Telemedicine also know as Virtual consultations with distant specialists, high-tech monitoring without having to leave home, and less-expensive patient care options are among the many reasons that the hospital industry is embracing telehealth technologies. But telemedicine isn’t a one-size-fits-all solution for hospitals. As part of the U.S. News Hospital of Tomorrow forum on Tuesday, industry experts gathered to discuss the ways technology is changing the hospital industry.
Center for Connected Health founder and director Dr. Joseph Kvedar, Mercy Health President and CEO Lynn Britton, InTouch Health Chairman and CEO Yulun Wang, and Dr. James Marcin of the University of California-Davis Children’s Hospital spoke during a break-out session moderated by Ben Harder, U.S. News & World Report’s director of health care analysis.
Harder pointed out that though the idea of remote care seems exotic to some, “Telemedicine — though not necessarily telesurgery — is a part of daily medicine now, and increasingly so.” With more than 20 states now mandating reimbursement for telehealth services, it’s evident that health care is embracing this type of technology.
What started out as a way for people in rural areas to gain access to the expertise found in big-city hospitals, telemedicine has become a way to extend services and improve efficiency at the same time.
The benefit is magnified in smaller communities. Britton described a situation where a pediatrician might diagnose a heart murmur in a child, but when a pediatric cardiologist is brought in via telemedicine, they discover it was a false alarm. “All of that was urban-to-rural service,” he told the crowd. “For a long time that’s really how we thought about telemedicine. Let’s take that subspecialty care and port it out to those who need it.”
Now, however, “Health care is simultaneously local, regional and virtual.”
Kvedar says that telemedicine has a number of practical applications: heart failure monitoring, doctor-to-doctor and doctor-to-patient contact, online second opinions, and patient engagement, among other things. And you don’t need pricey, specialized robots to do it.
“There’s been a proliferation of connected devices that all have easy connectivity to the cloud and open APIs for sharing,” he said. Only about 5 percent of the population uses such devices, “but that will grow,” he said. “Our intent is to bring it to living rooms and kitchens of family homes,” he added. “We think that self-tracking is an incredibly powerful tool.”
Wang talked about his experience as part of the first transatlantic surgery in 2001, during which three robots allowed surgeons in New York City to operate on a patient in Strasbourg, France. That surgery was incredibly expensive, but medical culture has historically celebrated innovation. “What we need to do is evolve to where we’re celebrating the types of innovation that’s bringing value, where cost is figured into the equation,” he said.
Then he connected an iPad mini to the projector and used it, via a standard Verizon 4G connection, to control a robot in his office in California. He “drove” the robot over to the bed of a “patient,” maneuvering around another robot controlled by someone elsewhere, and examined the mannequin in the bed, zooming in on its eye, checking its vitals, and even looking at imaging on a monitor nearby. It was a powerful example of the efficiency and value of telemedicine.
“From the podium right here, from this little thing right here, I can beam into 900 hospitals instantly,” he explained. “Right now, if I was a real physician, I’d be able to take care of somebody. If you think about that, that’s a pretty powerful concept.”
“Telemedicine started as a mechanism to bring access to remote locations, but I think what’s going to happen here, and as we shift from a vol to value type process, there are all kinds of thing you can use telemedicine for,” he continued. His hope is that telemedicine is eventually incorporated into everyday medical delivery, making high-quality care more affordable simply by better leveraging expensive experts.
If you take away the need to drive traffic to your brick-and-mortar location, Kvedar said, you gain the ability to become much more efficient. Virtual follow-ups can go a long way to reducing overall costs in the industry. “If it’s something that can be dealt with without the patient traveling, we prefer to do that,” Marcin agreed.
The key is to make sure that patients feel connected to their doctors, even if they’re being evaluated by a team of health care providers.
“In our experience, programs work best when there’s a link back to the patient’s doctor,” Kevdar said. Even so, “It doesn’t mean that the doctor has to be in every single consultation.”
But even though the care is given remotely, “It’s not substandard care, in any event,” Kevdar emphasized. Wang agreed.
“Telemedicine has a ‘stigma’ — not quite the right word — on being a solution just for the rural area. That’s a notion I’d like to dispel,” he said. “It can be applied to everywhere. In LA, just getting across the city to another hospital can take an hour because of traffic, but telemedicine makes it more possible.”