The study, “Benefits of Telemedicine in Remote Communities and Use of Mobile and Wireless Platforms in Healthcare,” authored by four researchers – Alexander Vo, PhD, G Byron Brooks MD EE, Ralph Farr and Ben Raimer MD – outlines both the current successes in using “telemedicine” to help patients, and the future possibilities of utilizing mobile technologies in patient care.
It turns out that the use of technology to deliver healthcare is an effective way of overcoming some barriers to care, according to the UTMB Health report. The study points to successes in remote areas where there is little access to specialists, or in closing some of the gaps in crucial care where there is a shortage of sub-specialty providers. Researches found improved access to specialists; increased patient satisfaction with care; improved clinical outcomes; a reduction in emergency room visits; and, not surprisingly, overall healthcare cost savings.
Some of the examples the authors provide in treating patients through telemedicine include text, still images and video interactions – teleconferencing - between patient and physician. A typical session might include a doctor reviewing an electronic medical record that contains the patient’s history and lab findings, imaging studies and other medical testing, coupled with a real-time discussion with the patient.
This interactive capability, however, didn’t come easily. UTMB Health has been working since the 1990s to implement the necessary infrastructure to enable telemedicine in hard-to-reach and underserved areas. A growing emphasis on mobile capabilities and technologies throughout the country will only serve to increase the possibilities for telemedicine.
“All of these examples in healthcare delivery were brought about by the implementation of our high-speed data transmission infrastructure,” reads one portion of the study. “It is our belief that healthcare delivery is about to make a significant leap forward. The development and installation of inexpensive high-speed wireless telecommunications networks coupled with large-scale search engines and handheld smartphones will change healthcare delivery as well as the scope of healthcare services.”
Texas, the second largest state in the nation by land mass and population, provided an excellent proving ground for UTMB’s Telemedicine program. An evolution of its correctional and maternal child wellness programs, UTMB Health Telemedicine is currently being utilized in several rural healthcare delivery sites in seven counties – areas that have the technological infrastructure to enable the program. The population served in these counties includes low-income women and children, special needs children, elderly, and underserved children and adults. At the same time, UTMB Health has developed partnerships around the state with provider and educational institutions that low-income minority patients.
UTMB Health Telemedicine has expanded into other areas as well, including community health clinics, community mental health centers, corporate employees health programs, cruise ships, offshore industries and remote areas of the world, according to the report. Within the past few years UTMB Health has conducted more than 600,000 physician-to-patient telemedicine sessions and averaged more than 92,000 face-to-face telehealth encounters per year.
While the study itself is slim on overall patient population telehealth metrics, the authors do provide an example of how telemedicine has benefitted low-income pediatric psychiatric patients that live in areas with little access to psychiatric specialists.
In 2009 UTMB Health, in conjunction with the Texas Health and Human Services Commission, implemented telemedicine clinics to deliver mobile device-enabled psychiatric care. In the two years its been in operation the program, aptly titled UTMB Telehealth Network for Children, or UTNC, has scheduled more than 11,353 appointments for children located in 20 different clinical partnered sites across the state of Texas. Of those appointments it has scheduled, more than 7,775 real-time clinical appointments have occurred.
What’s important about these numbers is that Medicaid patients typically have a very high “no-show” rate. UTNC’s no-show rate is 32 percent, significantly lower than the national average of 42 percent for patient visits, and as high as 70 percent for outpatient mental health treatment, according to the report.
Similarly, a recent survey of 530 parents whose children received pediatric telepsychiatric care from UTMB Health found that 88.5 percent reported that telemedicine made it easier for them to receive treatment by a specialist. More than 60 percent reported better changes in overall functioning for their children. At the same time, the survey participants also went to the emergency room less, reporting a 50.5 percent reduction in ER visits for their children’s psychiatric needs.
Looking to the future, the paper examines the possibilities for telehealth as mobile devices, platforms and connectivity continue to proliferate.
“Mobile platform(s) can foreseeably be connected wirelessly to physiologic monitors worn on a patient’s body or embedded into a patients garment,” the report authors suggest. “Physiological monitors may be configured into a home health/ medical station with minimal space requirements. Some of the small monitors such as blood glucose, blood pressure, temperature, kinematic, EKG, imaging and electromagnetic field monitors are currently available and can foreseeably be interfaced with portable micro sample blood chemistry test sets, which are also available today. It is not difficult to imagine a patient being given a specific set of monitors tailored to his or her specific health care needs, and the data from these monitors and systems can be routed to the physician for either evaluation or to a monitoring program designed to give the doctor an alert or warning based on observed findings.”
The full report can be found at http://internetinnovation.org/files/special-reports/91311_Vo_Telehealth_Paper.pdf.
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Quelle/Source: Renal Business Today, 05.10.2011
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