Focus Writing: Telemedicine
Introduction: Telemedicine refers to the practice of caring for patients remotely when the provider and patient are not physically present with each other. A tool that makes healthcare more accessible, cost-effective, and that increases patient engagement – is telemedicine. Since making its debut in the late 1950s, advances in telemedicine has contributed to seniors having the choice to age in place. In addition, the patients that reside in rural areas that previously had difficulties accessing a physician can now reach them virtually.
Physicians and patients can share information in real-time from one computer screen to another. And they can even see and capture readings from medical devices at a faraway location. Using telemedicine software, patients can see a doctor for diagnosis and treatment without having to wait for an appointment. Patients can consult a physician at the comfort of their home.
The concept of telemedicine and telehealth could be still new to providers and physicians given the especially slow adoption of technology in healthcare.
It’s now a matter of time for the healthcare system, medical groups, providers, and even solo practitioners to integrate telemedicine as part of their medical services offering.
What is Telemedicine Healthcare: Telemedicine is simply defined as, “the remote delivery of healthcare services“. There are 3 common types of telemedicine, which include but not limited to:
• Interactive Medicine – which allows patients and physicians to communicate in real-time while maintaining HIPAA compliance
• Store and Forward – which permits providers to share patient information with a practitioner in another location.
• Remote Patient Monitoring – which allows remote caregivers to monitor patients that reside at home by using mobile medical devices to collect data (e.g. blood sugar or blood pressure)
How is telemedicine set up?
It can be simple or complex for a provider to implement telemedicine into their practice. For solo practitioner and clinic, most just require a basic HIPAA compliant video conference software to start delivering telemedicine consultation.
For providers looking to have a more complete virtual clinic solution, they need to consider their existing workflow and incorporate the telemedicine software solution into their practice. Usually, this software needs to have a waiting room, EHR, and payment function.
For large medical group or hospitals, they usually require custom telehealth solution to fit into their existing workflow to lessen the disruption of adopting telemedicine as its harder to train a large number of physicians to change their behavior.
How is it Conducted?
Telemedicine is conducted in a number of ways. The most basic is just a simple video call (like you normally do with family and friends), however, most countries required secured HIPAA compliant video conference tool, so telemedicine company such as VSee also provides this kind of secure and simple to use solution for providers.
There are also some telemedicine is conducted with portable telemedicine kits that include a computer and mobile medical devices, such as ECGs or vital signs monitors. High-resolution digital cameras are also available for physicians to send detailed medical images to specialists.
VSee PRODUCT SOLUTIONS: What is the difference between Telemedicine and Telehealth?
In the last decade, rapid advances in medicine and technology have resulted in the use of new terms. Policymakers, healthcare systems, advocacy groups, and vendors may unknowingly use terms incorrectly when discussing medicine and technology.
This is especially true when it comes to the terms, telemedicine, and telehealth. Although the words are often used interchangeably, there is certainly a difference between the two.
Telemedicine and Telehealth:
The terms telemedicine and telehealth bring with them plenty of debate among individuals in the healthcare field. One reason for this debate is due to the varying definitions pertaining to the terms themselves. Some experts consider telemedicine to be physician-focused and telehealth to include all health professionals in general.
As technology in the medical field continues to advance, the two terms will likely become more distinguishable. With these advances, there are fortunately industry experts like VSee that keep up with the varying changes for physicians and hospitals. Healthcare organizations interested in implementing telehealth or telemedicine do not have to do so alone.
History of Telemedicine: Contrary to popular belief, telemedicine is not a new practice. In fact, the concept of telemedicine is dated back to the 19th century! What began as a few hospitals wanting to reach patients in remote locations became an integrative system across the care continuum. The history of telemedicine will unveil how we got to where we are today.
Telemedicine Today: Today, most people have access to basic telemedicine devices like mobile phones and computers. With improved accessibility, individuals in rural areas and busy urban areas can connect with a provider with ease.
Home-use medical devices make it possible for caregivers to monitor everything from vitals to glucose levels. Physicians can gather essential medical information and make a diagnosis without patients stepping foot in a doctor’s office.
By 2020, telemedicine is expected to be a $35 billion industry and be an imperative piece of modern healthcare delivery. The history of telemedicine shows that we’ve come so far from where we started, and yet still have a long ways to go.
How Telemedicine Benefits Providers: Healthcare systems, physician practices, and skilled nursing facilities are using telemedicine to provide care more efficiently.
Technologies that comes integrated with telemedicine software like electronic medical records, AI diagnosis, and medical streaming devices, can better assist providers in diagnosis and treatment. The latter allows providers to monitor patients in real-time and adjust treatment plans when necessary. Ultimately, this leads to better patient outcomes.
How Telemedicine Benefits Patients: Because of telemedicine, patients who previously had limited access to health care services can now see a physician without leaving their homes. Seniors who would prefer to age in place can now do so with the use of medical streaming devices. The spread of disease is reduced as individuals with contagious diseases don’t have to expose it to others in crowded waiting rooms.
Telemedicine also benefits patients in the following ways:
• Transportation: Patients can avoid spending gas money or wasting time in traffic with video consultations.
• No missing work: Today, individuals can schedule a consultation during a work break or even after work hours.
• Childcare/Eldercare Challenges: Those who struggle to find care options can use telemedicine solutions.
What are the disadvantages of telemedicine?
Although telemedicine brings with it many benefits, there are some downsides to it as well. Providers, payers, and policymakers alike know that there are some gray areas that are difficult to keep up with. While the field will grow exponentially over the next decade, it will bring with it both practical and technological challenges.
Fewer Face-to-Face Consultations: Several physicians and patients are finding it difficult to adapt to telemedicine, especially older adults. Physicians are very concerned about patient mismanagement.
While advances in medicine have made it more efficient to use technology, there are times when system outages occur. There is also the potential for error as technology cannot always capture what the human touch can.
Interactive Medicine: Interactive medicine, also known as “live telemedicine”, allows patients and physicians to communicate in real-time while also maintaining HIPAA compliance. Communication methods include both phone consultations and video conferences. Physicians can assess a patient’s medical history, perform psychiatric evaluations, and more using interactive medicine.
Chronic Disease Management: With high-tech medical devices, physicians can now monitor their patient’s health over long distances. Touchscreen technology allows providers to access heart rate, blood pressure, glucose levels, and more through the transmission of data from one device to another.
Sharing Medical Information: Store and forward, a type of telemedicine that allows providers to share information over a distance, has been a game-changer. Today, primary care physicians can connect with specialists who are in another location than them. Healthcare information like diagnostic images, blood analysis, and more can be shared for appropriate patient assessment in real-time.
2nd Opinion:- Today, there are telemedicine solutions that allow patients to seek a second opinion from the comforts of their homes. Sending another physician copies of your medical images and more can easily be done by uploading the content to their secure website. This is very convenient for those who need a specialist but do not have the resources to drive thousands of miles away or wait a long time.
Mobile Health: Sometimes the answer to the question “What is telemedicine?” is simply mobile medicine. It doesn’t require a heavy desktop computer or a lot of equipment. Activities that used to happen only in person are now easy to do on a smartphone.
Modern consumers are accustomed to downloading apps and using their smartphones for simple transactions. The same is true for doctor visits. For example, with MDLIVE the patient simply opens the app and clicks to choose a doctor, with whom they can speak either by phone, instant message, or video.
Mental Health: Likely one of the most popular specialties for telemedicine, mental health practices can increase revenue, streamline patient flow, and provide counseling sessions from anywhere. With telemedicine, patients in rural areas can now access mobile and web apps to speak with their therapist.
In addition, cancellations and no-shows are less likely to occur. Mental health practices that implement telemedicine can also see more patients and still provide a high level of patient care. This leads to increased profitability and effective time management.
Pediatric: Parents can now avoid bringing their sick child out of the house to see a doctor because of telemedicine solutions. A Pediatrician can use HIPAA Messenger to securely share images, texts, and more to make a diagnosis and treatment plan. The pediatrician can also provide education to parents regarding the next steps just as they would at a clinic.
Dermatology: With telemedicine, patients can connect with their dermatologist using a smartphone, tablet, or computer. Using high definition images and video, dermatologists can examine a patient suffering from psoriasis, eczema, bedsores, and more.
This is extremely convenient for those patients that are housebound. Using telemedicine solutions, dermatologists can diagnose and treat skincare conditions effectively and efficiently. In addition, it not only saves a patient from traveling to a clinic but it also helps them maintain their dignity.
Telemedicine Vendors: A telemedicine vendor should have no reservations in signing a Business Associate Agreement. Those that do sign one are confident in their ability to securely store patient information. They are confident that their telemedicine solutions can protect pertinent patient information.
Medical Licensing Across States: With telehealth allowing physicians to expand their coverage area, there have been questions regarding interstate medical licensing. Interstate medical licensing permits more physicians to serve individuals in underserved and rural areas, but currently, only a few states offer this. The Interstate Medical Licensure Compact helps streamline the licensing process for physicians that are interested in practicing in participating states.
Medicaid and Telemedicine: Medicaid reimbursement varies for each state, but most states offer some form of coverage for telemedicine services. Similar to Medicare, there are reimbursement limitations for patient settings and facilities. As telemedicine continues to expand and technology improves, more states are removing geographic limitations.
To date, all but two states reimburse for live video conferencing and several reimburse for store-and-forward and remote patient monitoring. In addition, 29 states require informed consent prior to receiving telemedicine services.
What Telemedicine Software Solutions are available:
There are many different levels when it comes to providing telemedicine software solutions. Unlike telehealth, telemedicine focuses specifically on providing clinical care. We’ll explore three popular solutions that healthcare providers use today.
Video Call: Video calls are used for in-home care, ambulatory care, and acute care. Not only does it allow for providers to reach patients in rural populations, but it also makes providing care more efficient. Practices that choose to use video calls can do so for urgent care, primary care, or follow-up consultations.
VSee offers physicians and patients the ability to communicate using HD, HIPAA-compliant software. In addition, providers can use Pan-Tilt-Zoom to view close-ups of their patients on remote exams. They can also share and mark-up documents, CT Scans, and lab results.
Waiting Room (triage): Emergency room and urgent care environments are known for long wait times, overcrowding, and even staffing shortages. This leads to additional stress being added to not only the patient but the staff too.
With the-triage, patients can arrive at an emergency department and be seen by an off-site physician using video conferencing software. The off-site physician can order tests or determine a treatment plan, which moves patients through the system faster. Cases that are more severe can be moved to the next level of patient care and others can be discharged.
Virtual Clinic: Clinics that want to improve their workflow experience and backend experience, should consider using a Virtual Clinic.
With EMR: Because of telemedicine, physicians can access patient medical records without being onsite. Some telemedicine providers offer the ability to do data entry using a point-and-click method or video/handwriting recognition. This can cut down on the amount of time that physicians dedicate to administrative tasks. As a result, physicians can see more patients or spend more time with those cases that are more complex.
With Billing Solution: Like an onsite clinic, patients can check-in for walk-in or scheduled visits, complete an intake form, and make payment online. However, the biggest concern for physicians is reimbursement. Telemedicine experts, like VSee, can walk organizations through how successful practices have done it. A ‘Practice Set Up Guide‘ can be found here.
What are the barriers to Telemedicine: While telemedicine has shown to be a game-changer in the field of medicine, there are still a number of barriers to overcome. Physicians face challenges regarding how they’ll be paid and where they can practice, while patients voice security concerns. Once these barriers are removed, we can anticipate greater access to care and improved patient outcomes.
The Future of telehealth: Annually, millions of Americans receive care using telemedicine solutions and the numbers are increasing. With more patients using the service and more physicians offering it, telemedicine has no choice but to expand. Here is what the future of telehealth looks like:
Online Medical Centers: Imagine a 24/7 online collaborative platform for patients, providers, and staff. The future of telehealth may look like a group of remote physicians treating hospitalized patients from all over the state. With digital monitoring devices and video conferencing, physicians can treat and diagnose more patients in less time.
Telemedicine Across Borders: With technology becoming more robust, the future of telehealth could include international collaboration. Some countries offer medical advances that the United States does not have readily available (and vice versa), but telemedicine would lessen the barriers.
Great Acceptability: As patients experience reduced wait times and greater access to care, the hesitation regarding telemedicine will decrease. Physicians will also notice better patient outcomes and more revenue without an increased workload. In addition, private payers, Medicaid, and Medicare will respond to the demand after solidifying best practices.
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