Telehealth: Bridging Gaps in Geography to Save Lives and Money

VIDEO (coming soon)

Applications of telehealth, robotics, and ubiquitous connectivity and computing promise to transform health care, extending health care expertise beyond geographic or temporal barriers, and providing the right care where and when it is needed. The traditional “point of care” from a clinic or hospital will be transformed to a “point of convenience” for the patient - the home, the school, the workplace, or in between.

This session will offer perspectives on how these technology developments can de-institutionalize healthcare, from panelists who are already involved in developing and integrating such solutions into practice.

Telehealth — using medical information that’s exchanged from one site to another via electronic communications to improve a patient’s health — is gaining momentum as hospitals look for ways to provide more care to more patients at lower costs.

The mix of technologies can include videoconferencing, the transmission of still images and e-health, including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers. The market for these services is set to explode, with the U.S. and European market segments predicted to grow to an estimated $7.7 billion by 2012, according to Data Monitor. Intel, GE, AT&T and Royal Philips Electronics, among others, are rushing into the opportunity that comes with providing medical care to an aging population via computer technology.

Jeffrey S. Augenstein, MD, Professor of Surgery   and Director, Ryder Trauma Center

Experts who are developing and implementing telehealth solutions offered their perspectives in a panel session, “Telehealth, Robotics and Ubiquitous Computing: The De-Institutionalization of Health Care,” at the University of Miami Global Business Forum, held Jan. 12–14, 2011.

“We see telehealth as catalytic, using technology to bridge gaps of geography in medicine,” said Scott Simmons, UM’s director of telehealth. He believes it will de-institutionalize health care, and offered what he called “proof points” — five ways that this is already happening. Telehealth, Simmons said, is redefining the point of care, expanding specialist reach, enabling collaboration between primary and specialty care providers, improving customer service, and using consumer electronics as medical devices.

“We see technology being able to completely redefine care, especially with the ubiquity of telecommunications,” Simmons said. “We can deliver medical care at home, school, the workplace and anywhere through mobile devices.” He pointed to the iPhone, which, with simple apps, can serve as an EKG machine.

One of the strongest market opportunities for telehealth is virtual staffing, Simmons noted. Rural hospitals that don’t have neurologists on staff, for example, can rely on telehealth to consult with neurologists at other facilities. Instead of patients traveling to faraway cities or states to see specialists, they can sit in a doctor’s office close to home and consult with some of the best specialists in the world. And hospitals in disaster-stricken regions like Haiti can benefit from access to remote specialists.

Yulun Wang, chairman and CEO of InTouch Health, a Santa Barbara, Calif.-based telemedicine solutions company, proved Simmons’ point by joining the panel from his company headquarters via its remote-presence robot. The device is typically used to provide and document care delivered in emergency rooms, critical-care units, patient wards and operating rooms. The robot is equipped with a television screen that allowed the audience to see and hear Wang, and Wang was able to maneuver the robot remotely to get views of his fellow panelists and the audience.

“There is a new enabler on the scene that was not there 10 or 20 years ago — ubiquitous bandwidth,” Wang said. “Now that we have bandwidth available at reasonable costs, we can think about reshaping and retooling our medical delivery system. Even remote surgery is possible. I don’t believe frequent remote surgery is going to happen soon, but places like UM are doing remote surgery mentoring.”

Wang pointed to four drivers of telemedicine: Internet speed is faster, computing power is growing, electronic medical records enable remote care, and remote-presence technology allows physicians to assess patients. InTouch Health has developed a cloud-based, networked health care delivery model that is being used by stroke care services, universities and hospital groups in Mexico.

While some have expressed concerns about privacy when delivering health care or health information over broadband networks, Wang said complying with HIPAA (Health Insurance Portability and Accountability Act) rules addressing privacy issues is not difficult. “It’s an easy solution. We encrypt the information,” he said.

Jeffrey Augenstein, professor of surgery and director of the UM-JMH Ryder Trauma Center, called computer technology the key to the future of health care, noting its particular applications in treating trauma. “Trauma is America’s most expensive disease,” he said. “It costs hundreds of billions of dollars a year. It takes a lot of people to take care of an injured person.”

Telehealth can reduce the opportunity for “horrific” mistakes in trauma care by making patient information more transparent. Many poor decisions in trauma care stem from emergency medical personnel being unaware of critical information about a patient, such as the use of a blood thinner or a diabetes diagnosis. Computers can help bring that information to responders when they need it.

“Trauma quality and costs can be improved by identifying and addressing problems through monitoring, computerized education and evaluation, and computerizing the point of care,” Augenstein said. “Like it or not, medicine is changing. We have to use tools like these. We have no choice.”