Telemedicine is growing at a rapid pace fueled by faster Internet connections, the ubiquity of smartphones and personal devices, and new software platforms that connect patients with providers more easily and efficiently.
According to an IHS Report, the number of patients using telehealth services will rise to 7 million in 2018, up from less than 350,000 in 2013. The rise of telemedicine is a clear attestation that our healthcare system is being forced to adapt to rising expenses, an aging population, and the increasing prevalence of chronic diseases. Yet, the aim of telemedicine is not to replace the patient-provider relationships altogether but to supplement and optimize the care experience. One such application is remote patient triage, which provides better emergency care and more access to healthcare for patients in rural areas while reducing healthcare costs.
Telemedicine for Emergency and Urgent Care Triage
Last year witnessed an increasing amount of health systems beginning to use telemedicine to screen emergency department patients, a trend that will only continue to grow. Wisconsin-based startup EmOpti recently developed a telemedicine platform that is currently being used in eight hospitals across four different health systems. Patients who are admitted to the emergency room and are waiting to be seen by a doctor can first be seen by another doctor or physician assistant in a remote “command center” via a secure video-conferencing technology platform. The remote physician, or assistant, examines the patient with the help of on-site triage nurses and can order tests or prescribe medications. Triage via telemedicine can help physicians better screen patients and allow them to determine who requires urgent care first. It can also play a key role in managing the physician shortages and patient congestion that have long been a hallmark of emergency rooms.
TeleMedCo, a Florida startup, has also developed a real-time communications platform that utilizes IBM’s machine-learning solution to engage in primary patient care in the emergency room and in urgent care environments. Their solution assists doctors by overseeing non-urgent care patients from diagnosis to prescription or other treatment recommendations. The solution is built to code and bill for the entire patient visit, while also alerting doctors if immediate human intervention is required based on the information, analysis, and rules built into the software. Telemedicine triage continues to illustrate how automation can help expedite the more routine facets of healthcare while increasing physician efficiency and optimizing health outcomes.
Telemedicine is also expanding to include biometric data collection and real-time monitoring, thereby increasing the number and type of cases that can be addressed remotely. Cambridge Design Partnership created a medical wearable device that measures and monitors the vital signs of multiple trauma patients for emergency response in disaster and battlefield situations. The small and portable device, called The First Response Monitor, clips to the nose and helps medics accurately monitor both heart rate and respiratory rate as well as collecting and transmitting data in real-time. This allows medics to care for a larger number of casualties, providing more effective triage to improve patient outcomes.
Telemedicine in Rural Communities
Telemedicine health solutions can also support remote patient triage by facilitating greater access to healthcare among rural and underserved communities. Today, health disparities and access gaps between urban and rural communities continue to widen, because rural hospitals and health facilities are closing while more urban ones remain open. In fact, one-fifth of Americans live in areas that have physician and healthcare specialist shortages. In Texas, for instance, the closure of rural hospitals affects 20 percent of the state’s entire population. This problem is compounded by the fact that there is about a 25 percent higher death rate for ischemic heart disease and a 53 percent higher death rate for COPD within these already vulnerable populations.
Healthcare providers are turning to telemedicine to bridge the gap in healthcare access for rural communities. Project ECHO uses a telehealth model to link primary care clinicians with specialists through real-time learning made possible by low-cost videoconferencing technology. With the implementation of ECHO, patients in remote areas with limited access to physicians can receive care in their communities. In 2009 alone, the project saved patients in a New Mexico community 539,000 travel miles. As well as assisting with remote patient triage, telehealth projects like ECHO can expand the reach of specialists and alleviate care and travel costs.
Leveraging Telemedicine to Lower Costs
Telemedicine is largely publicized as a cost-efficient way to deliver healthcare for both providers and patients. On average, a routine doctor’s visit costs a patient approximately $100, compared to $45 for a virtual visit – and the difference only grows with a visit to the emergency room. Of course, some people will have to visit the ER, but telemedicine can assist by triaging those cases that can either be solved over a virtual “visit” or at least postponed until a regular doctor’s appointment is made. From the provider’s perspective, telemedicine cuts costs starting from a technical standpoint: the overhead costs of a telehealth technology can be significantly lower than the costs of rent, salaries, and utilities for a physical facility.
Telemedicine could bring long-term value-based care by optimizing emergency and urgent care delivery, assisting in earlier detection and diagnosis, and helping patients more effectively manage chronic conditions at home. Improving patient triage to focus on high-risk patients, and harnessing telemedicine to remotely monitor chronic disease patients, will ultimately lower costs, increase efficiency, and generate revenue. Ideally, telemedicine would first be leveraged for chronic disease management, which makes up the highest percentage of the nation’s aggregate healthcare spending, and thus would have the biggest impact on lowering costs. Effective at-home management of chronic diseases, facilitated with a combination of remote patient monitoring and telemedicine, would be the catalyst for this transition. For instance, a remote cardiac device could actively monitor a patient’s ECG in real-time, constantly collecting and compiling data on the device and uploading to the cloud. When physicians are then provided with a summary report of the patient’s data, they are better equipped to make an accurate diagnosis and prescribe an effective treatment plan.
Bridging the Healthcare Gap by Making Telemedicine Mainstream
Policy makers, healthcare providers, and technology manufacturers are starting to make telemedicine more mainstream, but there is more to do. The Centers for Medicare & Medicaid Services (CMS) recently released new payment rules that will give mHealth and telemedicine technology a better shot at reimbursement. Ultimately, telemedicine will be successfully implemented in everyday healthcare when it provides value-based care within a reimbursement structure that pays for expanded remote services and makes it easier for providers to both facilitate and bill for it. Healthcare providers should ensure that any sharing and storing of sensitive patient health data follows security requirements set out by the Health Insurance Portability and Accountability Act (HIPAA). From a technology standpoint, telemedicine should include videoconferencing capabilities for a more personable experience and operate on a reliable and fast network so that healthcare providers can more efficiently share files and utilize cloud storage. As demand for telemedicine escalates, these issues need to be addressed to push toward greater adoption.
About the Author:
Waqaas Al-Siddiq is Founder and CEO of Biotricity, a biometric remote monitoring solutions company. He is a serial entrepreneur, a former investment advisor and expert in wireless communication technology. He has vast experience through executive roles within start-ups, mid-sized companies, and non-profits. For more information visit https://www.biotricity.com