Author Archives: Bob Higginbotham

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

The Telephone ‘Bill’ You Actually Want!

Many years ago, I was asked to work with a group of Senators in Washington, DCremote monitoring to come up with an equitable bill to reimburse physicians for their time when they consult via video for a second opinion. I also sat on the committee that discussed payment from insurance companies to medical personnel when they perform a video visit over video conferencing. Although we worked hard to get these bills passed, it met with opposition from individuals who knew nothing first hand of the practice of video visits and imposed legislation to limit the payment to and for the individuals who use the service.

A new bill that has been introduced will help eliminate some of that “red tape” and allow the people using the practice to do so without limitations of borders and hoops to jump through. As you might read between the lines, people are starting to believe that technology is here to stay and that maybe it is time to loosen the reigns a bit to help those who use the service to get the most out of it.

I am not a political person by nature, but this bill will have my attention as it slowly moves through the Washington, DC cog…let me know what you think!

With all the political hype surrounding candidates visiting Iowa, New Hampshire, and South Carolina you may think it strange that I am recommending you pay attention to Tennessee and Colorado. Why?  A Tennessee Congresswoman and a Colorado Senator have sponsored bills in the House and Senate respectively that would greatly expand telehealth’s role in providing better and more convenient patient care.

It’s called the Telehealth Innovation and Improvement Act of 2015 and it’s currently under review in the Healthcare Subcommittee under Ways and Means.

How would this bill affect telehealth, especially for Medicare services?

1) It Defines Conditions- The following conditions are specifically designated as eligible for Telehealth under this bill:

  • Chronic hypertension
  • Ischemic heart diseases
  • Chronic obstructive pulmonary disease
  • Heart failure and/or heart attack
  • Osteoarthritis
  • Diabetes
  • Chronic kidney disease
  • Depression
  • Atrial fibrillation
  • Cancer
  • Asthma
  • Stroke
  • Total hip and/or knee replacement procedures
  • Parkinson’s disease

2) It Sets Parameters for Types of Remote Care- This bill goes further than previous legislation to define more remote technologies that would be eligible for payment. These include:

  • Remote monitoring technologies, including remote device management for purposes of remotely interrogating or programming a medical device outside the office of the physician specialist involved.
  •  Bi-directional audio/video technologies.
  •  Physiologic and behavioral monitoring technologies
  •  Engagement prompt technologies
  •  Store and forward technologies.
  •  Point-of-care testing technologies.

3) It Removes Restrictions on Time and Location of Rendering Services- Current restrictions on providing remote services across state lines as well as requirements for all remote care to happen in real time are being eliminated in this bill. This means a doctor in New York could remotely treat a patient in New Jersey by reviewing the patient’s remote monitoring data and then updating care instructions without needing to have a real time one on one video conversation. IT also removes the requirement for the patient to be a certain distance from the physician in order to make remote care available.

Given all of the proposed changes to telehealth policy above, it is obvious as to how this bill would not only help telehealth expand in rural areas where there is limited access to medical resources, but also in urban areas as well. It would increase physician choice by eliminating geography as a requirement for payment, and create efficiencies by utilizing technology that allows physicians to access current biometric data about a patient and their condition, even if the patient wasn’t available for a face to face call at that time. The passage of a bill of this nature could really do great things for telehealth, so let’s hope it makes it out of committee for a vote. This could be the only telephone bill that you ever actually hope to get.

Avidex AV is revolutionizing the way healthcare facilities and doctors are delivering care. Their 20 years of experience is being leveraged to drive down the cost of care while promoting positive healthcare outcomes. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

Resources:

#1: https://www.congress.gov/bill/114th-congress/house-bill/4155

#2: https://www.govtrack.us/congress/bills/114/s2343

#3: https://www.govtrack.us/congress/bills/114/s2343/text

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Ace Ventura: TeleVet???

I live on a real-life working farm. Oh no, not that kind of farm, it is a horse-farm.  It still keeps me busy stacking hay, feeding, cleaning stalls and taking care of the animals. I don’t need to buy an expensive John Deere to do my work!

I have had many encounters with vets over the years and I have also had many two hour trailer rides to take a horse to a specialist in the Twin Cities to take care of some critical issues. I have even lost a horse because we couldn’t get to the specialist in time just to find out that the local vet, if told what course of action could have been taken once the specialist saw him, could have saved our horse.

People are attached to pets, and that is what my horses are, big dogs that don’t live in thepolycom equipment horse house. They are part of the family and anything we can do to get them the help they need, we will do! See how getting to a specialist a lot soon than a two-hour drive is saving countless animals around the globe.

I have to admit that when the idea of writing this blog came up, the subject seemed somewhat silly to me, as maybe it does to you at first glance. Telemedicine for pets?  They can’t even talk on the phone!  Can you imagine Cesar Millan, “whispering” to a puppy with separation anxiety over a video call?  Now that would be some “must see TV!”

Upon a little reflection however, I quickly understood the advantages of utilizing telemedicine to mitigate the barriers of time and distance in efficiently administering veterinary care. There are a few key factors that when considered, make veterinary care the perfect candidate for improvement through video teleconferencing technology.

  1. Veterinarians are relatively scarce. It is easier to get into Medical School in the United States than it is to get into Veterinary School, just by the sheer fact that there are less Veterinary Schools nationwide. As such, veterinarians are relatively scarce. In fact, there are over 912,000 licensed physicians in the US while only 65,000 veterinarians in private practice (nearly 40% of veterinarians actually work in research). Telemedicine allows these scarce veterinary resources to be used more widely and efficiently.
  2.  Distance to specialists. It is widely agreed that rural populations benefit greatly from the advent of telemedicine, giving people needed access to physicians that may not be local and/or easy to get to otherwise. Imagine you own a horse ranch in a remote region of Wyoming. Given that there are only 3600 equine veterinarians in the US to begin with, what are the odds one is close to your ranch? However the odds are extremely high that one will be close to phone and internet service.
  3.  Rural population ratios. Here is something else to consider. In rural areas livestock and other animals may outnumber human populations by more than 50 to 1. All of a sudden telemedicine becomes even more important in making sure that these large populations of animals have access to an extremely small number of veterinarians.
  4.  Potential Impact. I am in no way minimizing the loss of a pet. I understand that companion animals carve out spaces deep within their owner’s hearts and that losing one can be a traumatic experience. I also know that the loss of a friend or relative has the potential to cut much deeper, so on the surface, telemedicine for veterinarians may seem less important than for doctors. However, if you think about the impact a cow with and infectious disease could have on the rest of the herd if not diagnosed and quarantined in a timely and appropriate manner, you quickly realize that there is a potentially huge positive impact telemedicine would have in these situations.
  5.  Easier Billing. Unfortunately, one hurdle to wider adoption telemedicine has faced in the past is the difficulty of assuring and securing payment for these services from the insurance carrier (imagine that!) In most cases however, veterinary care is not dependent on an insurance approval, as the care is paid for by the individual instead. Sure there are a select few that have veterinary insurance, but most are paying out of pocket with discretionary income.

So there you have it! Five reasons that telemedicine is an amazing fit for veterinary care, despite the fact that animals can’t talk on the phone. I can now definitely see the value of a future where portable tablets with cameras facilitate conversations between ranchers in the field and veterinarians located elsewhere.

Avidex AV is revolutionizing the way healthcare facilities and doctors are delivering care. Their 20 years of experience is being leveraged to drive down the cost of care while promoting positive healthcare outcomes. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

Resources:

#1: https://www.fsmb.org/Media/Default/PDF/Census/2014census.pdf

#2: https://www.avma.org/KB/Resources/Statistics/Pages/Market-research-statistics-US-veterinarians.aspx

#3: http://www.gopetplan.com

#4: http://www.modernhealthcare.com/article/20150912/MAGAZINE/309129971

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Plane Ol’ Video Teleconferencing

I was out shoveling snow last winter and I heard ahelicopter thundering sound that I have never experienced before in the winter time…a massive helicopter flying low and fast right over the top of my roof and tree line heading into the St. Cloud area in Central Minnesota.

Don’t get me wrong, I’ve seen Blackhawks, Chinooks and Apaches fly overhead on training runs from the Camp Ripley National Guard facility as they have been getting ready to deploy…but not in the winter time. And this red and white helicopter had the LifeLink III insignia on it.  Then this past year, I have heard and seen several of the low-flying thunder makers transporting patients from Wilmar to St. Cloud or Duluth as part of the new LifeLink program that is reaching rural areas during bad accidents or life-threatening situations. And when I met with the folks at LifeLink, they told me about their really cool helicopters and the gear they have on board.  I was impressed with what I saw…I hope they can get a few to a hospital near you

Get on an airplane run by a major airline today and although they will no longer provide you with a meal, they will provide you with WiFi that will allow you to utilize your connected devices to catch up on work, access important files, and even do a cloud based video-teleconference if you so choose. The airplane uses a satellite based system to assure its passengers can stay connected and efficiently and productively use their in-air time.  It’s a welcome luxury and convenience for most, and a better use of time than reading the SkyMall catalog for the 18th time.

Drive up on a major auto accident with critical injuries, and many times you’ll see an emergency helicopter land to facilitate transport to the nearest ER or trauma center. These airships are equipped as you would expect a first response transport to be. Heart monitors, blood pressure and blood oxygen monitors, IVs, defibrillators etc adorn the walls and fill the compartments, creating essentially a “flying ICU.” helicopter and paitentPlanes are also outfitted in this manner for patient transport, to assure all the essential equipment is in place to transfer patients from facility to facility. Now these aircraft have been around for some time, and have always been able to communicate with their destinations via radio communications.  However, with the advent of in-flight WiFi capabilities like the ones mentioned in commercial aircraft above, being able to connect to the internet goes beyond being a luxury and instead becomes a huge opportunity to increase the quality of care during critical transport.

WiFi can enable flying ICUs to access a patient’s important electronic health records (EHRs) to assess potential allergies, health history, or other factors that may best determine the care provided and increase the odds of success of administering potentially life-saving care. It can also provide the opportunity for a doctor at the receiving facility to video conference with the medics and EMTs on board to prepare properly for the patient’s arrival or to remotely assess the patient and provide additional in transit care instructions.

Now if you are envisioning transport within a major metropolitan area, you may be thinking that the patient will arrive within minutes anyway, so there may not even be enough time to isolate an ER physician and initiate a call of this type. However, think of rural areas where the facilities may be quite a distance from the actual incident.

According to Mark Monte, M.D., chief of trauma surgery at St. Luke’s Hospital in Duluth, MN, “There’s some debate as to the value of having a helicopter system in New York City or Detroit or Chicago. But we cover a large expanse of open territory. So to have a helicopter which can go out and reach a great distance and bring a patient back is a great advantage.”  Based on this, Minneapolis based Life Link III services 9 hospitals from six helicopter bases located in small Minnesota communities.

As you can imagine, having remote, in-flight access to EHRs and ER physicians is also exponentially important in these situations as well.

So if your facility already has a comprehensive telemedicine system and strategy in place, you are ready to interface not only with patients at home but also with those in the air. If you have been slow to embrace telemedicine in efforts to provide greater physician access or as a strategy to reduce re-admissions, perhaps these new developments may inspire you to take the plunge, at least in the ER where the extra few minutes a physician has to assess and prepare for the arrival of a patient in critical condition, may just save lives.

Avidex AV is revolutionizing the way healthcare facilities and doctors are delivering care. Their 20 years of experience is being leveraged to drive down the cost of care while promoting positive healthcare outcomes. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

Resources:

#1: http://www.fiercehealthcare.com/story/flying-icus-medical-helicopters-provide-advanced-care-rural-patients/2015-11-24

#2: http://flyingicu.com/

#3: http://www.fiercehealthcare.com/story/flying-icus-medical-helicopters-provide-advanced-care-rural-patients/2015-11-24

#4: http://blog.avidex.com/the-new-house-call-telehealth-is-bringing-the-doctor-back-home/

#5: http://blog.avidex.com/telemedicine-a-428-million-silver-bullet/

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Deliver Better Care, Be More ‘Sensor’-tive.

A four year old is admitted to the hospital with a congenital heart condition. Traditionally,child in hospital ipad the hospital staff would connect him to a multitude of modern machinery to track blood oxygen levels, heart rate, and breathing rate.  Each of these systems would require wires that restrict the child’s movement and would be able to alert the staff if any of the systems drop below an acceptable baseline.  Today however, a few small wireless sensors are placed on the child’s chest to track all of these things.  Not only are there no wires, but the sensors work together to identify relationships and trends across this bio data, creating a predictive analysis of any potential deterioration in the child’s condition before any single reading drops to a dangerous level.

If this sounds improbable, it’s not. It’s actually being done in the UK at the Birmingham Children’s Hospital where 4 year old Maci was the first child to utilize the program.

It’s all an extension of the Internet of Things (IoT), but instead of allowing someone to control their lights from their iPhone, it is potentially saving lives and creating better patient outcomes in healthcare.

The implications of wireless connected sensors in a hospital environment are huge. They can communicate with each other, with hospital staff, and even with patient tracking systems as well. They allow patients to remain connected to vital monitoring equipment while moving through different departments and tests without having to be continually disconnected and reconnected at each stop.  In short they increase staff efficiency and promote better patient outcomes. Now imagine the impact these same types of sensors have on remote healthcare services like telemedicine.

With the advent of sensor technologies, telemedicine goes way beyond a video conference with your doctor. There are a variety of sensors currently on the market and even more on the way, that all work to better assist healthcare providers with gathering important biometric data remotely.  Some states like Texas are starting to put regulations in place that require a doctor to have either a previous in-person relationship with a patient and/or a way to perform a similar medical evaluation a patient would get in the office before prescribing care.

They argue, “How can a physician make an accurate diagnosis when they have no objective diagnostic data? All they have is what the patient has told them.” But sensors are turning that argument on its head by providing real objective data, the same data collected in an in-person exam.

Imagine how telemedicine can be enhanced by sensors like:

  • Wireless, needle-free, glucose monitors for diabetes
  • Shoe insoles that track amputees’ gait for prosthetic evaluations
  • Stick sensors that monitor hydration levels
  • Wearable and ingestible sensors that track ingestions and physiologic data
  • Sensors that collect ECG and pulse oximetry data
  • A connected asthma inhaler tracking dosage, frequency and location of use
  • A breast cancer detection sensor tracking cell temperatures over time
  • A sensor that can be placed on the forehead for 10 seconds to get heart rate, blood oxygen levels, temperature, and blood pressure with 99% accuracy.

The small sample of the sensors above are either on the market or in development today. It’s obvious the benefit this type of technology provides to remote health monitoring, especially to telemedicine.

With access to electronic health records and sensor data, a doctor can sit across from a patient virtually through an HD teleconference and make real-time diagnoses and care recommendations based on health history and current biometric data. Fitbit eat your heart out.

To the casual observer, all this data collection is happening invisibly. No longer does a patient have to wear large recording devices or battery packs.  Sensors are now wearable, embeddable, and ingestible. They utilize new printing techniques and materials to make them comfortable, with some even deeming the resulting sensors as eSkin. Data flows to secure phones or mobile devices or to HIPPA compliant cloud based systems in a “store and forward” fashion for later access and review.

Given the state of sensor technology in healthcare, it’s time to get connected to your patients in new and exciting ways, whether they are inside your facility or at home. The IoT just got very interesting didn’t it?

For more than 20 years Avidex AV has provided innovative technologies that drive business outcomes for our clients. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

Resources:

#1: http://www.mhealthnews.com/press-release/isansys-wearable-technology-and-wireless-patient-monitoring-platform-scale-deployment-

#2: http://www.npr.org/sections/health-shots/2015/06/02/408513139/texas-put-brakes-on-telemedicine-and-teladoc-cries-foul

#3: http://www.mhealthnews.com/content/infographic-are-you-ready-sensors-healthcare

#4: http://www.vivalnk.com/eskin

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Have Your Telemedicine Wishes “Granted.” Act Now!

When I was in college, they always talked about “finding money” for a project or a need on Free Money Imagecampus. When I talked to the Business Development guy, he always told me that “using other people’s money is always better than having to use only yours!”

So when the local Polycom Rep contacted me and wanted to talk about customers who might need to get some “free money” for their telemedicine or distance education projects, it sparked an interest within to see if YOU might be one of those in need of money to get a project going. Polycom has a resource that will work with you and in some cases, write the grant for you, to get funded!

Read on and let me know if you want to look into this “free money” and how Avidex and Polycom might help you get your piece of the pie!

Earlier this year, we alerted everyone to a grant opportunity provided by the U.S. Department of Agriculture designed to help rural areas build their infrastructure. Since that time, 75 projects across 31 states spanning California to Alaska to Maine to Florida were awarded grants. Funds ranging from $72,000 to $500,000 helped these much needed distance learning and telemedicine projects get off of the ground.  With over $23.4 million at stake, the people running these projects didn’t want to miss out on the opportunity.

Maybe you missed our June blog and weren’t aware of the grant opportunities above. Or maybe the whole grant process is just too convoluted and involved to dedicate your already scarce resources to pursuing with no guarantee of success.  Or maybe you were aware of the opportunities, but your project didn’t qualify because you are not in a rural area.

Whatever the reason, if you weren’t one of the 75 projects funded by the USDA, you still have an opportunity to get some much needed grant funding for your telemedicine projects!

“How?” you ask. Well the federal government has dozens of programs and may just have funds set aside for projects like yours.  They range across different federal departments and initiatives and can many times be much harder to identify than programs like the USDA grants above.  For this reason, these other programs are many times under-utilized and funds can go unused.

Don’t let that happen.

We rarely mention a specific product manufacturer in any of our posts here. First, because the needs of our clients vary so widely, we don’t lead with product first but rather design solutions to fit those specific needs.  Second, because this blog is not an infomercial or an e-commerce site, it is genuinely designed to be a resource for you to keep up with technology trends and opportunities in the healthcare vertical.

However in this case, we have to break our own rule in order to let you know about an opportunity, not a product.

Polycom is a trusted partner of ours and they run a Grant Assistance Program that tracks funding from 26 U.S. federal grant-making agencies, as well as numerous state and foundation funding sources. Not only do they track the funding, they actually help you get those funds for your projects. They take on the sometimes overwhelming task of assessing your projects ability to be funded and then help take the project from application to funding, navigating the entangled web of bureaucracy.

The opportunity is now.

Polycom has asked us to assist in identifying projects just like yours between now and February 2016, so together we can assure that the funding available is awarded to you and your telemedicine wishes are “granted” in 2016.

Contact us today to get started and potentially join the list of telemedicine projects funded! Then we can all do a little victory dance together.

 For more than 20 years Avidex AV has provided innovative technologies that drive business outcomes for our clients. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

Resources:

#1: http://blog.avidex.com/are-you-getting-your-part-of-the-19-million-dollar-giveaway/

#2: http://www.rd.usda.gov/files/DLTAwardees_2015.pdf

#3: http://www.healthcare-informatics.com/news-item/usda-awards-234m-grants-rural-telemedicine-projects

#4: http://www.polycom.com/content/www/en/solutions/solutions-by-industry/education/education-programs/grant-assistance.html

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Are You Ready? The Tele-Med Act of 2015

dr on video conferenceMy parents taught me a few things growing up: open the door for all females (no matter the age); be polite; say “thank you”, “please” and “your welcome” when needed; and never talk religion and politics in social settings. Okay, so some of them I do all the time, and one of them, talking politics in a social setting, I will break today!

Having lived in rural areas for most of my adult life and having family in Montana, Idaho and Wisconsin, rural medical practices are an area near and dear to my heart. My family utilizes telemedicine with the great folks at Eastern Montana Telemedicine Network, and I hope to see a time when one of the fantastic doctors at the Billings Clinic will be able to work on my brother-in-law in Wisconsin when he slips in the boat an gashes his leg, gets a hook stick in his body or any of the dozens of accidents that occur on their family outings to the lakes.

Medicine is medicine, and if you graduated Med School and are a doctor, you should have every ability to treat your patients wherever they are – on vacation, winter living or hiking. Laws are in place for telemedicine as guidelines and the time has come to allow the people with the skills to do what they need to across state lines without interruption. Doctors are at a shortage, technology is not. Read on and let us know what you think.

Love her or hate her, Hillary Clinton may be your best friend if you are looking for someone to champion the telemedicine cause.

“Today, our health care system has changed dramatically, but it’s still too difficult for families in rural America to find quality, affordable health care…Telemedicine can help”.       -Hillary Clinton

If you aren’t aware, there is a bill going through congress titled H.R. 3081 or “The Tele-Med Act of 2015” that may just lower existing barriers to implementing telemedicine services, especially across state lines. Now, as it is a federal bill, it really only applies to Medicare currently, but it would set a precedent for other private insurance companies to follow and open up the boundaries that may currently prohibit them from offering services in neighboring states.

There is still a question as to whether this type of bill will be effective given that providers are licensed by their individual states to provide services, and if the provider would be required to be licensed in the state the patient resides in as well in order to legally provide medical care and advice, even by video conference. Breaking down the barriers to payment is one thing; navigating licensure and the 10th Amendment are another.

In any case, there are real shortages of care, especially in rural areas, and there are definite opportunities for health care providers to grow their practices by offering telemedicine services. According to a recent study, the services in the shortest supply in these areas seem to be those centered on primary care, mental health, and allied health professions.

The Tele-Med Act also lays out some proposed guidelines to help protect patients as well as practitioners form potential misdiagnoses and malpractice concerns.

Given these guidelines, here are 3 steps your practice can take to be ready to provide services given this new legislation passes.

  1. Electronic Health Records access and storage. Your practice will need to be able to manage and access electronic health records in a way that is compliant with HIPPA regulations on patient privacy. Part of the telemedicine legislation is that the care provider will need to have some prior knowledge of the patient and their pre-existing condition and treatments to responsibly recommend any treatment plan.
  2.  A proper teleconferencing system. Current regulations require that there be real time, interactive, 2 way communications between doctor and patient, assuring that a proper treatment plan can be arrived at while answering patient concerns and questions. Both Audio and Video capability are required. In order to assure reliable communication, an enterprise quality VTC system should be in place.
  3.  Store and Forward. The ability to capture images ahead of time and forward to a practitioner for evaluation can be a major asset in diagnosis. Recording sessions for future liability reasons is also a huge plus, and again HIPPA compliant encryption to protect patient data is a must for any data stored and/or forwarded.

Hopefully The Tele-Med Act of 2015 will fulfill its promise to allow service providers to serve patients across state lines without extensive licensure issues. If it does, telemedicine will certainly become an even bigger component to improved medical care. The question is will you be ready to capitalize on it?

For more than 20 years Avidex AV has provided innovative technologies that drive business outcomes for our clients. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

Resources:

#1: http://www.memd.me/telemedicines-big-break/

#2: https://www.congress.gov/bill/114th-congress/house-bill/3081

#3: https://www.healthcarelawtoday.com/2015/08/26/will-the-tele-med-act-of-2015-really-change-licensure-rules/

#4: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Delivery-Systems/Telemedicine.html

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Beyond TV: Guest Entertainment Systems in Healthcare

1610059_10203878090935723_6324864536840676894_nLet’s face it. No matter how amazing your healthcare facility is and how great the doctors are, the reality is that being admitted to the hospital is never any fun.  It has to rank way down the list of “ways you’d love to spend your days”.

With positive attitude being a potential component of a speedy recovery, it’s only logical that creating a better patient experience in the patient’s room itself can go a long way toward generating positive patient outcomes.

The patient room of the past included a TV and a remote that controlled the channels, sound, lighting and potentially a nurse call button as well. Today however, with the march of technology moving ever forward, there are ways to elevate the patient room experience beyond that paper privacy curtain and a TV.  In fact, adding this type of technology has even changed the way people look at being hospitalized, from being a patient, to being a “guest”. With that, we offer up these few simple ways to elevate your guest experiences by turning your TV into a Guest Entertainment System.

Modernize- Nothing says I’m in a foreign land from years past than a 150lb, 27” CRT television hanging from the ceiling via a heavy duty pole and tray.  Flat Panel LCD screens in the 30” range are more affordable than ever.  They give your guest rooms a modern look and offer 21st connectivity options as well.

Connect- Having an LCD screen in the room can give your guests access to much more than some Brady Bunch reruns. These screens can be connected to an enterprise grade video teleconferencing (VTC) system to allow patients to remotely connect to doctors and specialists. Smart TVs may also include a built in app suite that allows guests to connect to family and friends via consumer grade VTC platforms like Skype.  Nothing reduces anxiety than instant access to a doctor or raises spirits like the face of a loved one.

Control- Ahhhh, the Internet of Things! (IoT) Everything from lightbulbs to thermostats to window shades are now all WiFi enabled.  Allow your guests to control their surroundings through a dashboard on their LCD screen and assure their surroundings always meet their needs.

Share- There is a very high likelihood that your guests already have a connected computer with 4” LCD screen in their pockets when they arrive. Offer the ability to share that device to the LCD screen in the room.  There are lots of wireless options today to do that.  Everything from an Apple TV with mirroring, to WiDi, to Miracast allow devices to connect and share media to other screens via a wireless network access point.

Educate- Towards the end of any guest’s stay, there comes a time when discharge instructions are given as well as information about continued home care. This information should be readily available to the guest at their convenience for the best possible absorption and retention of this important information.  Many of these Interactive Patient Education Systems also allow the facility to track and verify the information was viewed for liability purposes, and the potential reduced readmissions may save the facility a ton of money in government fines.

Gamify- Whether it’s creating trivia challenges that allow guests to test their mettle about after care instructions or providing app based game entertainment via an Android based USB stick computer or a new Apple TV, there are a lot of ways to bring some much needed fun and escape into the guest room via video games. The nature of connected displays means that they could even play games with family members at home as well.  Come on, you know you like them too. At the end of the day, these tips can all help your rooms offer your guests the comforts of home. With a healthy mind being at least the start of a healthy body, and the healthcare landscape shifting towards payments based on patient outcomes and not services rendered, can your facility afford not to?

Avidex  is revolutionizing the way healthcare facilities and doctors are delivering care. Their 20 years of experience is being leveraged to drive down the cost of care while promoting positive healthcare outcomes. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

Resources:

#1: http://www.huffingtonpost.com/2013/10/03/optimism-and-health_n_4031688.html

#2: http://blog.avidexav.com/telemedicine-a-428-million-silver-bullet/

#3: http://blog.avidexav.com/creating-better-patient-outcomes-through-interactive-technology/

#4: https://www.medicare.gov/hospitalcompare/linking-quality-to-payment.html

#5: http://blog.avidexav.com/theres-more-to-hippa-than-encryption-choosing-the-right-vtc-platform/

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Friday Night Telehealth

injured soccor player TelemedicineMy freshman year, I started the year playing three sports at my Southern California High School. By the end of October, I was down to two sports, after my quarterbacking days were cut short by a larger-than-me-linebacker who purged my offensive line and took me out at the knees. Thank the good Lord that no “real damage” was done (at the time, but the winter provides a tougher haul on my knees now than the summer months!)  I then walked away to concentrate on baseball and education.

High school sports are getting as competitive as college and the players are getting bigger and bigger. With the size and speed of these players today, minor injuries can turn major without the immediate treatment of a doctor during our Friday Night Lights adventures. See what one state is doing about that, and ask if Texas will be far behind…

“Set! Green 80, Green 80! Hut-Hut!” The quarterback takes the ball and falls back into the pocket, he scans his eyes downfield and to the right as his receiver puts a move on the cornerback and peels away toward the end zone.  The quarterback’s eyes are wide with excitement as he loads the ball with his arm and rockets it into the waiting hands of his receiver.  The crowd erupts in celebration, and it is not until several seconds later, that everyone notices that the quarterback has not joined the game winning celebration.  He is down on the field from a crushing blow, delivered as he released the ball.  In any other state, he would need to be taken to the locker room, seen by the team doctor, and potentially sent to a specialist for a evaluation of his ankle.  But luckily for this quarterback and his parents observing anxiously from the stands, he is in Washington State, where 50 high schools utilize telemedicine on the sidelines for rapid evaluation of potentially dangerous blows like this one.

It’s amazing how the continuing acceptance of telemedicine by doctors, patients, and insurance companies alike is changing the way that we experience healthcare. For the Seattle area schools that have embraced telemedicine for player injury evaluations, they are saving time and money while offering players, coaches and families better peace of mind.

The cost for an emergency room visit for an ankle sprain is up to $1,400, compared to a telemedicine consultation, which is typically $50.”

The proliferation of devices with cameras and cellular and WiFi connections make this technology extremely portable an accessible as well.

“That means students injured while playing a sport will be able to access a doctor virtually using a cellphone or computer.”

Currently, parameters are in place that require more serious injuries like concussions to be evaluated in person and in more serious cases utilizing a more traditional 911 strategy, however, as technology gets better and less expensive, this may change as well.

We need only look to the NFL for the potential applications of technology in assessing serious player injuries on the field. NFL teams are already using telemedicine in the same way as above for instant access to specialists from the sidelines.  They are also utilizing electronic health records (EHRs) on the sidelines to assure the team doctors’ have access to each player’s unique health history.

However the NFL has gone one step further in evaluating wireless sensors designed to record and communicate the amount of shock put on a player’s helmet during plays in the game. They have also used software to assess the effects of a concussion and its severity based on a player’s eye movement responses to some electronically delivered stimuli.

This year, some of those pilot programs have been put on hold, but not because they were not deemed valuable, but rather that there is still some improvement needed in the accuracy of the sensors. There have also been some concerns about the privacy of the data these sensors transmit and the potential detriment a full history of hard hits to the head may have to a player’s value in the future.  It lends to the question as to whether healthcare should and will have its own internet at some time in the near future to alleviate these types of concerns and HIPPA compliance.

The use of telemedicine in sports is just another example of how technology is enabling healthcare practitioners to provide quality care anywhere at any time. Whether it is used on the sidelines of a football game or in the living room of a remote patient with a chronic illness, telemedicine is an integral part of the future of healthcare.

Avidex AV is revolutionizing the way healthcare facilities and doctors are delivering care. Their 20 years of experience is being leveraged to drive down the cost of care while promoting positive healthcare outcomes. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

Resources:

#1: http://usatodayhss.com/2015/sports-telemedicine-now-available-at-50-seattle-area-high-schools

#2: http://www.nytimes.com/2015/02/20/sports/football/nfl-suspends-use-of-helmet-sensors.html?partner=rss&emc=rss

#3: http://www.jacoinc.com/blog/bid/246267/Electronic-Health-Records-Ready-to-Make-an-Impact-on-NFL-Sidelines

#4: http://blog.avidexav.com/breaking-through-the-telemedicine-payment-barrier/

#5: http://blog.avidexav.com/next-stop-the-ioh-will-there-be-an-internet-of-healthcare/

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Next Stop the IoH??? Will There Be an Internet of Healthcare?

internet of healthcarePolitics and healthcare go hand-in-hand. They haven’t always been that way, but in the world of politics today, you better have a stance on healthcare issues or you will get eaten alive by the media, by the polls and by the people.

Politics and the internet seem to go hand-in-hand since Al Gore invented the internet way back when (okay, the US Army actually designed and initiated the internet, but who cares! Sounds better that the Vice President developed it…)

Now, healthcare and the internet might be teaming up to create their own secured “superhighway” in the future, thus providing security to your personal information AND medical records while allowing for blazing fast connections between patients, doctors and clinics/hospitals, including video, audio and imaging. The way we know healthcare today is evolving into the technology of tomorrow. Will you be ready for this new age of healthcare delivery?

Would it surprise you if I told you that Bush and Obama actually agree on something? Ok so it’s not George W. Bush, but it is his cousin Jonathan Bush, and he agrees at least in part with Obama that the internet will play a huge role in the provision of healthcare services from today into the future. He contends that we’ll have a ‘healthcare Internet’ within five years.” See his interview on CNBC here.

“Evidence suggests the shift may already be underway. While just 15 percent of hospitals used electronic health records [EHRs] in 2010, that number skyrocketed to 59 percent in 2013, according to data from the Office of the National Coordinator for Health Information Technology.”

However the increased use of EHRs doesn’t automatically necessitate the need for a ‘healthcare internet’. And based on the interview, it is unclear exactly what that would entail. There is an obvious need to connect patients to doctors and doctors to other doctors to share information and create better patient outcomes. Whether this requires creating a whole new domain for healthcare providers like a dot org for non-profits, creating a national healthcare data center or cloud, or connecting every healthcare facility on a common VPN is yet to be seen.

The reality is that privacy of healthcare data is a major concern and as more healthcare data is digitized and more medical equipment is connected via the Internet of Things (IoT) that concern grows.

Could a private “healthcare internet’ be the answer?

Bush goes on to site Amazon as an example of a company that created a comfort level for consumers in online shopping and the perceived safety of their financial information. I think he makes a mistake however in his downplaying of the theft of medical information.

“Frankly, I’d rather have the bad guys see my colonoscopy than get my credit card number,” Bush said. “And my credit card and my equities are all online.”

His comment discounts the fact that medical identity theft is a major concern, one the Federal Trade Commission has created a web page for.

“A thief may use your name or health insurance numbers to see a doctor, get prescription drugs, file claims with your insurance provider, or get other care. If the thief’s health information is mixed with yours, your treatment, insurance and payment records, and credit report may be affected.”

With that in mind, it’s no wonder HIPPA is so strict on how we store and protect medical records and history. Maybe a “healthcare internet” of some kind is the answer. Even if it is, Bush believes it is five years away.

So as a healthcare provider, how do you protect data in the meantime as more and more technology hits the network in your facility?

Make sure to work with trusted technology partners when implementing connected devices, digital signage, interactive patient engagement systems, and telemedicine systems.

This will assure that the proper care is given to the design and implementation not only of the required hardware, but also of the connection strategy and access to the facility’s network.

Utilizing things like hardware firewalls, VLANs, and even completely separate WiFi networks for patient and visitor internet access and also for digital signage systems and screen based wayfinding can help separate these pieces of hardware from computers storing confidential patient information. Making sure your technology team is sensitive to network security today will only make things easier if healthcare actually does get its own internet in the future.

 

Avidex AV is revolutionizing the way healthcare facilities and doctors are delivering care. Their 20 years of experience is being leveraged to drive down the cost of care while promoting positive healthcare outcomes. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

 

Resources:

#1: http://www.cnbc.com/2015/07/24/health-care-will-have-its-own-internet-soon.html

#2: https://www.healthit.gov/sites/default/files/oncdatabrief16.pdf

#3: http://www.consumer.ftc.gov/articles/0171-medical-identity-theft

#4: http://medcitynews.com/2015/04/healthcare-really-prepared-amazon-dash-button/

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Don’t Wait, Simulate!

manican
There’s a great opening scene in Pixar’s Monsters Inc. where a monster cracks the door of a young child’s closet, quietly approaches the bed, and then just as he’s about to scare the kid from his peaceful slumber, the child wakes up screaming. The monster is taken by surprise, screams as well, and ends up accidentally injuring himself several times. Then the alarms sound, the camera pans out, and you see that it is not in fact a real child but a robotic simulation. The monster is in training on a sound stage, being observed by both instructors and his peers, and unfortunately, he has failed to pass this part of the real life simulation.

Of course this is a computer animated movie, set in a parallel universe, but the reality of this type of simulation in our world is not far from the truth, especially in the world of healthcare.

Medical simulation is an extremely valuable tool used today to train new medical professionals, and AV technology is essential in maximizing these simulation environments. You will find simulation labs everywhere from vocational trade schools to major universities to world class hospitals. The technology is not only experienced and utilized by the student, but as in the animated example above, also by instructors and the students’ peers.

Let’s take a brief journey through the technology that makes these simulation labs so valuable from the three perspectives of the student, the instructor, and the student’s peers.

The Student

A critical component of every medical simulation is the patient. Fortunately, students don’t get to practice on actual people having major medical emergencies, so instead a technologically advanced surrogate is used. The high definition mannequins or advanced patient simulator is the first major component of a modern simulation lab. These mannequins blink, breathe, and have heart beats and blood pressure. They can exhibit symptoms of physical, neurological and psychological illness and even respond to drug administration. When coupled with an array of medical equipment like EKGs and blood oxygen meters, students can start to assess symptoms. PCs or touch screens that give the students access to the simulated patients sensitive medical history and Electronic Health Records, EHRs, can also be used in tandem. A virtualized audio system may also be integrated so the student can alert the appropriate staff of the patient’s condition through the use of the facilities code system and a public address system as well. This combination of a patient simulator, sensors, medical equipment, displays, microphones, and speakers all help to realistically recreate the environment in which the student will be working in the future.

The Instructor

If there is one thing that is certain about patients, it’s that they are all different. A simulator is only as good as it is programmed to be, and going through a few pre-canned scenarios may be helpful to some degree, but in the real world, things don’t always go as planned. It is for this reason, technology also allows the instructor to control these simulated environments. Typically there is a control area outside of the simulated patient room, where the instructor will use a control system to initiate a condition in the patient simulator. This means that a touch screen of some kind will most likely be used. A computer or processor is needed to send data to the patient simulator. The instructor can create unique combinations of symptoms and patient responses to them, keeping the student in the mode of active thinking, an important skill set to be had by any medical professional.

A camera system can also be employed to give the instructor a more detailed look at the way the student handles the initiated emergency and/or condition. There may also be a two way communication system between the control area and the simulated patient room so that the instructor can listen and even coach the student on next steps.

The Student’s Peers

Finally, technology can allow observers not directly involved in the simulation to witness it first-hand without having to be hands on.   Many simulation labs have an observation window where other students can sit and observe the simulation and the involved student’s response to the instructor triggered events. There are also displays that may show these students duplicate vital data available on the machines in the room. Those same screen may relay what type of event the instructor has triggered, so they can observe what would be the typical response of a professional given those parameters.

The cameras in the simulation room may also be leveraged with some type of codec to encode the video for live streaming over the internet or for live video teleconferencing, to make the simulation available in other rooms or other campuses live and simultaneously. These same cameras also facilitate recording for later distribution, in classroom teaching, or even a review of the active student’s role in the simulation and how they performed.

As you can see, technology has allowed simulation to reach new heights in medical schools and facilities across the US and the world. A strong working knowledge of Audio Video technology has become increasingly valuable in designing, installing, and maintaining these systems as well.

Avidex AV is revolutionizing the way healthcare facilities and doctors are delivering care. Their 20 years of experience is being leveraged to drive down the cost of care while promoting positive healthcare outcomes. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

Resources:

#1: http://www.laerdal.com/us/SimMan3G

#2 http://blog.avidexav.com/cracking-the-code-of-state-of-the-art-hospital-communication/

#3: https://www.wctc.edu/programs-and-courses/health/hps-lab.php

 

 

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com