Strategic Interests’ Al Kinel joins panel experts from AT&T and RIT to explore what opportunities are ahead for Rochester as 5G rolls out. Kinel will provide perspectives on how 5G will enhance telehealth and healthcare technology overall.
Event is free. Jan 22, 2020 5:30pm at NextCorps in Rochester
Register here: https://www.eventbrite.com/e/the-impact-of-5g-registration-88157743183
As a market sector, healthcare can sometimes be slow to adopt new and emerging technology but there have been several recent “wins” that give advocates of telemedicine reason for optimism. The passing of the Veterans E-Health and Telemedicine Support Act of 2017 (VETS Act) in the US House of Representatives, is another step toward integrating telemedicine into mainstream healthcare. It allows for telemedicine in the VA to be provided across state lines, moving toward “anywhere to anywhere” healthcare as described by the VA Secretary David Shulkin. This shift forward, if the companion bill passes in the Senate, will likely increase access to telemedicine across other sectors of healthcare as well as it signals an increasing acceptance of the technology. http://www.healthcareitnews.com/news/8-reasons-why-telehealth-gaining-momentum-right-now
This legislation comes shortly after new payment rules were released by the Centers for Medicare and Medicaid Services. The CMS’ Merit-based Incentive Payment System (MIPS) improvements, includes changes which would enable doctors using “non-face-to-face chronic care management using remote monitoring and or telehealth technology” to receive Advancing Care Information (ACI) program points for activities such as sending medication reminders, collecting, monitoring and reviewing patient physiological data and prescribing patient education.
Of concern is the infrastructure needed to support telemedicine. Some aspects of telemedicine, like remote monitoring, use lower levels of internet connectivity and may be easier to deploy. As the standard shifts toward more video conferencing that requires high speed internet at both ends of the visit, a lack of infrastructure can be a barrier to full use of the technology. Many rural communities don’t have the broadband infrastructure that is needed. There is proposed legislation that addresses the problem and, if adopted, could help move the process forward.
While these recent changes are very good signs for the advancement of telemedicine, there is still much about the technology that will need to be supported and understood to realize all the potential benefits. If done well, emerging research is showing both clinical and financial benefits for providers and patients across many different settings. Frequently in healthcare, it is legislation that triggers interest in new technology so expect more and more stakeholders to recognize the growing appeal of telemedicine.
In a forward to a book entitled Snake Oil, British evolutionary biologist Richard Dawkins stated, “there is no alternative medicine. There is only medicine that works and medicine that doesn’t work.” This was important conceptually because it illustrated that the umbrella of Medicine (with a capital M) encompasses all that is useful in the treatment of patients. Do you remember a time when asking to use someone’s telephone meant they would bring you into their kitchen, hand you a receiver on a coiled wire and make sure you weren’t calling long-distance? Now, if you ask to borrow someone’s phone, they are more likely to reach into their pocket and hand you their portable device. However, we do not necessarily need to specify that we need to borrow a cellular phone or a landline phone — if they work, Dawkins might posit, they are all phones.
Telehealth or telemedicine is the utilization of IT or telecommunication devices to provide health care. The emphasis is on health care — not on the tool used to provide it. In other words, we do not provide stethoscope-type medical treatment. Nobody would ask if your doctor is the blood-pressure-cuff using kind of doctor. Medicine is medicine and the tools used to facilitate it, while integral and vital, do not change the overall category.
Shortly, we will discontinue the distinction between telehealth care and non-telehealth care. It will simply be viewed as a necessary and effective tool used in the usual and customary delivery of treatment to patients. If your organization is ready to embrace a strategy in which this important tool is incorporated into the care you deliver to patients, Strategic Interests can help you develop the strategy, select equipment and vendors, implement and deploy the equipment, and most of all, help your people learn to use these tools to enhance the highest quality of care.
Strategic Interests principal specializing in clinical and business transformation, Brett Kinsler, will deliver a webinar in partnership with one of our technology clients, iVEDiX. Leveraging knowledge gained from an SI led study examining transitions of care data gaps, Dr. Kinsler discusses how one patient’s movement stemming from an emergency situation at home, through EMS, into the ED, admission to the hospital, care by the specialist and back to home care can all be positively impacted using a mobile visualization platform.
EHRs and HIEs are constrained in the manner in which they present information, struggle to show a longitudinal view of clinical and psychosocial patient information, and are not optimized for a workflow that engages patients. This negatively impacts outcomes. In this webinar, we focus on how customizable mobile dashboards and an innovative presentation of content from EHRs, HIEs, and a myriad of systems can improve patient care and transition success.
Date: Thu, Jun 2, 2016 2:30 PM – 3:30 PM EDT
Please join us by registering at this link: https://attendee.gotowebinar.com/register/3687692005145498626
A recent publication in publication Mayo Clinical Proceedings (2015;90(12):1600-1613) concluded that in the United States, physicians are worse off than they were just three years ago. The work-life balance has suffered and more than 50% of physicians report professional burnout. This is in contrast to the high degree of professional satisfaction reported with their career choice.
Burnout is a term that reflects emotional exhaustion, a loss of meaning in work, feelings of ineffectiveness and a tendency to view people as objects rather than as human beings. This has profound implications in healthcare and is likely one of the largest causes of high rates of physician turnover. The problem is pervasive and getting worse. The inventors of the Maslach Burnout Inventory (MBI) describe burnout as “…an erosion of the soul caused by a deterioration of one’s values, dignity, spirit and will.”
Researchers noted a 10% increase in burnout prevalence over the last 3 years despite no increase in the number of hours worked, no change in career satisfaction or symptoms of depression. And before you say that this is probably just a human condition of living in the United States, the trend among the general US working population does not follow suit.
What are the possible solutions to this problem? Here are a few suggestions:
1. Increase Efficiency: this does not mean pushing more patients through the office at a faster rate but rather helping organize, calibrate and fine-tune workflows to empower physicians to be more effective in the time they have during an encounter.
2. Promote Work-Life balance: end the ridiculous long shifts of residents and encourage physicians to optimize their career with their families. Create an environment that nurtures community, flexibility and control that will yield more meaning in the care of patients. Establish programs that provide healthy outlets for physicians in the workplace such as exercise facilities and farmer’s markets. Permit physicians to exert control over their work hours whenever possible.
3. Encourage Self-Reflection: give physicians time and space to examine their own wellness as well as personal and professional values. Teach strategies for conflict resolution and stress reduction. Skills for resilience in challenging situations can be taught and learned. Workshops and group discussions can help doctors know they are not alone in their feelings and give them a sounding board for their symptoms.
4. Leverage Technology: utilization of tools such as telemedicine can allow physicians to schedule treatment time without a physical presence. This provides flexibility and a refreshing newness to the work.
5. Focus on the Value: physicians should be permitted to shift their focus to the aspects of health care they find most valuable. For some, this is research. For others, teaching. Finding a good career fit may not be the same thing they thought it was in medical school.
Physician burnout can lead to rising costs, reduced quality of patient care and even medical errors. Doctors who are stretched to the limit are unable to provide necessary empathy to their patients. If you are a physician who is experiencing burnout or an administrator who recognizes the symptoms in your employees, examine whether or not your health system is overworking the providers or simply failing to provide needed support. Changes can lead to improvements in all aspects of the care spectrum, for patients and for the organization as a whole.
At the dawn of medicine, when a physician wanted to assess a patient’s heart, he would put his ear directly on the patient’s chest to listen. Then came stethoscopes. At first people didn’t trust they would be as accurate as the human ear alone and deemed the scopes to be simply gadgets.
In the development of modern medicine, when a physician wanted to assess a patient’s heart rhythm, he would use an electrocardiogram. At first, people didn’t trust all of those wires and electrodes and deemed them to be just gadgets. The stethoscope, of course, was the standard.
During the growth of technology based healthcare, when a physician wanted to assess a patient’s cardiac function, he might order an echocardiogram. At first, people didn’t trust their accuracy and deemed them to be just new gadgets. What could deduced from an image that could not be detected from EKG tracings?
Well into the stride of evidence-based, data-driven, patient-centered healthcare, the emergence of telehealth devices allow physicians to assess their patients from a distance of another building, state or even a different country. Whether in real-time (synchronous) or using a store and forward method (asynchronous), remote visits bring a level of care to people who otherwise might not receive it. Specialized telehealth-enabled instruments, like video otoscopes or dermatologic cameras are operated by a nurse, technician or sometimes by the patient. Such procedures increase access, convenience, lower costs and can improve quality of care when a physician or specialist could not otherwise be consulted locally.
Just as prior breakthroughs permitted hearing and seeing what we could not previously perceive, this technology breaks the barriers of geography and access to healthcare and education. Unfortunately, there are people who do not view telehealth this way.
There is a debate occurring in some states whether or not to permit physicians to rely on telehealth when they have not seen the patient face-to-face. In some areas, like Texas, technology is losing the battle. At a time when people need better access to quality care at lower costs, you may think this is a surprising and alarming trend. You will recall that people often fear and dismiss technology they don’t yet understand.
We trust our physicians to prescribe medications, perform surgeries and myriad other procedures that hold a life in the balance of their judgement. If a physician deems a remote visit sufficient to make a diagnosis, and the research supports that decision, shouldn’t he or she be permitted to treat the patient as they see fit? But a great barrier is erected when telemedicine is restrained: research populations remain low and quality measures are often called into question when any measurements have been taken by patients themselves.
Better standards need to be in place for certain, but this can only be accomplished through an increase in telehealth initiatives, third-party reimbursement parity and industry advocacy to standardize telemonitoring data collection. And, as we’ve proven with so many other new technologies in healthcare, it should not be dismissed out of hand but vigerously studied, tested and validated.
To paraphrase The Independent journalist John Diamond, “perhaps there is no such thing as [telemedicine]…just medicine that works and medicine that doesn’t.”
There is no need to apologize for disrupting our beliefs about the traditional doctor-patient relationship; that’s par for the course in technology. Rather, when we find something that is safe and effective, especially when it is an improvement or provides an option where none existed previously, it should be fully enveloped into the scope of modern healthcare.
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