Does E-Health Stand a Remote Chance?

Gienna Shaw, for HealthLeaders Media , February 13, 2011
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But there are still technological hurdles—such as protecting patient privacy, securely sharing a patient’s medical records, and ensuring the accuracy of data transmitted from system to system. In that area, help lies in the government’s push for electronic health systems and calls for better interoperability and connectivity among providers’ systems, says David.

Another problem is that remote technology can make it more difficult to authenticate both people and data. Systems must have a function to validate the identity of the physician and the identity and the medical history of the patient.

Additionally, systems should be designed to ensure that images are accurate and to flag possible errors in data, such as missing pixels in a digital x-ray.

One way to control technical issues is to stick with procedures already in place—new technology doesn’t mean organizations should change the way they operate. “It’s very important for executives to insist that the program will be integrated into regular services support they provide,” David says. For example, if you already have a dermatology clinic on Tuesdays, telemedicine consultations should be held on the same day. Protocols such as taking a medical history should not vary between live and remote visits. “That way you are sure that you comply with all the necessary clinical requirements as well as the technical requirements,” he says. 

The bottom line
 The most common questions that leaders ask about telemedicine programs focus on cost and return on investment. Loyola’s leadership team was concerned about the capital expense of implementing a telemedicine program, so Webster put together a chart comparing the cost of the organization’s options, including hiring new physicians, attendings, or advanced practice nurses, starting a fellowship program, or investing in new telemedicine technology without hiring any new staff. The data turned out to be “pretty impressive,” she says: The capital equipment cost for starting a telemedicine program was about one-thirtieth of some of the other options.

Loyola’s system is not a big, fancy, high-ticket solution. But it fits its needs, Webster says.

“There are different reasons for using different technologies. They have varying levels of cost,” she says. “It’s important to do a needs assessment and say, ‘What is it we need to achieve from this?’ And that helps you determine what the cost is. You can get sucked into buying a lot of things that you don’t need or you can go too low and not get enough technology to meet your needs. It’s important to build that up front when you’re designing your program.”

Rather than trying to measure ROI based on the dollars per life saved, healthcare organizations should measure other benefits, such as improved quality and safety, Webster says.

“There is a financial barrier to entrance” to telemedicine, David says. But healthcare leaders should balance investment with expected ROI, he says.

“Definitely do not wait, because your market share, I believe, will [suffer] if you don’t have this type of program available to you. If you’re not participating, you might be late for the train. It definitely will not wait.”

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2 comments on "Does E-Health Stand a Remote Chance?"

Sherif E Issa (2/17/2011 at 5:58 AM)
I think at this stage; m-health or Tele-medicine succeeds better when presented as simple, mostly SMS based applications. A reminder to take your medication, or vaccination, or follow-up with pregnant women are some examples. These tools are very well accepted in developed and developing communities alike. But for more complex, fully fledged Tele-medicine applications, I can speak from my experience here in Egypt where we launched a 'Tele-Derma' project. Dermatology was an ideal candidate due to its highly visual nature.... several major entities collaborated to make this project a success – and it was – but only from a technical point. Pictures were taken, data logged in, information sent to experts and a full diagnosis + prescription was sent back.. all through broad band mobile technology; so it worked like a charm. Expert doctors were even more able to organized their schedules better, that was a bonus. On the human level however nor doctors or patients wanted to lose the 'personal' touch they enjoyed for years... some patients actually preferred to go to junior doctors in their local community where they can see and interact with him rather than get treated by an expert hundreds or thousands of kilometers away.

roger (2/15/2011 at 6:41 PM)
An excellent article, Gienna, identifying the areas that most people want to know about telemedicine and telemedicine equipment: ROI, ease of use, regulations, reimbursement. As I said, the important areas. I would suggest some other aspects that are crucial in designing the solution that best fits a practice or facility: Scalability - Is the system designed to accomodate other peripherals used in other modalities? Interoperability - Too many vendors have their own "secret sauce." In other words, the equipment they offer works with their systems, but no one else's. Connectivity - Does the equipment require special adaptors, connectors or interfaces to work with your system? If so, you're looking at a jangle of wires and cables and the likelihood that it still won't play well. Regarding Dr. Webster, we're proud to say that she chose GlobalMedia's telemedicine solutions that were designed for her needs at Loyola. Roger Downey GlobalMedia




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