HIMSS Feature: Smartphones, sociological changes create perfect storm for telemedicine
ATLANTA--The prevalence of immediate information combined with connectivity created by technology and the clinical workforce expectation of better time management is a perfect storm for better mobile applications and delivery of medical care including telehealth, said William F. Bria, MD, CMIO for Shriners Hospitals for Children in Tampa, Fla., today at the annual Healthcare Information and Management Systems Society (HIMSS) conference.
Bria reviewed the current medical applications of new technologies and their impact on the growing field of telehealth.
“The era of telemedicine has gone from curiosity to, for many, commonplace,” said Bria. In an interview, Bria gave an anecdotal example of telehealth's capabilities after receiving a second degree burn on his hand in Tampa and sending images to a specialist in Cincinnati via his mobile phone. The specialist was able to administer medical assistance to Bria over his phone, allowing Bria to tend to the burn. According to Bria, he was completely satisfied with specialist's medical advice.
There are certain drivers affecting the healthcare industry's current push to become more mobile, he said. “The existence of the technology itself would not be sufficient in the interest of the growth of applications and opportunities we are starting to see nationally without a couple of other things being true,” said Bria.
The need for monitoring patient care since inpatient services are now more carefully managed is gone for reimbursement reasons and for utilization reviews, according to Bria. “If you’re in the hospital, you probably need to be there so the notion of messaging services on a real-time basis is not a safety or quality of care issue, it’s a financial issue,” said Bria.
Patients have changed too. “Their expectation of contact to their physicians hasn’t changed in many ways but patients are mindful that the old primary care physician coordination practices are gone,” said Bria. “The notion or idea of being able to contact their physician has changed.”
Also, patients that aren’t experiencing trauma or other emergency medical needs have begun to think that since devices can provide instant news feeds and have data input ports and cameras, there is no reason that a device can’t interface with a glucometer to read blood sugar measurements, according to Bria.
Telemedicine is being sought because cell phones are so ubiquitous and service is so well documented that many problems can be avoided if dealt with early instead of stewing in an ER or waiting to go to the doctor, Bria said.
Younger, technologically-savvy patients don’t mind receiving health information whether it is through a text or Twitter message, according to Bria. The greatest challenge to this potential mode of health information exchange between the patient and provider will be financial, said Bria.
However, he does not see this to be a problem as telehealth reimbursement codes are already surfacing.
"Additionally, from a physician’s standpoint, if you were to ask a physician if he or she would you like to stay in the office until 7pm or go home and do non-acute follow up monitors on your laptop or iPhone, I don’t know too many physicians that wouldn’t answer that question quickly and choose to go home," said Bria.
From the patient's standpoint, according to Bria, chronically diseased patients are beginning to feel they need to take control of their health records and have better access to the healthcare environment. So the telelhealth option for patients asks the question whether they would rather wait for two hours until the patient is seen in the ER by someone unfamiliar to them or send an attached picture or lab measurements to a doctor they've known for years, said Bria.
“The drivers of cost, time, expectation of care and service and need for monitoring all coming together makes this era is the perfect opportunity for patients to take control of their health and achieve the responsiveness of the healthcare that wouldn’t been possible otherwise,” concluded Bria.
Bria reviewed the current medical applications of new technologies and their impact on the growing field of telehealth.
“The era of telemedicine has gone from curiosity to, for many, commonplace,” said Bria. In an interview, Bria gave an anecdotal example of telehealth's capabilities after receiving a second degree burn on his hand in Tampa and sending images to a specialist in Cincinnati via his mobile phone. The specialist was able to administer medical assistance to Bria over his phone, allowing Bria to tend to the burn. According to Bria, he was completely satisfied with specialist's medical advice.
There are certain drivers affecting the healthcare industry's current push to become more mobile, he said. “The existence of the technology itself would not be sufficient in the interest of the growth of applications and opportunities we are starting to see nationally without a couple of other things being true,” said Bria.
The need for monitoring patient care since inpatient services are now more carefully managed is gone for reimbursement reasons and for utilization reviews, according to Bria. “If you’re in the hospital, you probably need to be there so the notion of messaging services on a real-time basis is not a safety or quality of care issue, it’s a financial issue,” said Bria.
Patients have changed too. “Their expectation of contact to their physicians hasn’t changed in many ways but patients are mindful that the old primary care physician coordination practices are gone,” said Bria. “The notion or idea of being able to contact their physician has changed.”
Also, patients that aren’t experiencing trauma or other emergency medical needs have begun to think that since devices can provide instant news feeds and have data input ports and cameras, there is no reason that a device can’t interface with a glucometer to read blood sugar measurements, according to Bria.
Telemedicine is being sought because cell phones are so ubiquitous and service is so well documented that many problems can be avoided if dealt with early instead of stewing in an ER or waiting to go to the doctor, Bria said.
Younger, technologically-savvy patients don’t mind receiving health information whether it is through a text or Twitter message, according to Bria. The greatest challenge to this potential mode of health information exchange between the patient and provider will be financial, said Bria.
However, he does not see this to be a problem as telehealth reimbursement codes are already surfacing.
"Additionally, from a physician’s standpoint, if you were to ask a physician if he or she would you like to stay in the office until 7pm or go home and do non-acute follow up monitors on your laptop or iPhone, I don’t know too many physicians that wouldn’t answer that question quickly and choose to go home," said Bria.
From the patient's standpoint, according to Bria, chronically diseased patients are beginning to feel they need to take control of their health records and have better access to the healthcare environment. So the telelhealth option for patients asks the question whether they would rather wait for two hours until the patient is seen in the ER by someone unfamiliar to them or send an attached picture or lab measurements to a doctor they've known for years, said Bria.
“The drivers of cost, time, expectation of care and service and need for monitoring all coming together makes this era is the perfect opportunity for patients to take control of their health and achieve the responsiveness of the healthcare that wouldn’t been possible otherwise,” concluded Bria.