medical history. The system often asks different questions depending on the patient's answers, as a doctor would. The doctor gets notified of the inquiry and posts an answer online for the patient to look up.
"When they fill out the form, all the questions I would have asked [in person] are already answered," Whelihan said. "I can actually make a pretty good diagnosis."
E-consults cost $25 to $40, payable by credit card. If insurance covers it, the patient may only face a small co-pay.
"Once [patients] use it once or twice and realize how nice it is, they use it more and more," said Reyes, who started e-consults in April.
Some doctors and medical organizations are skeptical of e-consults, saying an online exchange cannot replace a face-to-face visit and increases the risk of a doctor misdiagnosing a serious problem.
"There's so much potential for miscommunication when you can't see someone's face or detect the tone of their words, or watch their body language," said Dr. David Hutchinson, president of the Minnesota Academy of Family Physicians.
Proponents of cyber-medicine dismiss such fears, saying doctors can use their judgment to restrict e-consults to simple health issues.
Reyes' hand-held wireless unit jangled with an online question from a man whose ulcer resumed bleeding one night. He said he quickly called and ordered him to the emergency room.
RelayHealth, a leading online consultation system, says about one-third of its e-consults end with the doctor asking to see the patient in person.
Doctors who like the approach tend to be younger and tech-savvy. They find that dealing online with routine illnesses and matters is faster and more efficient than taking phone calls, and produces better records.
The online systems also ease foot traffic at a time when office visits have surged by 20 percent in five years, federal figures show.
The fact that big insurers have started covering e-consults bodes well for growth, supporters say. Cigna and Aetna tested e-consults since 2006 in Florida and other states before going national. Insurance officials said the service fits the trend of having patients take more responsibility for their health and costs.
The number of Cigna doctors using the system jumped by one-third this year, spokesman Joe Mondy said, but still has reached only 12,000 of 500,000. At Aetna, not 5 percent of 490,000 doctors are signed up, spokesman Walt Cherniak said. Doctors may hold off unless many patients show interest, while patients may not even know their doctor has access.
RelayHealth, a California e-consult firm, has signed up 17,000 doctors since 1999, said Ken Tarkoff, vice president and general manager. Thousands more use Medem Inc., Medfusion and others.
One in 10 of Spier's 5,000 patients have signed up for his service. One in five of Whelihan's 5,000 patients have; she fields one e-consult daily.
"A lot of physicians say, 'You're so out there.' We're really not," Reyes said. "This is 2008, folks. This is a natural evolution."
(Source: Florida Sun-Sentinel, July 21, 2008)8/4/2008
As part of his infectious diseases practice, Dr. Javeed Siddiqui regularly sees
California State Department of Corrections and Rehabilitation prisoners as patients. It's just that he's never in the same room with them. The UC Davis physician is a part of the increasing role that telemedicine has been playing in inmate care in the past two years.
Between 1997 and 2006, about 50,000 corrections agency inmates were seen by doctors via telemedicine. In the year ending June 2008, the patients numbered more than 16,000.
Doctors who treat inmates say telemedicine is a win-win because it's easier on them and the patient, more cost-efficient for the prison system and provides a patient base for medical institutions.
Transporting prisoners for outpatient visits costs taxpayers a lot of money and is logistically difficult, said Dr. Thomas Nesbitt, head of the UC Davis telemedicine program.
Community providers near prisons can be backlogged, but with telemedicine, "patients don't have to wait," said Annie Brennan, who schedules telemedicine appointments for the prison system.
"I've never come across a situation where I feel I need to see the patient in person," Siddiqui said of his telemedicine experience.
Ricky Reeder, a prisoner at Mule Creek State Prison in Ione, has had hepatitis B and C for at least 12 years. He's been a telemedicine patient for about one year.
"It's a lot easier than going to the yard to see the doctor," said Reeder, 54. He likes that he can get in and out of appointments quickly.
Reeder likes seeing the same doctor every time. His infectious diseases doctor also treats his other health needs, even prescribing him multi- vitamins, he said.
About 30 percent to 40 percent of UC Davis telemedicine consultations are with inmate patients, Nesbitt said.
"They needed specialty services," he said of the corrections agency. "We had specialty services. Our equipment talks to each other."
For UC Davis, prison telemedicine is a stable source of business that allows the medical center to have a program big enough to also serve smaller, rural hospitals, said Nesbitt.
Doctors in the prison system said patient feedback has been positive.
"I'm pleasantly surprised with their lack of concern about not seeing a live doc," said Dr. Dwight Winslow, prisons medical director. "Maybe they're getting attention they previously weren't given. Maybe they grew up with TVs and they accept it as the way business is done."
Winslow believes telemedicine is underutilized. All 33 state prisons have the technological capabilities, though some institutions don't use their equipment. He aims to use it in more prisons and to recruit more specialist partners.
Prison health care has changed dramatically, Winslow said, since it was put under federal receivership in 2001 after a federal judge found that the program violated the U.S. Constitution's prohibition against cruel and unusual punishment. The challenge is now figuring out how telemedicine fits into the delivery plan, he added.
According to Siddiqui, receiver J. Clark Kelso has demonstrated an increased commitment to telemedicine, having visited the UC Davis telemedicine offices several times.
"He looks at technology as real tools to solve (the prisons') problems. He's investing in these tools," Siddiqui said.
(Source: Sacramento Bee, August 3, 2008)
The telepsychiatry program at the
University of New Mexico Health Sciences Center recently received a significant grant at a ceremony on July 29.
The $767,192 grant will be used to research and develop telehealth services across the state that allow providers to use real-time video links to treat behavioral health patients in remote, underserved areas.
The money was appropriated by ValueOptions New Mexico, a private entity that manages the state's public behavioral health expenditures.
(Source: New Mexico Business Weekly, July 28, 2008)
The Davis Family Foundation of Falmouth,
Maine has awarded $25,000 to Maine's HomeHealth Visiting Nurses. The grant funds will bring new advancements in telehealth technology to patients at high risk for hospitalization.
HomeHealth Visiting Nurses' current telehealth project will install telehealth units in the homes of chronic disease patients who are at high risk for re-hospitalization following hospital discharge or recent disease exacerbation. This equipment allows for 24-hour monitoring of vital signs, patient education and medication compliance.
National studies show that telehealth services significantly reduce hospitalization and emergent care rates, improve medication management and enhance patient's health knowledge and self-care abilities. Using the new equipment, patients will learn to: search the electronic library for educational information about their illness; transmit data to nurses, such as vital signs and confirmation that they have taken their medication; reply to text questions from nurses; and transmit messages to tell nurses how they are feeling. Skilled nurses monitor patients remotely and contact them regularly via telephone to provide reassurance and coaching, clarify any changes in their condition (i.e. weight gain or shortness of breath), identify when medical intervention is necessary, and arrange for access to needed care. The equipment also includes patient education resources that will teach patients disease-specific self-management skills.
HomeHealth Visiting Nurses pioneered Home Telehealth in York County in 2002, bringing live, interactive video "visits" between clinicians and patients. The program was expanded in 2005 to Cumberland County.
(Source: Seacoast Online, July 24, 2008)
U.S. Department of Health and Human Services (HHS) Secretary Mike Leavitt recently visited southern
Alaska to see how telehealth is being used to improve access in rural parts of the state.
To better understand the challenges of access to care, Leavitt visited Native villages and two regional tribal health consortiums.
Leavitt will met with tribal leaders to discuss the healthcare goals of the Alaska Native people and viewed demonstrations of how telemedicine and telehealth are employed to increase access and quality of care to Alaska Native communities. The use of telemedicine and telehealth is making an important impact on improving access to healthcare in rural Alaska.
"While Alaska faces unique access to care challenges, the healthcare delivery systems in place serve as model of effective telehealth and telemedicine for other rural communities," Leavitt said. "I look forward to continuing my work with local, state and tribal leaders to address barriers and increase access to care."
(Source: Healthcare IT News, July 24, 2008)
Connecticut Governor M. Jodi Rell recently announced the award of a $75,000 grant to VNA Health at Home in Watertown, CT, to help implement a telehealth monitoring program.
VNA Health at Home provides home health care services to patients of all ages in the Greater Waterbury area. The telehealth program will allow patients to check their vital signs daily with an at-home monitoring system and send the information via computer to their home health nurses.
"This grant will help improve the care and quality of life for so many people who rely on home health care," Gov. Rell said. "The dedicated nurses of the VNA will have another important tool to help them carry out their mission."
The grant is from the Connecticut Health and Educational Facility Authority (CHEFA), a quasi-public agency that helps Connecticut nonprofit organizations enhance their programs and continue their ongoing health and education services for citizens of this state.
(Source: Town Times News, July 17, 2008)
Rochester General Hospital in
New York recently unveiled a new telehealth robot.
The technology allows physicians to connect remotely with patients without having to physically travel miles away. Conversely, patients may receive care or consultations with specialists not generally available in rural areas, in particular, without having to make a costly drive to, in this area's case, a Rochester hospital. While doctors say face-to-face interaction with patients is preferred, telehealth technology, such as using robots, may save time and gas money.
Urologist Dr. Ralph Madeb, medical director of the new Department of Telehealth at Rochester General, said the technology will also mean that patients may receive timelier treatment and avoid unnecessary transfers to Rochester hospitals from more rural facilities.
The program's first robot is up and running at Newark-Wayne Community Hospital, an RGH affiliate.
The goal, Madeb said, would be to eventually also have robots at other area hospitals, like Clifton Springs.
Using the new electronic communication, which includes both visual and audio components, physicians and surgeons based at Rochester General have already used the robot to provide more than 500 consultations and care to patients at Newark-Wayne. Specialists are available for consults in dermatology, bariatric surgery, cardiology, endocrinology, plastic and vascular surgery, urology and a number of other areas.
"It really extends the specialist's hands," Madeb said, and can be used anywhere there is Internet service. To communicate through the robot, doctors need only a laptop computer and joystick with which to remotely move the about four-foot-tall device.
Called Remote Presence Robotics, it is believed that the RGH-Newark telehealth network is the first of its kind in the northeast and one of only two in the nation.
"Patients and doctors are excited about it," said Diane Ewing of the RGH staff.
Using the new technology, Newark patients who have met with doctors via the robot talked with Madeb and others recently.
She could still meet one-on-one with a specialist, said one of the patients, who wasn't named, and not miss as much time off work or spend the money it would cost for gas to drive to Rochester.
"Not having to drive to Rochester is a positive," agreed another patient, who also wasn't named.
Plastic surgeon Dr. Ralph Pennino has been using the technology and predicts that it will become more common in the coming years.
"You can do an exam and pretty much everything you want through this (robot)," he said.
The video screen "head" of the robot has the ability to zoom in very closely to patients. It also has screen-in-screen technology, so that a doctor can see his patient and vice versa.
"The great thing is that a doctor can show up anywhere in the world," Madeb said.
There was some worry that doctor-patient interaction would be lost and patients wouldn't like the robot, he conceded, but that doesn't seem to be the case because it's not just a phone call.
The doctor and patient are still face-to-face and the doctor can see a problem area, if necessary. Both the robot and the video screen have the ability to rotate 360 degrees, and the robot can also move forward and back.
The robot also includes a telephone, if a more confidential consultation is needed, a printer, advanced head gear, and even a digital stethoscope. The unit can even upload X-rays, Madeb said.
The point is, he said, patients want to and should be able to be treated close to their homes ... and this robot facilitates just that.
(Source: Messenger Post, July 18, 2008)
8/4/2008
AMD Global Telemedicine has reported an increased demand for products worldwide. In the last quarter, AMD has received orders and shipped products to support new projects in countries such as; Canada, China, Greece, Greenland, India, Kazakhstan, Mexico, Spain, Saudi Arabia and the UK.
Dan McCafferty, Director of Global Sales and Corporate Development at AMD Global Telemedicine said: "AMD has historically done a good job of supporting international telemedicine projects however, recently we have seen a general and well distributed increase in telemedicine worldwide.
"We attribute this to three things; the continued technological advances in telemedicine which open more doors for telemedicine use, the continuing gap between rural residents and urban medical resources - and our international staff and worldwide network of resellers. This is an expanding market with more and more countries interested in its mainstream utilization."
The lack of healthcare access between urban and rural geographies in many countries drives communities to reevaluate healthcare access making telemedicine a remarkable alternative. According to Telemedicine In Rural India, published in 2006: "In India, nearly 75% of the population lives in rural villages, and more than 75% of doctors are based in cities." These circumstances stand true in many countries across the world.
Steve Normandin, President of AMD said: "Telemedicine is an essential tool in geographic areas where distance is a barrier for obtaining proper healthcare as well as a great cost-cutting opportunity for single payer systems and national health plans. We are excited to see the market growing not only domestically, but internationally as well."
(Source: Hospital IT Europe, August 4, 2008)
The U.S. Food and Drug Administration has granted market clearance to
Intel for its personal telehealth system, the Intel Health Guide. The system is an home telehealth device that provides online access for healthcare providers to monitor and treat patients. The system can connect to blood pressure machines, glucose meters, pulse oximeters, peak flow meters, and weight scales. The information collected is stored and once transferred to a secure FTP site, it can be studied by health care professionals via a touch screen, at their convenience.
The telehealth system is expected to be available commercially from healthcare providers in the United States and the United Kingdom, towards the end of 2008 or beginning of 2009.
The touch screen based device also allows patients to monitor their health status and correspond with clinicians via video conferencing and e-mail, empowering them to take active role in their care management. The device includes features such as interactive patient health sessions, audio and visual patient reminders, schedules, multimedia educational content and feedback.
Pilot studies to facilitate the understanding of Health Guide by patients and clinicians have been completed in the United States and United Kingdom, and the company has plans of conducting additional pilots with healthcare providers in order to assess the integration of the solution with various care management models. Intel hopes to develop a wide range of usage models for not only chronic conditions but also programs for in-house health and wellness management.
The personal and telehealth market is becoming increasingly competitive with the demand for novel approaches in healthcare. According to Centers for Disease Control and Prevention (CDC), more than 90 million Americans suffer from chronic diseases, with expenditures on diagnosis and treatment nearing $7,000 per person annually. The magnitude of the problem and the costs involved have steered a change in the way healthcare is delivered. Telehealth, the delivery of healthcare and health-related services to patients leveraging telecommunication and information technology, has been found to reduce the cost of chronic disease care. A 2007 report, by independent market analyst firm Datamonitor, predicts the homecare telehealth market to grow at a five-year compound annual growth rate (CAGR) of 56% compared to 9.9% in the clinical market, and anticipates the overall global telehealth market to exceed US$8 billion by 2012.
Intel, the largest manufacturer of computer chips, has been involved in extensive research in developing home-based technology that would move care delivery from within the hospital, to the convenience of homes of patients suffering from chronic diseases. The company is also a member of the Continua Health Alliance since its launch in June 2006. The open industry alliance of medical device, health, and fitness industry organizations, works together to establish interoperability between personal health products in the market to forge patient participation in their own healthcare, for better health outcomes. Santa Clara, California-based Intel, a world leader in silicon innovation, recently reported first quarter revenue of $9.7 billion, an increase of 9% from $8.9 billion of the previous year.
(Source: Health News, July 15, 2008)
XTend Medical, a provider of telehealth and telemedicine solutions for monitoring and caring for patients with chronic disease conditions, recently announced the company will begin a telemedicine program in Europe to track the remote monitoring of diabetic patients.
Paul D. Lisenby, CEO of XTend Medical, said, "Our presence here in the U.S. has attracted many companies from Europe that are interested on our telehealth programs. By having a presence in Europe, this will assist the company as we grow our brand globally over the next three years and on. We'll release further information regarding our European program as the results are monitored through the University that has asked us to maintain their privacy for now."
(Source: XTend Press Release, July 23, 2008)
The
Vodafone Group Foundation, along with other technology heavyweights, recently held a one-week mHealth and mobile telemedicine conference with the United Nations Foundation. The conference in Bellagio, Italy, was designed to harness the potential of mHealth (mobile health) to unlock access to health data and improve health care in the developing world.
Dubbed "Making the eHealth Connection: Global Partners, Local Solutions," the meeting was co-facilitated by the U.N. Foundation-Vodafone Group Foundation Partnership and the Telemedicine Society of India.
Participants included representatives of Cisco, Google, Microsoft, Nokia and Qualcomm, as well as the Earth Institute, Gates Foundation, MIT and the U.N. World Health Organization.
"There is a larger need for technological innovation to help strengthen international public health efforts," said Claire Thwaites, technology partnership head of the U.N. Foundation and the Vodafone Group Foundation.
As the mobile phone has proven its ability to transform lives in the developing world, the conference will examine the landscape of mHealth and mobile telemedicine, assess priority issues and identify potential next steps for a multi-sector partnership dedicated to advancing mHealth programs.
"Mobile phone use is exploding across the developing world, offering the opportunity to leapfrog other applications and services on both the health and technology fronts," said Mitul Shah, senior director of technology at the U.N. Foundation.
"Developments in the field of mHealth, in particular, are creating a remarkable opportunity to bring about a sea change in healthcare delivery, even in the most resource-poor environments," Thwaites noted.
(Source: IDG News Service, July 30, 2008)
The
market for telemedicine devices and services will exceed $1.8 billion within the next five years, with mobile services companies taking a sizeable chunk of that revenue, market research firm Pike & Fischer projects in a new report.
In addition, Pike & Fischer predicts that telecommunications companies that possess both wireline and wireless solutions will be best positioned to achieve competitive dominance in the telemedicine market.
"Companies such as AT&T and Verizon are capable of providing multifaceted, converged solutions and can form partnerships necessary to fill gaps in their organic offerings," says Tim Deal, Senior Analyst for Pike & Fischer's Broadband Advisory Services and author of the report, "Mobile Medical Applications and U.S. Telemedicine: Opportunities, Analysis and Insight."
New wired and wireless broadband networks are saving time and costs in the medical environment. They allow specialists to remotely triage, diagnose and monitor medical cases by viewing data and images conveyed wirelessly to their locations. They also enable specialists to access medical records and medical reference material that are germane to a specific patient's case.
The need to control costs, along with the development and expansion of faster wireless broadband networks, smartphones and data compression solutions, will drive the market growth, Deal says. AT&T will have the largest presence in this industry, followed closely by Verizon and Sprint Nextel, Deal predicts. Smaller software and device manufacturers will quickly find themselves targeted for acquisition, he says.
(Source: Pike and Fisher Press Release, July 24, 2008)
7/15/2008
A new survey from Frost & Sullivan finds that the European telemedicine market generated revenues of $118 million in 2007 and could reach $236 million by 2014. Frost officials say that although the telemedicine industry has reached great heights in Europe, certain technological advances have inadvertently led to new hurdles. Problems such as lack of physician acceptance of novel telemedicine technologies and the pressing need for standards have begun to haunt the industry, according to the firm's report. An effective telemedicine technology will help in increasing the number of patients that physicians treat remotely lowering the costs and travel times associated with treatment, the report says.
Although the technology in industry is becoming increasingly sophisticated and powerful, prices for computers, software and transmission equipment are falling, Frost says. To widen the deployment of telemedicine, many market participants are lowering the cost of technologies.
Also, health organizations are increasingly using telehealth technology to monitor patients remotely, according to the report. However, the lack of payer reimbursement is a major barrier to broader adoption. But questionable returns on investment, the technology is perceived to be extremely expensive, the report says.
Frost says that if the government wishes to keep pace with future demands for healthcare and reduce escalating healthcare costs, they will be compelled to adopt certain eHealth strategies accompanied by concrete actions. The number of Web sites/portals dedicated to patients with specific diseases will expand as well as the number of households connected to the Internet grows, according to the firm's report. This trend will also increase online communication between doctors and patients, Frost officials say.
"While it is apparent that the telemedicine industry is in the midst of great change, it is not clear how the industry will look in the years to come," said Frost & Sullivan Research Analyst Janani Narasimhan. "Technological developments have the potential to not only alleviate the current growing pains but also provide some solutions for the major challenges facing the business of telemedicine delivery."
(Source: TCMnet.com, July 10, 2008)
7/15/2008
Writers working in telemedicine and knowledge management as researchers and practitioners are invited to submit book chapters to be published by IGI Global, www.igi-pub.com.
The Handbook of Research on Knowledge Management in Telemedicine: Advanced Ethics, Policy and Regulatory Applications will cover a wide range of topics from early adopters of Telemedicine to the latest innovation and futuristic tele-robotic technologies.
In the fields of knowledge management in telemedicine and associated fields of datamining and biomedical ontology, there exists a need for an edited collection of articles in this area. The book aims to provide relevant theoretical frameworks and latest empirical research findings in the area.
More information, including submission submission procedures and contact information can be found
here.
(Source: IGI Global Press Release, July 5, 2008)
7/15/2008
The new report "Home Health Care during an Influenza Pandemic: Issues and Resources" highlights the critical need for
home healthcare technologies in providing care during a pandemic influenza event. The report funded by the HHS Assistant Secretary for Preparedness and Response and CDC, and developed by AHRQ, describes the resources and the technology needed by home healthcare providers and community planners to prepare for such an event.
The report stresses the need for telehealth technologies to deliver patient care and to do advanced planning and coordination at the local level. Using technologies would allow remote monitoring of patients and the ability to prompt patients on taking medications.
The equipment needed includes:
- Remote vital sign monitoring units using standard phone lines. This technology is already being adopted in New York, Pennsylvania, and several other states
- Interactive voice response systems to enable callers to use their touchtone phones to receive information automatically.
More information can be found at
< www.ahrq.gov/prep. The report can be downloaded at
here.
(Source: Federal Telemedicine News, July 13, 2008
AMD Global Telemedicine, a telemedicine hardware and software solutions with over 5,000 installations in more than 72 countries, recently re-emphasized the importance of the role telemedicine applications can play in helping to improve health care delivery in disaster situations. The recent earthquake in China and the recent cyclone in Myanmar, where many lives were lost and many others were seriously injured, serve as reminders that telemedicine technology is important in many emergency medical care situations, not just the more traditional settings of remote or hard-to-reach locations.
The U.N. has reported that the death toll in Myanmar as a result of the cyclone is in excess of 100,000 with many more injured, while the death toll in China as a result of the earthquake is estimated at more than 69,000 lives. The 2004 Indian Ocean tsunami killed more than 225,000 people, while the 2005 Kashmir earthquake killed approximately 80,000 people and injured countless others. The medical care available to these victims is greatly enhanced by telemedicine devices and equipment, which combine traditional medical evaluation tools, such as stethoscopes and ultrasounds with Internet, satellite and video conferencing technology to virtually bring the expertise of medical experts located hundreds or thousands of miles away into the disaster area. These devices can make disaster recovery into a truly global effort and can help equalize the quality and availability of medical care around the world.
Telemedicine can be of great help here to identify and understand patterns of injury, as well as to access information and experience on treatment. Dr. Richard Aghababian, a fellow of the American College of Emergency Physicians (FACEP), an Associate Dean for Continuing Medical Education at the University of Massachusetts Medical School (UMMC), past Chairman of the Department of Emergency Medicine at the University of Massachusetts Medical School and past president of the American College of Emergency Physicians (ACEP) explained in a recent presentation at the 13th annual American Telemedicine Association meeting that telemedicine can play a vital role in the triage process, which is often a critical tool at disaster scenes.
"Telemedicine can be of great help here to identify and understand patterns of injury, as well as to access information and experience on treatment," stated Dr. Aghababian. Noting that preparedness is the key to successful response, Dr. Aghababian also discusses how telemedicine training can be vital prior to a disaster and what that training would entail.
"Telemedicine provides a critical, visual link between a disaster site and experienced medical personnel at a distant facility, and also can be a conduit of vital patient data to enable life-saving treatment to begin right in the field," said Steve Normandin, President of AMD. "A key to enhancing and improving the quality of medical care available in disaster situations is that the rescue teams need quality telemedicine devices available to them and also need prior training as to proper use of this equipment. We are convinced that lives will be saved when telemedicine devices are properly deployed and utilized by qualified and trained rescue teams.
(Source: AMD Global Telemedicine Press Release, June 24)
MDPIXX, is a recently launched global interactive Web platform that allows physicians and medical students from all over the world to easily share multimedia clinical information over the Internet.
In its public version, MDPIXX is a free-of-charge Web portal for sharing clinical cases, images, and videos. Physicians can post cases with their associated images for discussion among colleagues. All the shared information is tagged with SNOMED CT keywords for quick search and other members of the community can vote and write comments on the cases and images posted.
However, MDPIXX is also offered as a white label solution for hospitals, clinics, and faculties of medicine. Private organizations can benefit from having a customized MDPIXX tool to solve their specific clinical image management problems.
According to Patricio Ledesma, MDPIXX Representative, "the great value of MDPIXX resides in its unprecedented versatility to implement an endless list of telemedicine applications, including interconsultation platforms and online medical education programs."
Ledesma remarks "MDPIXX's potential to automate the capture, storage and sharing of large volumes of images and videos across distributed corporate scenarios, such as networks of clinics that need to organize their multimedia contents in an effective and secure way."
Regarding the response of the healthcare community, Ledesma states that "initial feedback has been quite promising; we recently completed a project for a Swiss hospital requiring MDPIXX technology to incorporate more than 1500 clinical cases for private interconsultation purposes."
As far as MDPIXX's use in the United States is concerned, Ledesma explains a project with one Anatomic pathology department that used MDPIXX to "make their images accessible and searchable via a flash viewer integrated in their own Web site. Our customer benefited from MDPIXX potential running backstage while keeping its corporate image intact for the public."
C2C welcomes both public and private healthcare organizations to test this revolutionary tool. Ledesma ensures that "MDPIXX is ready to implement almost any digital image sharing application. We are confident that MDPIXX will turn our customers' ideas into realities."
As part of its current international expansion strategy, C2C seeks to cooperate with clinical content providers (hospitals and physicians) and business partners (investors or health organizations) interested in developing new MDPIXX-related projects.
More information is available at
www.mdpixx.com.
(Source: MDPIXX Press Release, July 7. 2008)
French telecos Alcatel-Lucent has announced the launch of
LifeStat Remote Monitoring and Health Management, a telemedicine service developed with its Canadian partner SaskTel.
The technology will be used to manage patients with chronic conditions in primary care such as diabetes. Future LifeStat applications will include monitoring and reporting for chronic illnesses such as congestive heart failure, Chronic Obstructive Pulmonary Disease and asthma.
The new service records and transmits daily blood glucose and blood pressure readings, automatically creating confidential, easy-to-use reports that can be viewed online by individuals their health professionals and caregivers.
Alcatel-Lucent is marketing and selling the product internationally under the name Alcatel-Lucent Health and Wellness Application to its global enterprise customers in the utilities and healthcare verticals.
SaskTel will market and sell the LifeStat service directly to consumers and healthcare providers in Canada.
The ongoing development and support of the LifeStat platform and applications will be managed by SaskTel and Alcatel-Lucent through their Salveo project, which is based in Saskatchewan. The Salveo project, which is funded by SaskTel and Alcatel-Lucent, aims to become an international leader in health and wellness telemonitoring software applications.
(Source: eHealth Europe, July 11, 2008)
Hospitalists -- physicians working full-time in hospitals, instead of dividing their time between private practice and hospital rounds -- are in such short supply, many daytime hospitalists are being overworked. Hiring a full-time nocturnist, or nighttime doctor, is expensive.
Night Hospitalist Company (NHC) was recently launched to provide a nighttime hospital telemedicine solution and coverage by telephone.
NHC provides reliable telephonic care from 7 p.m. to 7 a.m.. All NHC physicians are Board-certified or Board-eligible internal medicine M.D.s or D.O.s with extensive hospital experience. Each is qualified to handle emergency room calls, floor calls and stable ICU admissions. The NHC solution is seamless and designed to free hospitals up to concentrate their resources on patient care: NHC covers its own physicians' malpractice insurance and documents all patient-related activity overnight using a web-based proprietary software called MDHandOff. All overnight changes in medical management are transmitted to the correct hospital floors for insertion into patients' medical records. The company contracts directly with hospitals for ease of billing.
"NHC is the first solution of its kind," stated company founder Dr. Yomi Olusanya. "We exist to give hospitals a viable way to provide high-quality patient care at night at a cost far lower than that of hiring on-site physicians. Our clients are not only weathering the hospitalist shortage and unexpected physician absences, they're actually finding NHC to be a real alternative to full-time nocturnists."
NHC physicians are also available to cover night calls for physicians in private practice as well as for nursing homes and acute care facilities. The company is currently evaluating telemedicine vendors, with an eye to remotely examining and evaluating patients via video telemetry. NHC serves facilities in Missouri but will soon have night hospitalists practicing across the U.S.
(Source: Night Hospitalist Company, June 24, 2008)
6/20/2008
Health plans can cut costs for businesses and employees by encouraging frequent phone or Web-video conversations between chronic-disease patients and doctors or nurses, University of Missouri research suggests. With chronic diseases generating 70 percent of U.S. health costs, they offer nearly $1.5 billion a year to be cut.
The telehealth interactions bring important symptoms to light earlier, "triggering early intervention from providers and reducing the need for patient hospitalization," said Bonnie Wakefield, a nursing school professor who studied patients who had been hospitalized with heart failure. Those with phone or video follow-ups "significantly delayed hospital readmission rates" compared to those without.
"People who suffer from chronic illnesses usually wait three to six months between office appointments," Wakefield said. Nurses who check in regularly with patients "provide a sense of security. Patients discuss concerns on a frequent basis, and nurses give advice and detect problems that the patient might not notice."
The result, she said, is fewer and shorter hospital stays, "lower health care costs" and patients who better "manage their diseases and ultimately feel better."
The report, "Home Telehealth for Heart Failure," will be published in the Journal of Telemedicine and e-Health.
(Source: Dayton Daily News, June 9, 2008)
6/20/2008
The U.S. healthcare industry is expected to spend $55 billion on telecommunicationsover the next five years, according to a recently released study by Insight Research Corporation. The use of telecommunications by healthcare providers will grow at a compounded rate of 8.4 percent, from $7.5 billion this year to $11.3 billion in 2013. According to the report, "Telecom, IT, and Healthcare: Wireless, Wireline and Digital Healthcare, 2008-2013," an aging population and worker shortages are pushing healthcare providers to find alternative approaches to current business practices, including the use of telecommunications.
"Most of the high costs inherent in the current system are related to the proximity of the patient and provider, as well as to the archaic administrative systems used to manage records and exchange information," the study said. "Telecommunications can bridge these proximity gaps as well as provide a normalized set of baseline data that can remain secure and yet be shared among healthcare workers."
According to Insight Research President Robert Rosenberg, telecommunications and information technology providers have responded to the interest by providing more bandwidth, packet services and healthcare applications, such as video monitoring, electronic health records and telemedicine.
For telecommunications and IT providers, healthcare is an attractive market, Rosenberg said. The U.S. healthcare industry is a $2.3 trillion ecosystem of hospitals, physicians, pharmaceutical companies and insurance providers. Healthcare outpaces all other industries for growth rate and is projected to grow 6.9 percent per year to $4.1 trillion by 2016.
"This increased emphasis and spending on healthcare reflects the increased value that consumers perceive in medical treatment," Rosenberg said. "At the same time, providers and patients share the objective of improving healthcare quality and reducing costs. Information technology and telecommunications will play a critical role in addressing these objectives."
Rosenberg said many of the trends Insight Research has predicted in previous reports have come to pass.
(Source: Healthcare IT News, June 2, 2008)
6/20/2008
The Center for Healthcare Robotics within the Health Systems Institute at Georgia Institute of Technology and Emory University are looking at ways that
robots can be used to help when providing homecare for patients. The research team led by Charlie Kemp, Director of the Center has found a way to instruct a robot named El-E to find and deliver items it may have never seen before by using a laser pointer. The researchers are now gathering input from ALS patients and their doctors to use to prepare the robot to assist patients with severe mobility challenges.
The verbal instructions a person gives to help find an object are very difficult for a robot to use. These commands require the robot to understand everyday human language and a description of the object at a level well beyond the state-of-the-art in language recognition and object perception. According to Wallace H. Coulter, Department of Biomedical Engineering at Georgia Tech and Emory, "Robots have some ability to retrieve specific predefined objects but retrieving generic everyday objects is a challenge for robots."
The laser pointer interface and methods developed by Kemp's team is overcoming this challenge by providing a direct way for people to communicate the location of interest to El-E and ways that will enable the robot to pick up an object found at this location. Through these innovations, the robot can retrieve objects without understanding what the object is or what it is called.
The researchers see fetching as a core capability for future robots in healthcare settings such as the home. In the home, El-E is able to find objects since there are common structures found indoors. In the home, most objects are found on smooth flat surfaces that have a uniform appearance such as floors, table, and shelves. Regardless of height, the robot is able to localize and pick up objects by elevating the arm and sensors to match the height of the object's location.
The robot uses a custom-built camera that is omni-directional to see most of the room. After the robot detects that a selection has been made with the laser pointer, the robot moves two cameras to look at the laser spot and triangulate its position in three dimensional space.
Next the robot estimates where the item is located. If the location is above the floor, the robot finds the edge of the surface on which the object is sitting, such as on the edge of a table. The robot then uses the laser range finder to scan across the surface to locate the object. Then the robot moves its hand above the object, uses a camera in its hand to visually distinguish the object from the texture of the floor or table. After refining the hand's position, the robot descends upon the object while using sensors to decide when to stop moving down and closes upon the object with a secure grip.
Once the robot has picked up the item, the laser pointer can be used to guide the robot to another location to deposit the item or direct the robot to take the item to a person. El-E is able to distinguish between these two situations by looking for a face near the selected location and then is able to present the item.
The researchers are now working to help El-E expand capabilities that will include switching lights on and off when the user selects a light switch and opening and closing doors when the user selects a door knob.
(Source: Federal Telemedicine News, June 11, 2008)
AmeriGroup Holdings recently launched
MDWebLive.com, which offers webcam appointments with physicians on a flexible schedule that includes nights and weekends. There are limitations to what a doctor can offer without a physical examination, but simple diagnoses that require just a look over, a chat and a prescription can work online.
The company's Web site lists dozens of conditions its doctors can treat, including cold, flu, headache, allergies and heart problems. It also treats children who are at least 2 years old. Doctors can't prescribe controlled substances through MDWebLive.
Dr. Stephen Q. Parker, president of AmeriGroup's medical association, said any patient with a serious condition or in need of a more thorough exam will be referred to the nearest medical facility.
"We can't be all things to all people," said AmeriGroup CEO Robert Smoley, an attorney. "We're not trying to replace primary care physicians."
Visits are recorded for playback by either doctor or patient, and the medical records are stored with MDWebLive. The company set up an electronic prescription service to send orders to the patients' designated pharmacy.
"It is convenient for the physician," Parker said. "It's a way to supplement your income in times of cutbacks in every area."
All of that convenience isn't free. Physicians must pick up part of the company's medical malpractice insurance premium, but the company provides its software at no cost.
Patients must pay a $99 annual membership fee, which includes a webcam, and $40 per consultation. Smoley said he hasn't signed up with any health plans for coverage, but patients can submit their receipts to their health plan and ask for a partial reimbursement.
When it comes to health plans recognizing Internet and telephone consultations - called telemedicine - it's hit and miss. Humana's South Florida medical officer, Dr. Jill Sumfest, said the company is looking into this technology, but does not have a formal coverage policy yet. It has paid for e-mail communications between patients and physicians when using approved medical billing codes.
Telemedicine has been in place since 1996 at the University of Miami's Miller School of Medicine, which offers it to military bases and Veterans Administration and Florida Children's Medical Services clinics. Dr. Anne E. Burdick, associate dean for telehealth and a professor of dermatology at UM, said psychology and dermatology are two of the specialties easily practiced via videoconference.
UM's telemedicine program connects with patient centers that have expensive diagnostic equipment allowing doctors to check a patient's vital signs remotely. A nurse or physician assistant helps with the exam on the patient's end.
"Certainly prescription refill is simple if the physician is familiar with the patient's history," Burdick said of an online consultation without diagnostic equipment. "But doing an evaluation without looking in the ear or throat or getting vital signs would be very limited."
(Source: South Florida Business Journal, June 20, 2008)
Researchers at the University of Edinburgh have developed
cellphone technology that will allow patients to receive virtual medical checkups from home.
Under a new project funded by Scotland's Chief Scientist Office, patients with chronic conditions such as high blood pressure and chronic lung disease can measure their vitals at home and then send the readings through mobile technology, the BBC reports. A text message will follow with information about any steps the patients need to take, and doctors can communicate with the patients via a video link.
(Source: Chronicle of Higher Education, June 3, 2008)
YourCity.MD, a city-specific medical navigation system, and
TelaDoc Medical Services, which provides 24 hour telehealth services, recently announced a partnership to expand the availability to consumers of round-the-clock, non-emergency telephonic based medical consultation services with trained, board certified primary care doctors, providing more healthcare access, convenience and affordability than traditional medical services for common illnesses.
Consumers in over 400 cities can now reach a board certified TelaDoc primary care physician (PCP) licensed in their state via telephone to receive affordable, convenient telehealth services. TelaDoc physicians are available 24x7 to discuss non-emergency medical problems and recommend treatment including prescribing medication when applicable. Calls are substantially less than office visits or ER/urgent care visits.
(Source: YourCity.MD Press Release, June 17, 2008)
Consumers increasingly are turning to
motion sensors and remote monitoring systems to track the health of aging relatives. Such systems can track whether users leave their beds or take medications from a dispenser, as well as inform family members of any changes in their routines that could indicate injuries or illnesses. More comprehensive versions of such systems also can track blood pressure, weight or respiration in users.
Privacy is an issue for some older people, and the basic package can range from $50 up to $85 a month. More comprehensive packages can include devices to track blood pressure, weight or respiration.
Experts on aging say the systems will become commonplace as the 76 million baby boomers approach ages when disabilities or conditions like diabetes and failing eyesight jeopardize the ability to live independently. The population of those 65 years and older is almost 40 million today, and the federal Census Bureau says that will more than double, to nearly 87 million, by midcentury.
Right now, there is little federal health care reimbursement for such devices. And private insurance coverage is evolving because the area is new, said Dr. Jeremy Nobel, a professor at the Harvard School of Public Health who co-wrote a study on the feasibility of such technologies. "We are at the beginning stages regarding the availability of such services and before business models are developed," said Dr. Nobel, a medical doctor. "I expect we'll see a significant increase in the adoption of such systems in two to five years, and widespread adoption in 10 years."
The coming wave of aging Americans threatens to swamp the existing stock of retirement communities, assisted living and nursing home facilities — making it impossible to accommodate everyone who will need, or might want, more structured care.
Experts on aging say motion sensors and other high-tech devices will help cover the shortfall, allowing older people to live independently for longer.
The growing number of Alzheimer's sufferers, which is expected to more than triple from the current four million by 2050, may also spur wider adoption of technologies like motion sensors to alert others to deviations in routine, trackers to assure medications are taken and emergency response buttons.
Technology systems to underpin living independently, or what some call "aging in place," are still years from being rolled out in a big way, awaiting adequate financing for research and other incentives, like coverage by insurance companies, according to Mr. Nobel's study, which was released in March by the Center for Aging Services Technologies, a program of the American Association of Homes and Services for the Aging.
But projects are under way around the country to test high-tech gadgets for home use, including wireless sensors and devices to regulate temperature, lights and appliances, and sophisticated medical monitors. And some care providers have begun to equip clients with devices that fit their needs.
NewCourtland Elder Services, a care provider for some 2,000 people in Philadelphia, started a yearlong pilot in 2006 that equipped 33 patients living on their own with remote sensors that tracked changes in their health or living patterns that required early medical intervention, said Kim Brooks, the vice president for housing and services at NewCourtland.
One of the patients is Cleora Coley, 77, a retired pharmacy technician, who is in a wheelchair after losing a leg to diabetes. Two years ago, Ms. Coley moved to a living complex for the elderly because she could not maneuver the stairs in her family home.
In her apartment, she checks her blood pressure with a cuff that automatically sends the reading to a monitoring center, which notifies her and her doctor of any change. Sensors placed in each room keep track of her movements, and she has a button to summon assistance, which she used in April when she fell.
"I'm alone but I know I'm not all by myself," Mrs. Coley said, adding, "And I really like my independence."
NewCourtland is starting a trial in cooperation with health insurance companies and home health agencies, installing medical monitoring devices in 1,000 residences over the next six months.
One major roadblock for wider adoption of in-home monitoring has been concern that older people, unused to everyday technologies like the Internet, would resist their use. That was true for Mrs. Trost, who said she was apprehensive about having electronic gadgets around but said she had found that "they are really no bother." A survey by AARP found that older people were willing to use high-tech devices at home, and to pay about $50 a month.
The privacy issue made John T. Fowlkes, 86, of Raleigh, N.C., hesitate last year when his children wanted to install a motion sensor system.
"What convinced me was that there are no cameras," said Mr. Fowlkes, a retired postal service distribution clerk who lives by himself in an apartment building for retired people. "I get peace of mind, but no one is looking at me."
Some exploration into future technologies is being financed by the National Institute on Aging, part of the National Institutes of Health, which has been giving grants to entrepreneurs to develop devices like a video data collection system to analyze an elderly person's activity level.
But most research dollars have come from private companies like Intel Corporation.
Intel researchers are developing devices like a "memory bracelet" that vibrates at a specified time to remind the wearer of a doctor's appointment or to take medication. Also in trials are sensor-infused carpets — Eric Dishman, Intel's director of product research, calls them "magic carpets" — and wearable sensors, which would measure changes in gait, to help avoid falls.
Intel invested $3 million with the Oregon Center for Aging and Technology, which runs what it calls a living laboratory, with 225 volunteers. The project, which also received $7 million from the federal aging institute, uses sensors on walls, doorways and appliances — and computer games — to detect cognitive decline.
"There is going to be a major transformation in health care because of these technologies," said Dr. Jeffrey Kaye, director of the center, at the Oregon Health and Science University in Portland, who oversees the project. "It's more a question of when rather than whether."
Recognizing the commercial potential of technologies for the aging, dozens of companies, including GE Healthcare, IBM and Medtronic, two years ago formed the Continua Health Alliance to develop products to aid older people. Despite the projects, trials and commercial interest, Mr. Dishman said the United States was "missing in action" in aging technologies, compared with Europe.
"There just hasn't been enough research and development yet to prove these technologies work," he said. "None of us wants to put a bunch of technology in homes of frail elders unless it does."
He said the European Union had committed $1.5 billion to developing independent-living technologies.
Last year, Intel partnered with Ireland's government to open the Technology Research for Independent Living Center, known as Tril, in Dublin, to invent and test independent-living technologies in the households of hundreds of older people.
So far, he said, a dozen other countries and 30 universities have approached Tril for advice and assistance.
(Source: New York Times, May 25, 2008)
