7/15/2008
A new survey from Frost & Sullivan finds that the European telemedicine market generated revenues of $118 million in 2007 and could reach $236 million by 2014. Frost officials say that although the telemedicine industry has reached great heights in Europe, certain technological advances have inadvertently led to new hurdles. Problems such as lack of physician acceptance of novel telemedicine technologies and the pressing need for standards have begun to haunt the industry, according to the firm's report. An effective telemedicine technology will help in increasing the number of patients that physicians treat remotely lowering the costs and travel times associated with treatment, the report says.
Although the technology in industry is becoming increasingly sophisticated and powerful, prices for computers, software and transmission equipment are falling, Frost says. To widen the deployment of telemedicine, many market participants are lowering the cost of technologies.
Also, health organizations are increasingly using telehealth technology to monitor patients remotely, according to the report. However, the lack of payer reimbursement is a major barrier to broader adoption. But questionable returns on investment, the technology is perceived to be extremely expensive, the report says.
Frost says that if the government wishes to keep pace with future demands for healthcare and reduce escalating healthcare costs, they will be compelled to adopt certain eHealth strategies accompanied by concrete actions. The number of Web sites/portals dedicated to patients with specific diseases will expand as well as the number of households connected to the Internet grows, according to the firm's report. This trend will also increase online communication between doctors and patients, Frost officials say.
"While it is apparent that the telemedicine industry is in the midst of great change, it is not clear how the industry will look in the years to come," said Frost & Sullivan Research Analyst Janani Narasimhan. "Technological developments have the potential to not only alleviate the current growing pains but also provide some solutions for the major challenges facing the business of telemedicine delivery."
(Source: TCMnet.com, July 10, 2008)
7/15/2008
Writers working in telemedicine and knowledge management as researchers and practitioners are invited to submit book chapters to be published by IGI Global, www.igi-pub.com.
The Handbook of Research on Knowledge Management in Telemedicine: Advanced Ethics, Policy and Regulatory Applications will cover a wide range of topics from early adopters of Telemedicine to the latest innovation and futuristic tele-robotic technologies.
In the fields of knowledge management in telemedicine and associated fields of datamining and biomedical ontology, there exists a need for an edited collection of articles in this area. The book aims to provide relevant theoretical frameworks and latest empirical research findings in the area.
More information, including submission submission procedures and contact information can be found
here.
(Source: IGI Global Press Release, July 5, 2008)
7/15/2008
The new report "Home Health Care during an Influenza Pandemic: Issues and Resources" highlights the critical need for
home healthcare technologies in providing care during a pandemic influenza event. The report funded by the HHS Assistant Secretary for Preparedness and Response and CDC, and developed by AHRQ, describes the resources and the technology needed by home healthcare providers and community planners to prepare for such an event.
The report stresses the need for telehealth technologies to deliver patient care and to do advanced planning and coordination at the local level. Using technologies would allow remote monitoring of patients and the ability to prompt patients on taking medications.
The equipment needed includes:
- Remote vital sign monitoring units using standard phone lines. This technology is already being adopted in New York, Pennsylvania, and several other states
- Interactive voice response systems to enable callers to use their touchtone phones to receive information automatically.
More information can be found at
< www.ahrq.gov/prep. The report can be downloaded at
here.
(Source: Federal Telemedicine News, July 13, 2008
AMD Global Telemedicine, a telemedicine hardware and software solutions with over 5,000 installations in more than 72 countries, recently re-emphasized the importance of the role telemedicine applications can play in helping to improve health care delivery in disaster situations. The recent earthquake in China and the recent cyclone in Myanmar, where many lives were lost and many others were seriously injured, serve as reminders that telemedicine technology is important in many emergency medical care situations, not just the more traditional settings of remote or hard-to-reach locations.
The U.N. has reported that the death toll in Myanmar as a result of the cyclone is in excess of 100,000 with many more injured, while the death toll in China as a result of the earthquake is estimated at more than 69,000 lives. The 2004 Indian Ocean tsunami killed more than 225,000 people, while the 2005 Kashmir earthquake killed approximately 80,000 people and injured countless others. The medical care available to these victims is greatly enhanced by telemedicine devices and equipment, which combine traditional medical evaluation tools, such as stethoscopes and ultrasounds with Internet, satellite and video conferencing technology to virtually bring the expertise of medical experts located hundreds or thousands of miles away into the disaster area. These devices can make disaster recovery into a truly global effort and can help equalize the quality and availability of medical care around the world.
Telemedicine can be of great help here to identify and understand patterns of injury, as well as to access information and experience on treatment. Dr. Richard Aghababian, a fellow of the American College of Emergency Physicians (FACEP), an Associate Dean for Continuing Medical Education at the University of Massachusetts Medical School (UMMC), past Chairman of the Department of Emergency Medicine at the University of Massachusetts Medical School and past president of the American College of Emergency Physicians (ACEP) explained in a recent presentation at the 13th annual American Telemedicine Association meeting that telemedicine can play a vital role in the triage process, which is often a critical tool at disaster scenes.
"Telemedicine can be of great help here to identify and understand patterns of injury, as well as to access information and experience on treatment," stated Dr. Aghababian. Noting that preparedness is the key to successful response, Dr. Aghababian also discusses how telemedicine training can be vital prior to a disaster and what that training would entail.
"Telemedicine provides a critical, visual link between a disaster site and experienced medical personnel at a distant facility, and also can be a conduit of vital patient data to enable life-saving treatment to begin right in the field," said Steve Normandin, President of AMD. "A key to enhancing and improving the quality of medical care available in disaster situations is that the rescue teams need quality telemedicine devices available to them and also need prior training as to proper use of this equipment. We are convinced that lives will be saved when telemedicine devices are properly deployed and utilized by qualified and trained rescue teams.
(Source: AMD Global Telemedicine Press Release, June 24)
MDPIXX, is a recently launched global interactive Web platform that allows physicians and medical students from all over the world to easily share multimedia clinical information over the Internet.
In its public version, MDPIXX is a free-of-charge Web portal for sharing clinical cases, images, and videos. Physicians can post cases with their associated images for discussion among colleagues. All the shared information is tagged with SNOMED CT keywords for quick search and other members of the community can vote and write comments on the cases and images posted.
However, MDPIXX is also offered as a white label solution for hospitals, clinics, and faculties of medicine. Private organizations can benefit from having a customized MDPIXX tool to solve their specific clinical image management problems.
According to Patricio Ledesma, MDPIXX Representative, "the great value of MDPIXX resides in its unprecedented versatility to implement an endless list of telemedicine applications, including interconsultation platforms and online medical education programs."
Ledesma remarks "MDPIXX's potential to automate the capture, storage and sharing of large volumes of images and videos across distributed corporate scenarios, such as networks of clinics that need to organize their multimedia contents in an effective and secure way."
Regarding the response of the healthcare community, Ledesma states that "initial feedback has been quite promising; we recently completed a project for a Swiss hospital requiring MDPIXX technology to incorporate more than 1500 clinical cases for private interconsultation purposes."
As far as MDPIXX's use in the United States is concerned, Ledesma explains a project with one Anatomic pathology department that used MDPIXX to "make their images accessible and searchable via a flash viewer integrated in their own Web site. Our customer benefited from MDPIXX potential running backstage while keeping its corporate image intact for the public."
C2C welcomes both public and private healthcare organizations to test this revolutionary tool. Ledesma ensures that "MDPIXX is ready to implement almost any digital image sharing application. We are confident that MDPIXX will turn our customers' ideas into realities."
As part of its current international expansion strategy, C2C seeks to cooperate with clinical content providers (hospitals and physicians) and business partners (investors or health organizations) interested in developing new MDPIXX-related projects.
More information is available at
www.mdpixx.com.
(Source: MDPIXX Press Release, July 7. 2008)
French telecos Alcatel-Lucent has announced the launch of
LifeStat Remote Monitoring and Health Management, a telemedicine service developed with its Canadian partner SaskTel.
The technology will be used to manage patients with chronic conditions in primary care such as diabetes. Future LifeStat applications will include monitoring and reporting for chronic illnesses such as congestive heart failure, Chronic Obstructive Pulmonary Disease and asthma.
The new service records and transmits daily blood glucose and blood pressure readings, automatically creating confidential, easy-to-use reports that can be viewed online by individuals their health professionals and caregivers.
Alcatel-Lucent is marketing and selling the product internationally under the name Alcatel-Lucent Health and Wellness Application to its global enterprise customers in the utilities and healthcare verticals.
SaskTel will market and sell the LifeStat service directly to consumers and healthcare providers in Canada.
The ongoing development and support of the LifeStat platform and applications will be managed by SaskTel and Alcatel-Lucent through their Salveo project, which is based in Saskatchewan. The Salveo project, which is funded by SaskTel and Alcatel-Lucent, aims to become an international leader in health and wellness telemonitoring software applications.
(Source: eHealth Europe, July 11, 2008)
Hospitalists -- physicians working full-time in hospitals, instead of dividing their time between private practice and hospital rounds -- are in such short supply, many daytime hospitalists are being overworked. Hiring a full-time nocturnist, or nighttime doctor, is expensive.
Night Hospitalist Company (NHC) was recently launched to provide a nighttime hospital telemedicine solution and coverage by telephone.
NHC provides reliable telephonic care from 7 p.m. to 7 a.m.. All NHC physicians are Board-certified or Board-eligible internal medicine M.D.s or D.O.s with extensive hospital experience. Each is qualified to handle emergency room calls, floor calls and stable ICU admissions. The NHC solution is seamless and designed to free hospitals up to concentrate their resources on patient care: NHC covers its own physicians' malpractice insurance and documents all patient-related activity overnight using a web-based proprietary software called MDHandOff. All overnight changes in medical management are transmitted to the correct hospital floors for insertion into patients' medical records. The company contracts directly with hospitals for ease of billing.
"NHC is the first solution of its kind," stated company founder Dr. Yomi Olusanya. "We exist to give hospitals a viable way to provide high-quality patient care at night at a cost far lower than that of hiring on-site physicians. Our clients are not only weathering the hospitalist shortage and unexpected physician absences, they're actually finding NHC to be a real alternative to full-time nocturnists."
NHC physicians are also available to cover night calls for physicians in private practice as well as for nursing homes and acute care facilities. The company is currently evaluating telemedicine vendors, with an eye to remotely examining and evaluating patients via video telemetry. NHC serves facilities in Missouri but will soon have night hospitalists practicing across the U.S.
(Source: Night Hospitalist Company, June 24, 2008)
6/20/2008
Health plans can cut costs for businesses and employees by encouraging frequent phone or Web-video conversations between chronic-disease patients and doctors or nurses, University of Missouri research suggests. With chronic diseases generating 70 percent of U.S. health costs, they offer nearly $1.5 billion a year to be cut.
The telehealth interactions bring important symptoms to light earlier, "triggering early intervention from providers and reducing the need for patient hospitalization," said Bonnie Wakefield, a nursing school professor who studied patients who had been hospitalized with heart failure. Those with phone or video follow-ups "significantly delayed hospital readmission rates" compared to those without.
"People who suffer from chronic illnesses usually wait three to six months between office appointments," Wakefield said. Nurses who check in regularly with patients "provide a sense of security. Patients discuss concerns on a frequent basis, and nurses give advice and detect problems that the patient might not notice."
The result, she said, is fewer and shorter hospital stays, "lower health care costs" and patients who better "manage their diseases and ultimately feel better."
The report, "Home Telehealth for Heart Failure," will be published in the Journal of Telemedicine and e-Health.
(Source: Dayton Daily News, June 9, 2008)
6/20/2008
The U.S. healthcare industry is expected to spend $55 billion on telecommunicationsover the next five years, according to a recently released study by Insight Research Corporation. The use of telecommunications by healthcare providers will grow at a compounded rate of 8.4 percent, from $7.5 billion this year to $11.3 billion in 2013. According to the report, "Telecom, IT, and Healthcare: Wireless, Wireline and Digital Healthcare, 2008-2013," an aging population and worker shortages are pushing healthcare providers to find alternative approaches to current business practices, including the use of telecommunications.
"Most of the high costs inherent in the current system are related to the proximity of the patient and provider, as well as to the archaic administrative systems used to manage records and exchange information," the study said. "Telecommunications can bridge these proximity gaps as well as provide a normalized set of baseline data that can remain secure and yet be shared among healthcare workers."
According to Insight Research President Robert Rosenberg, telecommunications and information technology providers have responded to the interest by providing more bandwidth, packet services and healthcare applications, such as video monitoring, electronic health records and telemedicine.
For telecommunications and IT providers, healthcare is an attractive market, Rosenberg said. The U.S. healthcare industry is a $2.3 trillion ecosystem of hospitals, physicians, pharmaceutical companies and insurance providers. Healthcare outpaces all other industries for growth rate and is projected to grow 6.9 percent per year to $4.1 trillion by 2016.
"This increased emphasis and spending on healthcare reflects the increased value that consumers perceive in medical treatment," Rosenberg said. "At the same time, providers and patients share the objective of improving healthcare quality and reducing costs. Information technology and telecommunications will play a critical role in addressing these objectives."
Rosenberg said many of the trends Insight Research has predicted in previous reports have come to pass.
(Source: Healthcare IT News, June 2, 2008)
6/20/2008
The Center for Healthcare Robotics within the Health Systems Institute at Georgia Institute of Technology and Emory University are looking at ways that
robots can be used to help when providing homecare for patients. The research team led by Charlie Kemp, Director of the Center has found a way to instruct a robot named El-E to find and deliver items it may have never seen before by using a laser pointer. The researchers are now gathering input from ALS patients and their doctors to use to prepare the robot to assist patients with severe mobility challenges.
The verbal instructions a person gives to help find an object are very difficult for a robot to use. These commands require the robot to understand everyday human language and a description of the object at a level well beyond the state-of-the-art in language recognition and object perception. According to Wallace H. Coulter, Department of Biomedical Engineering at Georgia Tech and Emory, "Robots have some ability to retrieve specific predefined objects but retrieving generic everyday objects is a challenge for robots."
The laser pointer interface and methods developed by Kemp's team is overcoming this challenge by providing a direct way for people to communicate the location of interest to El-E and ways that will enable the robot to pick up an object found at this location. Through these innovations, the robot can retrieve objects without understanding what the object is or what it is called.
The researchers see fetching as a core capability for future robots in healthcare settings such as the home. In the home, El-E is able to find objects since there are common structures found indoors. In the home, most objects are found on smooth flat surfaces that have a uniform appearance such as floors, table, and shelves. Regardless of height, the robot is able to localize and pick up objects by elevating the arm and sensors to match the height of the object's location.
The robot uses a custom-built camera that is omni-directional to see most of the room. After the robot detects that a selection has been made with the laser pointer, the robot moves two cameras to look at the laser spot and triangulate its position in three dimensional space.
Next the robot estimates where the item is located. If the location is above the floor, the robot finds the edge of the surface on which the object is sitting, such as on the edge of a table. The robot then uses the laser range finder to scan across the surface to locate the object. Then the robot moves its hand above the object, uses a camera in its hand to visually distinguish the object from the texture of the floor or table. After refining the hand's position, the robot descends upon the object while using sensors to decide when to stop moving down and closes upon the object with a secure grip.
Once the robot has picked up the item, the laser pointer can be used to guide the robot to another location to deposit the item or direct the robot to take the item to a person. El-E is able to distinguish between these two situations by looking for a face near the selected location and then is able to present the item.
The researchers are now working to help El-E expand capabilities that will include switching lights on and off when the user selects a light switch and opening and closing doors when the user selects a door knob.
(Source: Federal Telemedicine News, June 11, 2008)
AmeriGroup Holdings recently launched
MDWebLive.com, which offers webcam appointments with physicians on a flexible schedule that includes nights and weekends. There are limitations to what a doctor can offer without a physical examination, but simple diagnoses that require just a look over, a chat and a prescription can work online.
The company's Web site lists dozens of conditions its doctors can treat, including cold, flu, headache, allergies and heart problems. It also treats children who are at least 2 years old. Doctors can't prescribe controlled substances through MDWebLive.
Dr. Stephen Q. Parker, president of AmeriGroup's medical association, said any patient with a serious condition or in need of a more thorough exam will be referred to the nearest medical facility.
"We can't be all things to all people," said AmeriGroup CEO Robert Smoley, an attorney. "We're not trying to replace primary care physicians."
Visits are recorded for playback by either doctor or patient, and the medical records are stored with MDWebLive. The company set up an electronic prescription service to send orders to the patients' designated pharmacy.
"It is convenient for the physician," Parker said. "It's a way to supplement your income in times of cutbacks in every area."
All of that convenience isn't free. Physicians must pick up part of the company's medical malpractice insurance premium, but the company provides its software at no cost.
Patients must pay a $99 annual membership fee, which includes a webcam, and $40 per consultation. Smoley said he hasn't signed up with any health plans for coverage, but patients can submit their receipts to their health plan and ask for a partial reimbursement.
When it comes to health plans recognizing Internet and telephone consultations - called telemedicine - it's hit and miss. Humana's South Florida medical officer, Dr. Jill Sumfest, said the company is looking into this technology, but does not have a formal coverage policy yet. It has paid for e-mail communications between patients and physicians when using approved medical billing codes.
Telemedicine has been in place since 1996 at the University of Miami's Miller School of Medicine, which offers it to military bases and Veterans Administration and Florida Children's Medical Services clinics. Dr. Anne E. Burdick, associate dean for telehealth and a professor of dermatology at UM, said psychology and dermatology are two of the specialties easily practiced via videoconference.
UM's telemedicine program connects with patient centers that have expensive diagnostic equipment allowing doctors to check a patient's vital signs remotely. A nurse or physician assistant helps with the exam on the patient's end.
"Certainly prescription refill is simple if the physician is familiar with the patient's history," Burdick said of an online consultation without diagnostic equipment. "But doing an evaluation without looking in the ear or throat or getting vital signs would be very limited."
(Source: South Florida Business Journal, June 20, 2008)
Researchers at the University of Edinburgh have developed
cellphone technology that will allow patients to receive virtual medical checkups from home.
Under a new project funded by Scotland's Chief Scientist Office, patients with chronic conditions such as high blood pressure and chronic lung disease can measure their vitals at home and then send the readings through mobile technology, the BBC reports. A text message will follow with information about any steps the patients need to take, and doctors can communicate with the patients via a video link.
(Source: Chronicle of Higher Education, June 3, 2008)
YourCity.MD, a city-specific medical navigation system, and
TelaDoc Medical Services, which provides 24 hour telehealth services, recently announced a partnership to expand the availability to consumers of round-the-clock, non-emergency telephonic based medical consultation services with trained, board certified primary care doctors, providing more healthcare access, convenience and affordability than traditional medical services for common illnesses.
Consumers in over 400 cities can now reach a board certified TelaDoc primary care physician (PCP) licensed in their state via telephone to receive affordable, convenient telehealth services. TelaDoc physicians are available 24x7 to discuss non-emergency medical problems and recommend treatment including prescribing medication when applicable. Calls are substantially less than office visits or ER/urgent care visits.
(Source: YourCity.MD Press Release, June 17, 2008)
Consumers increasingly are turning to
motion sensors and remote monitoring systems to track the health of aging relatives. Such systems can track whether users leave their beds or take medications from a dispenser, as well as inform family members of any changes in their routines that could indicate injuries or illnesses. More comprehensive versions of such systems also can track blood pressure, weight or respiration in users.
Privacy is an issue for some older people, and the basic package can range from $50 up to $85 a month. More comprehensive packages can include devices to track blood pressure, weight or respiration.
Experts on aging say the systems will become commonplace as the 76 million baby boomers approach ages when disabilities or conditions like diabetes and failing eyesight jeopardize the ability to live independently. The population of those 65 years and older is almost 40 million today, and the federal Census Bureau says that will more than double, to nearly 87 million, by midcentury.
Right now, there is little federal health care reimbursement for such devices. And private insurance coverage is evolving because the area is new, said Dr. Jeremy Nobel, a professor at the Harvard School of Public Health who co-wrote a study on the feasibility of such technologies. "We are at the beginning stages regarding the availability of such services and before business models are developed," said Dr. Nobel, a medical doctor. "I expect we'll see a significant increase in the adoption of such systems in two to five years, and widespread adoption in 10 years."
The coming wave of aging Americans threatens to swamp the existing stock of retirement communities, assisted living and nursing home facilities — making it impossible to accommodate everyone who will need, or might want, more structured care.
Experts on aging say motion sensors and other high-tech devices will help cover the shortfall, allowing older people to live independently for longer.
The growing number of Alzheimer's sufferers, which is expected to more than triple from the current four million by 2050, may also spur wider adoption of technologies like motion sensors to alert others to deviations in routine, trackers to assure medications are taken and emergency response buttons.
Technology systems to underpin living independently, or what some call "aging in place," are still years from being rolled out in a big way, awaiting adequate financing for research and other incentives, like coverage by insurance companies, according to Mr. Nobel's study, which was released in March by the Center for Aging Services Technologies, a program of the American Association of Homes and Services for the Aging.
But projects are under way around the country to test high-tech gadgets for home use, including wireless sensors and devices to regulate temperature, lights and appliances, and sophisticated medical monitors. And some care providers have begun to equip clients with devices that fit their needs.
NewCourtland Elder Services, a care provider for some 2,000 people in Philadelphia, started a yearlong pilot in 2006 that equipped 33 patients living on their own with remote sensors that tracked changes in their health or living patterns that required early medical intervention, said Kim Brooks, the vice president for housing and services at NewCourtland.
One of the patients is Cleora Coley, 77, a retired pharmacy technician, who is in a wheelchair after losing a leg to diabetes. Two years ago, Ms. Coley moved to a living complex for the elderly because she could not maneuver the stairs in her family home.
In her apartment, she checks her blood pressure with a cuff that automatically sends the reading to a monitoring center, which notifies her and her doctor of any change. Sensors placed in each room keep track of her movements, and she has a button to summon assistance, which she used in April when she fell.
"I'm alone but I know I'm not all by myself," Mrs. Coley said, adding, "And I really like my independence."
NewCourtland is starting a trial in cooperation with health insurance companies and home health agencies, installing medical monitoring devices in 1,000 residences over the next six months.
One major roadblock for wider adoption of in-home monitoring has been concern that older people, unused to everyday technologies like the Internet, would resist their use. That was true for Mrs. Trost, who said she was apprehensive about having electronic gadgets around but said she had found that "they are really no bother." A survey by AARP found that older people were willing to use high-tech devices at home, and to pay about $50 a month.
The privacy issue made John T. Fowlkes, 86, of Raleigh, N.C., hesitate last year when his children wanted to install a motion sensor system.
"What convinced me was that there are no cameras," said Mr. Fowlkes, a retired postal service distribution clerk who lives by himself in an apartment building for retired people. "I get peace of mind, but no one is looking at me."
Some exploration into future technologies is being financed by the National Institute on Aging, part of the National Institutes of Health, which has been giving grants to entrepreneurs to develop devices like a video data collection system to analyze an elderly person's activity level.
But most research dollars have come from private companies like Intel Corporation.
Intel researchers are developing devices like a "memory bracelet" that vibrates at a specified time to remind the wearer of a doctor's appointment or to take medication. Also in trials are sensor-infused carpets — Eric Dishman, Intel's director of product research, calls them "magic carpets" — and wearable sensors, which would measure changes in gait, to help avoid falls.
Intel invested $3 million with the Oregon Center for Aging and Technology, which runs what it calls a living laboratory, with 225 volunteers. The project, which also received $7 million from the federal aging institute, uses sensors on walls, doorways and appliances — and computer games — to detect cognitive decline.
"There is going to be a major transformation in health care because of these technologies," said Dr. Jeffrey Kaye, director of the center, at the Oregon Health and Science University in Portland, who oversees the project. "It's more a question of when rather than whether."
Recognizing the commercial potential of technologies for the aging, dozens of companies, including GE Healthcare, IBM and Medtronic, two years ago formed the Continua Health Alliance to develop products to aid older people. Despite the projects, trials and commercial interest, Mr. Dishman said the United States was "missing in action" in aging technologies, compared with Europe.
"There just hasn't been enough research and development yet to prove these technologies work," he said. "None of us wants to put a bunch of technology in homes of frail elders unless it does."
He said the European Union had committed $1.5 billion to developing independent-living technologies.
Last year, Intel partnered with Ireland's government to open the Technology Research for Independent Living Center, known as Tril, in Dublin, to invent and test independent-living technologies in the households of hundreds of older people.
So far, he said, a dozen other countries and 30 universities have approached Tril for advice and assistance.
(Source: New York Times, May 25, 2008)
5/24/2008
Email-based telemedicine has been reported to be an efficient method of delivering online health services to patients at a distance and is often described as a low-cost form of telemedicine. A new study by researchers at the Center for Online Health at the University of Queensland, Australia, finds that the service may be low-cost if the healthcare organization utilizes their existing email infrastructure to provide their telemedicine service. When the workload exceeded 5216 email consultations per annum, there were savings made when a purpose-written email application was used.
Many healthcare organizations use commercial-off-the-shelf (COTS) email applications. COTS email applications are designed for peer-to-peer communication; hence, in situations where multiple clinicians need to be involved, COTS applications may be deficient in delivering telemedicine. Larger services often rely on different staff disciplines to run their service and telemedicine tools for supervisors, clinicians and administrative staff are not available in COTS applications. Hence, some organizations may choose to develop a purpose-written email application to support telemedicine.
The researchers conducted a cost-minimization analysis of two different service models for establishing and operating an email service. The first service model used a COTS email application and the second used a purpose-written telemedicine application.
The actual costs used in the analysis were from two organizations that originally ran their counseling service with a COTS email application and later implemented a purpose-written application. The purpose-written application automated a number of the tasks associated with running an email-based service. The researchers calculated a threshold at which the higher initial costs for software development were offset by efficiency gains from automation.
They also performed a sensitivity analysis to determine the effect of individual costs on the threshold.
The cost of providing an email service at 1000 consultations per annum was AU$19,930 using a COTS email application and AU$31,925 using a purpose-written application. At 10,000 consultations per annum the cost of providing the service using COTS email software was AU$293,341 compared to AU$272,749 for the purpose-written application.
The threshold was calculated at a workload of 5216 consultations per annum. When more than 5216 email consultations per annum are undertaken, the purpose-written application was cheaper than the COTS service model.
The full analysis was published by the open access journal
BioMed Central and the full report is available for
free download [pdf].
(Source: BioMed Central, May 22, 2008)
5/24/2008
The home telehealth and remote patient monitoring market is currently close to a $5.6 billion level and will continue to grow at close to 70% for at least the next three to five years, according to a new strategic report published by Insight and Intelligence, a Mary Ann Liebert company. Insight and Intelligence interviewed industry leaders, conducted surveys, utilized government and other agency databases, as well as reviews of published literature to provide an in-depth look at the home telehealth and remote patient monitoring market segment of the telemedicine industry.
The healthcare provider market segment (companies that provide telemedicine services to health care providers) is represented by a number of small to medium-sized companies with average annual revenue of approximately $6.6 million. These companies' combined average revenue growth, however, is significant, approaching 72%. Consumer companies (defined as companies that provide services directly to the consumer) tend to be larger with combined average annual revenue of approximately $121.3 million. Their combined annual revenue growth is even more explosive than that of healthcare provider companies, with a combined average range of 118.5% to 193.5%.
The full report will be available in late June from Mary Ann Liebert, Inc.
(Source: Mary Ann Liebert, Inc. Press Release, May 22, 2008)5/24/2008
Eceptionist recently announced tthat their Eceptionist platform will be used by Johns Hopkins Medicine International ("JHI") to run its global "Medical Second Opinion" service. JHI's second opinion service gives patients anywhere in the world the ability to have Johns Hopkins physicians review their cases and provide remote second opinions.
JHI will be using Eceptionist's Telehealth and Triage Manager modules to manage the medical second opinion service between The Johns Hopkins Hospital in Baltimore and affiliate hospitals around the world. Eceptionist's Triage Manager is a solution that allows healthcare organizations to manage the request and referral of services both into and out of the healthcare economy. Triage Manager is a cutting-edge tool that organizations can use across multiple enterprises to optimize and efficiently triage patients to ensure that each patient is put on the right care plan and that each service-providing organization is able to optimize its resources. Eceptionist's Telehealth Manager is a platform that organizations use to manage and provide telemedicine services. Telehealth Manager supports virtual and asynchronous telemedicine models including virtual tele-consults, multi-disciplinary team meetings (MDT) and tele-learning.
(Source: Eceptionist Press Release, May 22, 2008)
New Mexico Software, a business and medical information service provider, recently announced that its IMEDCON telemedicine system will be made available to statewide critical care centers under an agreement with the New Mexico Department of Health.
New Mexico State Health Secretary, Dr. Alfredo Vigil recently said, "The Department of Health will be implementing the IMEDCON system from New Mexico Software to increase time-critical communications between New Mexico hospitals caring for stroke patients. Eight hospitals already have installed this important system that allows consulting physicians to review critical patient information and determine appropriate care in a timely way."
IMEDCON is New Mexico Software's web-based service developed to enhance the quality of numerous medical referrals, transports and consultations. The secure, HIPAA-compliant system allows referring hospitals from remote areas to transmit diagnostic digital brain and spine images. IMEDCON provides a way for consulting doctors to aid attending physicians in applying the appropriate care, reduce the initial assessment time and prepare for immediate actions when a patient may need to be transferred to a trauma center.
(Source: New Mexico Software Press Release, May 15, 2008)
MDWebLive.com, offering live video medical consultations via webcam between patients and board-certified doctors from multiple specialties has been launched in Miami by AmeriGroup Holdings, Inc.
The service allows patients the opportunity to interact with their doctors from home, office, hotel or anywhere else in the world. The service is intended for use with non-urgent healthcare related matters such as mild infections, hypertension, thyroid conditions, HIV counseling, men's and women's health issues to name a few. The service also allows for follow-up visits and second opinions and facilitates after-hours or on-call medical consultations.
At $40 per visit, an online doctor's visit represents a significant decrease in the cost of routine medical care. Sessions are recorded allowing physicians to review patient interactions, verify medical information and provide the basis for re-examination of diagnosis.
The site stores patients' medical records, sends prescriptions digitally to reduce handwriting error and coordinates lab work through Quest Diagnostics where all results are appended to your records.
MedMarket Diligence, the leading telehealth research firm, estimated that in 2003, there were 169 million telemedicine care visits that resulted in payments of $6.28 billion. The report adds that as the U.S. population ages, and pressures of medical care costs containment increase, home care will become more important. Because home telemedicine care has proven it can increase the number of patients seen by a healthcare provider by as much as four times, it becomes a more attractive alternative to traditional visits.
(Source: MDWebLive Press Release, May 23, 2008)
Google recently unveiled its health service, which allows consumers to manage their medical records and receive health advice online. The new service lets users create an electronic health profile by pulling together medical records imported from organizations such as pharmacies and lab testing companies. Users also can enter some information themselves. They can then elect to share that information with their doctors and other providers and use a range of online tools to do things such as track the risk of a heart attack or connect to a specialist for a second opinion.
Google said the company isn't selling advertising against the service for now but hasn't ruled it out for the future. In the meantime, the company hopes the service will help business by driving users to its search results and search advertising.
A number of other technology companies, including Microsoft Corp., are trying to help consumers aggregate their paper trail of medical records via the Web and to link consumers to a growing number of online medical tools and services. But it remains to be seen how willing consumers will be to store sensitive personal medical information online. And to start, Google Health is integrated with a relatively small number of major partners, including Beth Israel Deaconess Medical Center and Quest Diagnostics Inc.
Marissa Mayer, Google's vice president of search products and user experience, said the Mountain View, Calif., company is aware of the sensitivity of the information it is collecting and has taken steps to protect it, including beefing up security on the servers where records are stored. Consumers also can decide which medical organizations can read and send updates to their profiles, and can tailor the permissions for different providers.
(Source: Wall Street Journal, May 20, 2008)
Electronic prescription industry stakeholders recently sent a letter to congressional leaders in response to an earlier letter from the American Medical Association to Congress that called for the federal government to complete all national technical standards to support electronic prescribing by the end of 2009.
The AMA letter noted that the Centers for Medicare and Medicaid Services in April issued a final rule adopting three standards to support formulary and benefits, medication history, and fill status notification components of e-prescribing. But the AMA called for quick action on three additional standards covering medication instructions, standard terminology and real-time prior authorization. "So, it really is essential that these three incomplete standards be finalized and fully functional in order to realize the truly robust e-prescribing benefits sought by so many," the AMA letter stated.
But the recently letter to Congress from pharmacy, hospital, physician, insurer and vendor organizations contends that the lack of additional standards presently is not a barrier to physician e-prescribing adoption. The letter cites that an estimated 100 million electronic prescriptions will be successfully processed during 2008, nearly three times the volume last year.
The technical requirements for e-prescribing exist today, according to the letter. "Despite its newfound popularity as a talking point, the assertion that the U.S. healthcare system somehow lacks uniform or complete e-prescribing standards, or that those standards have yet to be adopted broadly by physician technology vendors, is simply not accurate."
Additional standards do remain in development, letter authors noted. "When ready, these additional standards will allow more advanced functions and features to be added to existing e-prescribing systems," according to the letter. "However, they are by no means preventing any physician, pharmacist or patient from realizing the substantial and measurable benefits associated with e-prescribing today."
Further, "Lack of uniform technical standards is one example of an e-prescribing barrier that is based entirely on perception," according to the letter. "In this case, misperception."
Signers of the letter include numerous pharmacy chains; the National Association of Chain Drug Stores; National Community Pharmacists Association; National Council for Prescription Drug Programs; CIO John Glaser of Partners HealthCare System; CIO John Halamka, M.D., of Beth Israel Deaconess Medical Center; Mark Frisse, director of regional informatics programs at Vanderbilt Center for Better Health; Lifespan, the ERISA Industry Committee; Rhode Island Quality Institute; Southwest Medical Associates; SureScripts and WellPoint Inc.
(Source: Health Data Management, May 23, 2008)
5/9/2008
The Medical Missions for Children charity (MMC) recently announced that will treat its 30,000th child via telehealth in June. The organization has created what it calls the Global Telemedicine & Teaching Network to enable U.S.-based doctors to consult with foreign pediatric physicians through a distance-medicine network called the Telemedicine Outreach Program so they can help diagnose and treat children worldwide. Technology also has allowed MMC to expand its services to include educational content for health care providers and patients in multiple countries.
"MMC fulfills a host of health- related needs throughout the world," says Alberto Salamanca, the Mexico-based president of MMC's Latin America region. "Technology has proven to be the most important tool to carry the mission and vision of MMC."
Medical Missions for Children is a nonprofit organization that uses technology to disseminate medical care and knowledge from the U.S. to medically underserved locales around the world. Its annual budget is US$15 million, 90% of which goes to technology costs. Project champions include MMC co-founders Frank and Peg Brady, and President and COO John Riehl.
The organization has 18 full-time workers, with 10 in technology-related positions. MMC has saved thousands of children's lives while also spreading medical knowledge around the world, thereby allowing local doctors to use their new skills to more effectively treat other patients. It allows participating hospitals in developing countries to contact medical specialists from U.S. hospitals to help diagnose and treat severely ill children. The consultation is done through teleconferencing, obviating the time and expense of travel.
Frank Brady says there's a dire need for such services. One out of every three children who comes to MMC has been misdiagnosed, and 85% of the properly diagnosed patients need their treatments adjusted.
MMC's first case linked doctors at St. Joseph's Children's Hospital in Paterson, N.J., where MMC is based, to physicians in Panama treating an 8-year-old boy with a cranial deformity.
Brady used about $100,000 from his retirement savings to buy Polycom Inc. teleconferencing equipment, which included integrated diagnostic equipment in addition to a monitor, a camera and speakers, for the Hospital del Ni�o in Panama City. He also bought a Polycom setup for doctors at St. Joseph's.
"We showed it could work, and we started putting it in hospitals around the world," Brady says.
The MMC network now connects volunteer doctors from 27 Tier 1 U.S. hospitals with pediatric health care facilities in 108 countries. In addition, MMC now operates a global satellite and IPTV network called the Medical Broadcasting Channel, as well as the Global Video Library of Medicine and the Giggles Children's Theater, which brings entertainment to pediatric patients in the U.S.
"It's a great humanitarian use of telemedicine," says Craig Stephens, an associate professor of biology at Santa Clara University in California and chairman of the judging panel for the health category of The Tech Museum Awards program, which is administered by The Tech Museum of Innovation in San Jose. MMC was a 2006 Tech Museum Awards laureate.
As it grows, MMC's IT needs remain very similar to what they were in its early days, says John Riehl, MMC's president and chief operating officer.
However, compared with earlier tools, today's teleconferencing equipment supports much richer interactions among doctors and offers more-advanced diagnostic capabilities. For example, cameras can provide magnified views of the skin, and scopes can look into patients' eyes and noses.
MMC has also started employing high-definition videoconferencing equipment, which can be used to view digital images, Riehl says. This gives doctors real-time access to MRIs, CT scans and X-rays, without loss of image quality.
"They can look at the same image at both locations with quality that allows them to draw diagnostic conclusions," Riehl says.
Improvements in equipment haven't addressed all of MMC's challenges, however. Brady says there are times when MMC must send its own staffers to foreign hospitals to set up equipment because of a lack of on-site expertise. The World Bank, which provides equipment for hospitals around the world, also helps install MMC's equipment. Polycom has also provided support to hospitals, Brady says.
Cost and access to bandwidth can also be challenges.
For example, in late 2005, MMC started working with Armenia's National Institute of Child and Adolescent Health. When MMC was negotiating for high-speed Internet service with Armenia's sole service provider, the ISP initially asked for $7,500 a month before agreeing to $500.
Despite the cost, the return is significant. Dr. Konstantin Ter-Voskanyan, a pediatric cardiologist and president of the Armenian Association of Pediatric Professionals, says MMC collaborated with local doctors on seven cases in 2007, and the collaboration saved several lives by allowing doctors to make the proper diagnosis and set up the right treatment.
Frank Brady started his tech-driven Medical Missions for Children organization with an old-fashioned tool: person-to-person networking.
"When I want to meet with a chairman, I just keep on talking to people until I get the right introduction," Brady says. "Even our trustees aren't trustees because they give us a lot of money -- it's because I value their Rolodex. I'm able to get to a whole lot of people that way."
Indeed, Brady's ability to build his organization relied as much on personal contacts as it did on IT connections. For example, a friend introduced him to Alberto Salamanca, who at the time was head of the Bolivian mission to the United Nations. Salamanca introduced Brady to Ambassador Mary Morgan-Moss, deputy permanent representative of the Republic of Panama to the U.N.
Brady says both people were instrumental in introducing him to contacts in Latin America.
"You get a lot more things done if you start from the top and work your way down," Brady says, noting that he uses ambassadors to the U.N. to gain access to -- and persuade -- the first ladies of various countries to be champions of MMC's work.
And even in the cases where the patients died, "the consultation had a positive impact," Ter-Voskanyan says, because the exchange of information helped the Armenian doctors learn how to deal with similar cases in the future.
At the request of the Armenian medical community, MMC also implemented an online environment for continuing education, and it now records and publishes lectures through a portal it hosts and makes those available to Armenia's pediatric health care professionals.
Riehl says that the system's underlying technology is from Accordent Technologies Inc., which donated about half of the tools needed.
"We have always first identified the technology providers that offered the goods and services that best met our needs and then attempted to build a philanthropic partnership with them," Riehl explains.
In addition to using Accordent equipment for its education portal, MMC uses products from Intelsat Ltd. for its satellite broadcast technology and tools from LHS Productions Inc. for its video library and broadcast scheduling setup.
MMC also has had a partnership with Polycom since 2001, when the Pleasanton, Calif.-based vendor named MMC a winner in a contest for innovative use of its videoconferencing equipment. Since then, Polycom has donated money and equipment to MMC.
Says Polycom Chairman and CEO Robert Hagerty, "It's the ultimate example of telemedicine at its finest."
(Source: Computer World, April 28, 2008)
