Tag Archives: video conferencing

It’s Good to be an Organ “Droner”

50877847_sDrones are everywhere. Applications range from military use for fighting terrorists to aerial photography to recreational use by hobbyists and even Amazon has announced it would like to start using them for package delivery. Imagine being able to deliver packages in dense urban areas without having to worry about traffic or parking. Now imagine that instead of delivering your nephew’s birthday present, the drone is delivering something much more critical…medical care.

Before you scoff at the idea, let me share a quick scenario.

Imagine your 21 year old daughter is in desperate need of a heart transplant. You wring your hands, hoping that somehow a heart will become available in time to save her life. 8 miles away, a 27 year old dies in a car crash. It’s both a tragedy and a miracle as he is an organ donor and his heart is a match. Your heart soars until you remember that the route from the crash to the hospital, that seemingly short 8 miles, takes 2 hours to traverse at this time of day in Chennai, India. It will take another miracle for police to clear the road to get the heart there in time.

This is a true story, and luckily, the second miracle also occurred. A whole team of police had to clear the route for the heart to arrive and they amazingly got it to the hospital in 13 minutes and saved the young girls life. But when minutes are the difference between life and death, should we have to take that chance? Metropolitan areas in New York City and Los Angeles have equally horrific traffic problems. Even dispatching a helicopter may present some delays in getting flight clearances and in finding a suitable landing location. Not only that, helicopters are a limited resource that may not be readily available for organ transportation. So isn’t there a better way?

Some students in Spain thought there was, and they developed a purpose built drone with a refrigerated storage compartment specifically for the purpose of transporting organs quickly and efficiently from one location to another. They are currently running a test program in India, and if successful, there is no reason that the same programs couldn’t be implemented in the US as well.

Drones in healthcare may not be so far-fetched after all.

Now think of extended applications. What about a drone that delivers medical care to those trapped in a mine? Or drone that uses a video teleconferencing system to respond to an accident and give bystanders instructions on what to do until the paramedics arrive? Or a drone that includes a defibrillator for a heart attack victim? (Here’s a great video on that idea as well.) The scenarios abound.

Then consider that the size and cost of the drones mean that a large network of them could be deployed. Imagine a series of roadside pedestal “garages” with drones at the ready every few miles, able to be dispatched to accidents and assess injury severity for positioning more scarce EMT and Paramedic resources. Now that may be very valuable indeed.

All too often we see technology positioned in films and pop culture as being a potential threat to the human race. However, in today’s world it seems technology is once again in the service of saving lives instead. After all, it’s good to be an organ “droner”.

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.newsweek.com/2016/02/05/india-organ-transplant-drones-419013.html

#2: https://www.youtube.com/watch?v=y-rEI4bezWc

#3: http://www.tudelft.nl/en/current/latest-news/article/detail/ambulance-drone-tu-delft-vergroot-overlevingskans-bij-hartstilstand-drastisch/

Anthony Paoletti

About Anthony Paoletti

Anthony brings over 23 years of audiovisual experience and has worn nearly every "hat" in the industry; from Consultant to End User; Account Representative to Install Technician; Project Manager to Systems Engineer. Contact Anthony at apaoletti@avidexav.com

Up with Telemedicine. Down with Healthcare Costs.

I hate paying too much for anything. Just ask my family and friends. When I need gas, I will drive out of my way to save three cents and use my rewards card to get three Telemedicinemore, saving a total of six cents on every gallon. My vehicle holds 16 gallons, so I saved less than a buck, 96 cents, searching for a cheaper place to buy gas.

When somebody asks me why, my instinct is to say “because I saved money!” But in reality, did the extra driving really save me anything?  Is going to the first place that has gas, paying a buck more, really that bad? To me it is, and that is why I do it. It makes me feel better.

In the health care world, we compare prices, talk about deductions, worry about our out of pocket…when in reality, we just really need to go see the doctor because we are not feeling good and have a need. We just need to go to make us feel better!

We rely on the government and insurance companies to keep the cost down…any way possible. So then why don’t they allow telemedicine to be paid when we want to use it? Why can’t I feel better at my place of employment, my home, a retail center? Why do I have to go see my doctor as HIS place, and not at mine?  We know that studies show that using telemedicine drives the cost of service down, but why won’t EVERY company provide coverage for it?

The debate has gone on long enough…time to man up and do what is right and cover the service. At least that is my feeling, because it makes me feel better. Sorry, low on gas, got to see who has the best price today and fill it up!

If there is one thing that the implementation of the Affordable Care Act (ACA) has shown us, it is that despite driving down costs of care, insurance premiums have continued to rise. It seems that just leveraging buying power by adding new consumers into the market place has not made a positive impact at the actual patient level when it comes to costs. The average total family healthcare premium has risen to about 23% of median income in employer provided plans. Even in the analysis of a handpicked plan on the insurance exchange, an example you could argue shows the best possible scenario, healthcare costs have essentially failed to decrease nationwide.

Considering that the tax penalty for NOT having healthcare is only 2.5% of income and that an individual can now buy insurance AFTER an event requiring treatment it is not surprising that many are threatening not to buy healthcare until it is needed. That would create a downward spiral, where less people paying in means costs continue to rise. Combine that with the fact that millions of people are being added into the existing medical system. Doctors’ time now becomes a rare commodity, and the perfect storm for ever-rising healthcare costs is definitely brewing. That is unless we deliver care more effectively in a way that costs less and creates efficiencies in how we use our doctors’ time.

Telemedicine drives down the cost of delivering care. It’s not in dispute. Whether you are a patient seeking a remote consultation, a provider needing access to resources from another provider like a specialist to read an MRI, or a hospital looking to reduce readmissions and potential fines, telemedicine is the answer. Studies show reduction of costs in all these areas and more.

Traditional concerns about the potential reimbursement of telemedicine and the privacy and quality of care delivered of remote services are quickly fading into the background. Legislation has and is continuing to assure that telemedicine will be covered by insurance plans and that healthcare facilities. Technology hardware and software providers as well as web-based communication platforms are delivering HIPPA compliant encryption to assure the privacy of patient information. Remote sensors of the wearable, implantable, and even ingestible variety are enabling physicians to gather, store and analyze biometric information to deliver state of the art care.

The environment for rapid adoption of telemedicine has never been better, especially given that most Americans are now comfortable with receiving care this way. People talk to their grandchildren, support highly technical products, and conduct multi-million dollar deals over video teleconferencing today. Why wouldn’t they conduct their routine healthcare visits in the same manner? The answer is that they would, they just need to be paired up with providers embracing the technology. Given that, a small investment in today’s technology is the perfect way to not only find new patients, but also to help drive down the cost of care long term, which helps everyone.

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.usnews.com/news/blogs/data-mine/2014/12/09/workers-are-spending-more-of-their-income-on-employer-health-insurance

#2: http://kff.org/health-reform/fact-sheet/analysis-of-2016-premium-changes-in-the-affordable-care-acts-health-insurance-marketplaces/

#3: http://www.americantelemed.org/docs/default-source/policy/examples-of-research-outcomes—telemedicine’s-impact-on-healthcare-cost-and-quality.pdf

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

#5: http://blog.avidex.com/the-telephone-bill-you-actually-want/

#6: http://blog.avidex.com/just-browsing-webrtc-for-healthcare/

#7: http://blog.avidex.com/what-is-it-and-why-is-it-good-for-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

Telemedicine: It’s Rocket Science.

Two things I want to get out there today: First, I wanted to be an astronaut when I was a kid (come on, so did you); Second, I use the phrase “it’s not Rocket Science” all the time.astronaut on laptop

But, working in the world of telemedicine, I am working in rocket science, as NASA was one of the first organizations to create “links” from their rockets and space shuttles to their mission control in Houston. They developed many of the technologies used in current day telemedicine many years ago…and they are still helping to generate new ideas in this market sector today. Read on to learn more.

As for the astronaut thing, after a few rides on the “whirly bird” at the state fair, you will know why I will never go into space! I like the ground, the stationary feel underneath my feet, way too much!

Imagine you are in a rural area and fall ill. You are just over 200 miles away from the nearest doctor. What do you do? You could drive if you felt well enough, or if it was an emergency you may call 911 for an ambulance or a helicopter to rush you to the hospital.  Now imagine that those 200 miles between you and the doctor are straight down, because you are an astronaut in low earth orbit.

This is the position NASA found themselves in back in the 1960’s at the dawn of manned space flight. In fact, before they sent people into space, they had to develop a way to send biometric data back from animals in orbit to assess how their circulatory and respiratory systems would work without gravity.  This technology was later put to use to monitor the astronauts themselves while in orbit.

Fast forward to 2035, the year in which Matt Damon’s character Mark Watney is stranded on Mars in the new film The Martian. Even though it’s a fictional account, the ability to communicate data like the biometric data Matt Damon’s character transmits back to NASA is very real.  In fact, it only takes from 4 to 21 minutes to send data back depending on the relative position of Earth and Mars in their orbits.  The Mars rovers currently transmit data regarding their Mars explorations back to earth.  It’s a sophisticated relay that starts with the Mars rovers transmitting to the Mars orbiters during an 8 minute window each day as they pass overhead, and then the orbiters relay the data back to earth at a much faster data rate than the rovers themselves can achieve.

Today, in the year 2016, a year firmly planted somewhere in between the history and the fiction referenced above, NASA is using video teleconferencing to connect doctors on earth to astronauts in orbit on the International Space Station. They have continually improved their systems to address the challenges of latency and data loss that a wireless transmission of this great distance can be subject to.  They use their systems to provide real time access to doctors as well as to allow the astronauts to see and talk to their families and to educate students who want to learn about life in space.

Given their history of innovation in this space (no pun intended) it is no surprise that NASA is not content to stop at video alone and is continuing to push the envelope.

“The focus of current agency efforts have expanded beyond the original mandate of telemetry and remote communication to encompass new “smart medical systems” that are designed not simply to communicate and diagnose ill astronauts—but also to provide physicians on the ground with the ability to remotely provide limited treatment options.”

NASA has also worked with the National Space Biomedical Research Institute and a key member of that association, Baylor College of Medicine, to develop advanced ultrasound technology to not only accurately diagnose things like illness and potential bone loss, but they also have the ability to focus and aim the ultrasound in a way that it can even stop internal bleeding in an emergency.

As you can probably imagine, these innovations can all have implications terrestrially as well, meaning that comprehensive remote treatments on Earth are probably not that far away.

Telemedicine will soon enable physicians to perform initial diagnosis, verify that diagnosis with physical patient data collected by remote diagnostic equipment including sensors, perform remote monitoring during treatment and recovery, and finally deliver after care and follow up.

So although telemedicine may have started as rocket science, today it is making remote care incredibly efficient and easy, not only in space, but also right here on Earth. Thank you NASA.

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.nasa.gov/content/a-brief-history-of-nasa-s-contributions-to-telemedicine/#.VvDndOIrLIU

#2: http://www.nasa.gov/mission_pages/station/expeditions/expedition19/earth_day.html

#3: http://blogs.esa.int/mex/2012/08/05/time-delay-between-mars-and-earth/

#4: https://vsee.com/blog/nasa-chooses-vsee-telemedicine-video-conferencing-iss/

#5: http://www.prweb.com/releases/2015/03/prweb12562316.htm

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

Just Browsing: WebRTC for Healthcare

When my kids were younger, we would watch “Finding Nemo” time-after-time-after-time because they thought it was one of the best animated movies made. I used to sit with them and watch too, laughing just as much as they did at all the great parts: Bruce the shark trying hard not to eat any little fish; all the seagulls squawking “Mine, Mine, Mine” and Dora, the fish that has no long term memory, and, when presented something shinny and new, she goes with reckless abandon to see the new thing.WebRTC

I relate to Dora…put something new and exciting in front of me and I am all over it. I love new gadgets, new things that might make my life easier and less stressful. But having been in this technology space for 23 years, new sometimes means not ready for prime time.

So when WebRTC was released, I did what I always do: looked at it, tried it and said to myself, “when it’s been here a while, I’ll buy into it.” Well, I think I was wrong. My normal Dora gave way to the safe, stuffy traditional video modes I so hang on to for the past 23 years!

WebRTC is real, it’s here and it works. If you are looking for ways to get into the Telemedicine space at an entry level, WebRTC might be a good way to start small and grow big. If you have been unlike Dora…doing the same thing year after year because it’s tried and true, look into WebRTC as a possible breakout solution for you.  You might just say “Mine, Mine, Mine” when you are all done looking!

Expensive hardware. Special software plugins.  Application downloads.  Varying system requirements. Limited hard drive space or system resources.  Lack of interoperability.

These have all historically been considerations that technology managers in healthcare had to deal with to successfully implement a telemedicine strategy to provide remote healthcare services to their patients. Quite honestly, for some healthcare facilities, they also acted as a barrier to entry based on the cost or the technical resources of the facility.  The costs of acquiring hardware and developing a comprehensive and secure telemedicine strategy seemingly outweighed the potential benefits telemedicine provides.

Enter WebRTC. Web browser Real Time Communications.

In short, WebRTC is an open source platform that leverages a communication application built into PC web browsers like Opera, Chrome, and FireFox and into mobile operating systems like Android and Apple OS.

This takes the term “just browsing” from a term to describe casual interest to one of serious business. If you have been daunted by the technical considerations of video teleconferencing in healthcare, here is why you should be excited about WebRTC.

It’s “skinny”. WebRTC uses a skinny client software integrated into the web browser.  This eliminates the need for valuable system resources to be used to store large proprietary application files.

It’s browser based.  WebRTC does not require any specialized hardware or require the user to download special applications.  It runs on existing computers and anyone utilizing a browser that supports WebRTC has access.

It’s secure.  WebRTC is subject to existing browser security protocols and data encryption is a mandatory feature. “WebRTC is currently regarded by some to be one of the most secure VoIP solutions out there.”

It’s open source. Interoperability has been a major issue with proprietary teleconferencing solutions, one that has been difficult to solve, so much in fact that many are giving up on it altogether. WebRTC is not a proprietary, branded piece of software. It is an open source project which means many interoperability concerns are a thing of the past.

It works with legacy investments. For those with an existing video teleconferencing solution, many legacy hardware solutions, like those from Polycom, are supporting expansion of their systems through WebRTC. This allows facilities to leverage all the QOS and enhanced security features of those systems while providing easier expansion in new facilities and access to remote patients via WebRTC.

In short, if you’re aware of the benefits telemedicine offers to your facility and are looking for a resource light, easy to implement, and secure solution that will work across browsers and with existing dedicated hardware, you need to look at WebRTC. Then the next time a patient needs a remote check-up or some aftercare, they can get access to it by “just browsing”.

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://webrtc.org/

#2: http://webrtc-security.github.io/

#3: http://www.excessionevents.com/blog/interop

#4: http://community.polycom.com/t5/The-View-from-APAC/Why-WebRTC-is-key-to-unlocking-mass-adoption-of-video/ba-p/51639

 

 

 

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

Telemetry. What is it and why is it good for healthcare?

Telemetry. It’s a word I had heard many times, but it was usually closely associated in my mind with rockets and space shuttles.  To be honest, the first time I heard it used in relation to healthcare I was a little taken aback.Telemetry photo  In fact, it caused me to look up a word I thought I knew for a formal definition. This is what I found:

Telemetry is an automated communications process by which measurements are made and other data collected at remote or inaccessible points and transmitted to receiving equipment for monitoring. The word is derived from Greek roots: tele = remote, and metron = measure.

In the light of that definition, the immediate impact of telemetry on healthcare, especially telemedicine came clearly into focus. In fact, looking further down the page of search results for telemetry, I noticed several results for a Telemetry Nurse as well, further solidifying an immediate link between the two disciplines.

If you run a hospital, you are most likely already very familiar with what a Telemetry Nurse does, but here is the description as posted by a University that offers degree programs for nurses.

Telemetry nurses work with patients that require special monitoring, including those recently released from the intensive care unit of a hospital. The patients they work with are often at high risk for complications, so RNs in a telemetry unit must carefully review equipment and data to detect potential symptoms of distress or danger.

Given that this type of physical on-premise equipment has been used in hospitals for quite some time, telemetry is not in any way actually new to medicine at all. However as technology advances, the applications for telemetry become wider and wider.

With the proliferation of internet connected devices and sensors, or the Internet of Things (IoT), telemetry extends beyond the on-premise, state-of-the-art equipment inside the nation’s hospitals and effectively becomes available wherever the patient may be. In fact the problem is no longer collecting the data for interpretation. Now the challenge becomes sifting through irrelevant data to find the important pieces, as well as securing that data to ensure the privacy of all that health information as it streams from a sensor through the internet, and to the nurse or physician it is intended for.

Think about the trends in technology today. People are already using telemetry in a personal way to manage wellness. They use Apple Watches or Fit Bits to track their steps and heart rates, track sleeping habits, and even set REM sensitive alarms to assure that they are always morning people. Companies like Google are even going a step further. Currently they have filed several patents on a glucose sensing contact lens, that not only tracks blood glucose levels, but also connects to the internet and smart devices, as well as includes a heads up display for the person wearing it to see the data from the lens right on their eye!

Now imagine taking all of this telemetry data and being able to share or save it right to your Electronic Health Records so that your physician has access to it to help determine the best care to give. Some say it’s comforting, others think it’s a bit scary, but in either case, it is objectively valuable to the care provider on the other end. If you consider for example some of the tragedies we have seen befall collegiate athletes because they collapse during a game from an undiagnosed condition, could it not be argued that telemetry may have reported some objective data beforehand, even though the athlete wasn’t noticing any symptoms themselves?

These are some of the encouraging promises of big data and healthcare. People like to focus on the negative side sometimes; that the insurance companies may get this data somehow and then deny insurance based on the figures. But on the flip side, your physician could be getting the data and proactively address a potentially life threatening condition as well. The risk of the first may be more than negated by the benefit of the second.

The point is that telemetry has in fact been here for a while in the ER and ICU, but now, in the new connected environment, just like a video conferencing system connects doctors and patients remotely for appointments and check-ups, telemetry connects the biometric data your body produces day in and day out to a physical data log. This allows that same physician to prescribe better treatments during those appointments and even to proactively help you manage your health long term.

I heard someone on a medical program state that “the first person to live to 150 has already been born.” IT is definitely something to ponder, and given the state of medical technology, it doesn’t seem like an outlandish claim. I can’t help but think that telemetry will play a huge role in the active management of personal health, transforming the doctor patient relationship from one of “break-fix” to a true collaboration that gives us all the ability to live long and healthy 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: https://en.wikipedia.org/wiki/Telemetry

#2: http://www.jacksonvilleu.com/resources/career/telemetry-nurse-job-description-salary/#.VruC_PkrLIU

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

#4: http://blog.avidex.com/the-doctors-watch-just-stole-my-medical-records-and-other-strange-tales/

#5: http://diatribe.org/google-secures-patent-glucose-sensing-contact-lens

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

The New House Call- Telehealth is Bringing the Doctor Back Home

woman video chat with DrWatch any movie set in the late 19th or early twentieth century where someone has taken ill and inevitably, a doctor will arrive at the patient’s home, black bag in hand, and sit next to them in their own bed to take a look. In fact, this is the origin of the term “bedside manner”.

In the 1930’s house calls were standard practice for physicians. Approximately 40 percent of doctor patient visits happened in the patient’s home. By 1950, this had decreased to 10 percent, and by 1980, to about only 1 percent. –American Academy of Family Physicians

In a way, some of this shift to medical care at a dedicated facility outside of the home makes sense. A physician at an emergency room (ER) for example may need access to a CAT scan machine, an MRI machine, a cardiology lab, or a lab for blood work. It is hard to imagine all of this being taken to the patient’s home in that traditional little, black doctor’s bag. The propagation of the modern day insurance system also played a part in the reduction of house calls by physicians due to their policy for reimbursement on these type of visits.

The house calls, for all intents and purposes, are gone. However, the march of technology and the need to better allocate the limited resources of a physician’s time, while reducing the cost of medical care are bringing back the house call in an innovative new way.

Enter Telehealth.

Telehealth as a concept has been around for some time, but it seems that the introduction of new technology alone is not enough to tip the scales. You need an accompanying change in the attitudes and acceptance of the technology by the patients themselves. You also need acceptance of the technology by both the medical community, as well as by the medical insurance system to assure payment. For the last few years, these needed changes had been slow to materialize, however today the pendulum has begun to swing in favor of telehealth.

A recent Harris Poll showed that 66% of people surveyed are open to visiting with their doctor over video. The appeal of convenience and shorter wait times were strong drivers of this willingness. Another interesting revelation in the poll was that for “middle of the night” care, 21% of respondents indicated they would choose a video visit. This may on the surface seem low, but when you consider the fact that 17% said they would call a 24 hour nurse line, and an additional 5% indicated they would use an online symptom checker, the result is that 43% of the respondents chose methods that did not require seeing a doctor in person. That means telehealth in some form has now reached the same level of preference as a visit to the ER, (44% chose this method), when it comes to middle of the night care.

For obtaining prescriptions, an overwhelming 70% of respondents said they would prefer a video visit with the doctor. Prescription refills, birth control, antibiotics, and prescriptions for chronic illness are all situations that align well with online consultations.

Doctors Matter

Another telling finding in the Harris Poll on telehealth was that doctors still matter. Just because patients are willing to meet with a doctor over video doesn’t mean that they are willing to meet with any doctor available. In fact, 88% of those polled wanted the ability to choose their online doctor just as they would their primary care physician (PCP). 7% of respondents said they would be willing to switch PCPs to get video visits, which indicates that adding telehealth services would not dramatically attract new patients to a practice, but would create opportunities to retain more existing patients, especially younger patients who would be more likely to leave.

Doctors do indeed matter, and not just in a patient’s choice of physician, but also in the doctor’s choice to use telemedicine in their practice. As stated above, doctors do not currently face a mass exodus if they choose not to employ telehealth. However, doctors who have made the leap have found they can offer the same quality of care and positive patient outcomes when they utilize HD video for patient visits.

“The first thing I do when I treat a patient is I look at their face,” said Dr. Peter Antall, President and Medical Director of the Online Care Group, which provides telehealth services. “A person’s facial expressions and body language give me an understanding for their overall well-being that could be missed over the phone. Beyond that, video gives me an opportunity to see skin rashes or tonsils – important signs when making a diagnosis. With the HD-quality video, I can assess the patient closely and provide a diagnosis that will produce the best possible outcome.”

This aligns well with the Federation of State Medical Boards’ policy recommendations of utilizing both high quality audio and video in telehealth.

Cost of Care

The survey shows that 62% of patients expect telehealth visits to cost less than an in person visits. This is a reasonable assumption, and has proven to be true in reality. Studies have shown that “telehealth visit saves about $100 or more compared to the estimated cost for in-person care.”  Given these savings, it seems odd that insurance companies have been slow to embrace reimbursements for these visits.  Today however, 22 states now have laws requiring that telehealth visits be paid in the same way as traditional office visits, and the Affordable Care Act also has rules in place that will continue to pave the way for increased technology in healthcare.

With consumer attitudes on telehealth dramatically shifting, insurance policies rapidly changing to allow for telehealth reimbursements, telehealth’s innate cost advantages, and the growing acceptance of telehealth in the medical community based on realized positive outcomes, it is no surprise that telehealth is poised to revolutionize healthcare.  It all adds up to one thing.

The house call…is back!

 

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.aafp.org/afp/2011/0415/p925.html

#2: http://www.fiercehealthit.com/story/patients-increasingly-open-video-doctor-visits/2015-01-23

#3: http://cdn2.hubspot.net/hub/214366/file-2374840622-pdf/TelehealthConsumerSurvey_eBook_NDF_Electronic_Version_(2).pdf\

#4: http://www.fiercehealthit.com/story/new-york-enacts-telehealth-parity-law/2015-01-12

 

Joel Harris

About Joel Harris

Joel Harris brings invaluable insight to the Avidex team in his role as CEO, with years of experience leading national technology, healthcare and business organizations. You can reach Joel at jharris@avidexav.com

The Wait is Over- Technology and the Continuum of Care

vectorstock_2226919Imagine you aren’t feeling well.  You call your doctor to get an appointment.  You are lucky and are able to get an appointment within a week due to a cancellation.  You have to schedule a couple hours off of work to travel to the doctor’s office and conduct the appointment.  A week later you leave work and get to the doctor’s office at the scheduled time.  It takes 30 minutes for you to be called back to an examination room by the nurse.  He conducts a brief precursory check of your vitals and then says the doctor will be with you shortly.  Another 20 minutes pass and the doctor comes into the room.  She asks a few questions and you answer.  After about 11 minutes she gives you a prescription and sends you on your way.  You return to work late and are greeted by a stern glance from your boss.  Hopefully the pills do the trick, because there is no way you want to do this again any time soon.

The story above details the typical American experience in seeing the doctor and is the reason why there is a major problem in America today.

People are voluntarily delaying essential healthcare.

A great number of people find getting healthcare difficult based on the time it takes to see a doctor.  In fact, 33% of people report some type of problem in seeing their Primary Care Physician (PCP) and nearly 25% report issues with getting time away from work for doctor’s appointments. “I have to wait too long” even made the list of 5 Reasons People Don’t Like Their Doctor.

The result is an undue burden on the urgent care and emergency room systems, with 55% of those visits not being urgent or emergencies. Studies also show that 46% of the time these visits could have been handled by a PCP.

The American Medical Association goes on to state that an estimated 70% of all doctor’s visits could in fact be handled…over the telephone.

A hurdle to that however is that few patients are confident that the telephone is effective in diagnosis of their medical needs. However, when asked about video-conferencing, the majority of patients are at least somewhat likely to meet that way. Over 36 million Americans have utilized some type of telemedicine service because of the convenience and time savings. So how does telemedicine help solve some of these problems?

Physicians are tasked with seeing more patients.

It’s the sad truth. One of the most limited resources in the healthcare system is a physician’s time. Physicians are being tasked with seeing more patients. The net result is that the average time a patient spends with a doctor during a visit is 11 minutes, and the patient usually only gets 4 of those minutes to talk. The average telemedicine appointment last 15 minutes or more, and does not require the patient to spend additional time traveling to the doctor’s office or waiting in the waiting room.

Telemedicine is more convenient.

Over 25% of people report trouble getting time off of work to see a doctor. That is because if you include travel to and from the doctor’s office and the time spent waiting to actually see the doctor, that 11 minutes of face time may easily take up 90 minutes of a patient’s day. It may be difficult to get 90 minutes off of work, especially if repeat visits are required. However, taking a 15 minute break to have a video conference with a physician at your desk or on your phone is very easy.

Continuum of Care

In today’s world of bits and bytes, medical charts have gone from analog paper to digital electronic health records (EHRs). EHRs make telemedicine even more feasible, as any physician can access the digital records given they have the proper permissions. EHRs are also stored and protected according to federal HIPPA guidelines to assure privacy. This allows a patients records to easily be passed form a physician to a specialist or accessed for follow up appointments or questions after an initial appointment.

The idea of telemedicine has been around for some time, however it is poised to accelerate in acceptance today. The continued consumer acceptance of videoconferencing, increased access to teleconferencing applications through computers, tablets, and phones, as well as the federal emphasis on the privacy of EHRs and continued support of telemedicine programs in the Affordable Care Act (ACA) are all strong indicators that telemedicine is indeed a major component of the future of healthcare.

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.huffingtonpost.com/richard-c-senelick-md/5-reasons-people-dont-lik_b_779950.html?

#2: http://www.ncpa.org/sub/dpd/index.php?Article_ID=24196

#3: http://www.corpsyn.com/knowledgecenter/articles/telemedicine.html#.VRlUmfnF9vk

#4: http://www.healthitoutcomes.com/doc/patients-accepting-of-telehealth-0001

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