Telemedicine is another area in health IT that interests me. Being a practicing physician with patients in multiple settings such as nursing homes and hospitals, I believe that telemedicine shows great promise and has yet to reach its potential in transforming how we practice healthcare . It's the combination clinical medicine and cutting edge healthcare IT that is really appealing to a techie physician. Telemedicine technology in many ways is about moving data around between patients and physicians, similar to a RHIO or an HIE.
To me, an HIE (Healthcare Information Exchange) is about moving and aggregating actionable clinical data from multiple data sources to a physician (or other healthcare provider) in order to provider patient care. Telemedicine is just another type of data that must be moved from the source (the patient from the remote location) to the physician.
I will be putting together a list of useful Telemedicine resources. please let me know if I should include anything else.
Telemedicine and Delaying Hospitalization: Interesting item on how telemedicine can reduce hospitalization of nursing home patients from a blog on senior care.
Some interesting points from the blog item:
- "...many doctors have skilled nursing facilities third on their to-do lists"
- “37 percent of the hospitalizations of long-term residents at urban nursing homes nationwide were potentially avoidable.”
- "A doctor can teleconference with a patient, see them via a monitor and make a decision as to what the patient needs."
" Many nursing homes have found this reduces the need for unnecessary hospitalizations.."
More links related to Telemedicine and Hospitalizations:
- Treating Acute Infections by Telemedicine in the Home PDF
- New telemedicine program pairs comfort of home with heart care
- Treating Acute Infections at Home with Telemedicine Presentation on real implementation of telemedicine. Has pictures of the equipment used, list of costs for the equipment and benefits of the program: Shows the reduction in hospital days, costs savings, patient satisfaction etc.
- Telemedicine Information Exchange (TIE) website : Great resource with a wealth of information on Telemedicine.
- Boston Globe article on Nursing home deficiencies and cutting unneeded hospitalizations. How Telemedicine is being used to address these challenges.
Telemedicine in Wound Care
Wound care in long term setting from Ostomy Wound Management
WoundMatrix, wound care EMR
Laser device to measure wounds.
Telemedicine Liability: Unfortunately, liability and malpractice are issues that must also be considered even in telemedicine. Here are a few resources:
Telemedicine Risk makes the following points:
- "...while remote medical practice can bring efficiency and cost savings... it can increase liability."
- "Malpractice insurance is merely the first step in risk management for telemedicine, since local laws may be different on each end of the link..."
Regional Telemedicine Issues
A map of Telemedicine and Telehealth State-by-State: A map with links to each state's telemedicine related issues such as existing programs, reimbursement policies etc.
Arizona's Telemedicine Program, equipment description
Telemedicine in Dermatology
Telemedicine in Nursing Home
Here is a 2006 presentation on the use telemedicine for nursing home care in the state of Maine.
Employing a Wireless Mobile Solution to Bring
Telemedicine to the Nursing Home Bedside
This is proposal to link three rural Michigan nursing homes via telemedicine.
Northeast Telehealth Resource Center , Partners Healthcare Telemedicine, ME and VT state.
There is a set of document links on their resource page. I have provided them here for convenience.
Informed Consent Reimbursement Policy and Procedures Tele-mental health Protocol for Correctional Inmates Protocol for Medical ASL Interpretation for the Deaf--Video Relay Interpreting Tele-Wound Care Protocol for Nursing Home Residents Tele-Pain management Protocol Tele-pharmacy Protocol
Wound care in long term setting from Ostomy Wound Management
Telemedicine Solution Vendors
REACH Remote Stroke Care
The use a 100% web enabled solution using webs cams, telemedicine carts to deliver reote stroke care to hospital emergency rooms.
ExhibitOne This company does high definition video conferencing for multiple applications including healthcare.
HealthPia America, Medical Device company. Their flagship product is the "All-in-One Diabetes phone, a cell phone with a built-in glucose monitor that essentially functions as a full-time nurse"
Team Health is a Tele-Radiology group: "TeamHealth Teleradiology (THTR) was founded in 1991, in Durham, North Carolina, by a group of physicians from Duke University. At that time, the centralized interpretative services group offered reading expertise in MRI and CT for rural physicians who lacked access or experience in these modalities. The group provided 24-hour-a-day coverage, including nights and weekends. THTR was the first and the largest teleradiology company of its kind."
TeleHealth and EMRs (5/2007) Makes a good case for telemedicine and its integration with EMRs. Also has a great set of EMR screenshots.
A. Hasan Sapci, M.D at the Telemedicine Resource Center at the University of Michigan Health System has included a comprehensive set of interesting telemedicine technical presentations on his online resume.
Telemedicine for developing countries, MIT developed solution
Telemedicine in Disease Management
Telemedicine in Diabetes
IDEATel- Informatics for Diabetes Education and Telemedicine
Home Telemedicine- A Practical Guide Addresses a number of issues: HIPAA, implementation, nurse case management, provider issues
RHIOs, Telehealth & Interop (HIMSS Architects of Change 3/2006) Lists several RHIOs with Telehealth components
Telemedicine Technical Resources:
The Value of Provider-to-Provider Telehealth Technologies, CITL
Telemedicine Market Article is a little dated, 2004, but does have an excellent market analysis.
Video Conferencing Solutions Vendors
New and Pre-owned equipment , Video Conference Store
Carries Sony Video Conferencing products
LifeSize, High Definition Video solution. This company has their own product which looks pretty slick. They have several excellent video demos of their product in action. Here is a review of their system.
MTN Missouri Telehealth Network
University of Iowa , Dept of Family Medicine: Samsung SDS of Korea, a development team at the University of Iowa has developed a Nursing Home Telemedicine system, Colonial Manor in Amana, Iowa. See their system diagram.
Policies and Procedures for providing telemedicine services in Maine
Alaska's AFHCAN user manuals