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Telemedicine has the potential to transform the delivery of mental health care by allowing healthcare providers to connect with patients better and increase their flow. According to a report by the National Institute of Mental Health (NIMH), an estimated 43.8 million adults in the US (1 in 5 people), experience mental health illness every year. Many of these individuals may also be struggling with multiple chronic conditions, phobias, substance use disorders, and suicidal tendencies, and need specialized care from several providers.

Unfortunately, these needs are met with a national shortage of mental health providers, which results in delayed appointment times and missed consults. Many of these people go untreated leading to deterioration in mental health with serious consequences.

Video conferencing and remote monitoring technology can help alleviate the backlog in appointment schedules and provide mental health patients with faster and convenient services. It is saving both hospitals and patients thousands of dollars each year by making consultation with healthcare professionals available from anywhere. This has increasingly supported patient’s access to psychological services at the time they need it the most, without the potential barriers of having to travel to see a healthcare provider or counselor.

By making consultation with healthcare professionals available from anywhere, psychologists can improve continuity of care and follow-up between visits and establish an emotional bond and rapport with the patient in a more private setting. Patients feel more comfortable and safe when care is delivered in the privacy of their homes as they can avoid the perceived social stigma associated with seeking behavioral health support.

Through the virtual visit model, psychiatrists are able to reach more mental patients in distant locations with even shorter appointment times. Patients should plan ahead of their appointments with any relevant records and information, including prescriptions, and a list of questions to address.

Medicaid programs reimburse for some telepsychiatry services in 48 states. Medicare and several other private health insurance companies also cover telemedicine.

As adoption of the technology grows and consumers’ awareness increases, telemedicine companies need to ensure that the systems they provide allow greater operational efficiencies through appropriate reporting and scheduling options.

The phenomenon of telemedicine has taken the American and international health care systems by storm. Research shows the manifold benefits of this kind of medical advancement, which delivers online diagnosis and treatment of patients via video conferencing and other specialized technologies. From efficiency, to convenience and cost-savings, telemedicine has all the hallmarks of a win-win for both patients and health-care providers.

Particularly when it comes to stroke neurology monitoring care, telemedicine stands out in the state of Massachusetts. In 2012, the Massachusetts General Hospital/Brigham & Women’s Hospital Tele-Stroke network, which continues to operate today, saw impressive results with its 24/7 acute stroke neurology services provided to emergency rooms in 11 counties across the state. This amounted to timely and efficient care for more than 700 patients who may not have otherwise received immediate care due to the many inefficiencies of in-person treatment. A deeper analysis of the Tele-Stroke network’s results in 2012 confirmed its effectiveness in curtailing approximately 400 would-be patient transfers to the state’s university hospitals, saving the Massachusetts health-care system upwards of $2 million. Which state couldn’t benefit from millions in savings?

With positive outcomes like these, some lawmakers are energized to expand telemedicine services in the state. Such is the case with Massachusetts State Senator Jason Lewis, who enacted legislation designed to do just that. Lewis said the law “will ensure parity in insurance coverage for telemedicine services at equivalent payment rates as in-person treatment; streamline the credentialing process for Massachusetts licensed clinicians using telemedicine services within the state; and ensure a uniform and consistent approach when defining telemedicine services.” The legislation has gained widespread support across a broad spectrum of health-care organizations, including the American Heart Association/Stroke Association, AARP Massachusetts, and the Massachusetts Health and Hospital Association, to name a few.

If the results of Massachusetts’ 24-hour Tele-Stroke Network says anything is that more health-care providers (and patients) would do well to get in on it. You’ll be happy you did.

Telemedicine on Vacation Better than Urgent Care or a Hospital Emergency Room for Minor Medical Conditions

The perfect situation for receiving medical care is when you see your doctor in person. However, if your family is away on vacation and one of you falls ill, a telemedicine visit can salvage the vacation for the rest of the household. Telemedicine is usually a substitute to a hospital emergency room or urgent care center for minor medical conditions.

This alternative allows those people on vacation to visit a qualified doctor if they need to address a health dilemma for their children or themselves. Telemedicine, also referred to as remote medical care is a situation where the patient and the health provider are in two different localities connected by a secure video or telephone link.

Univera Healthcare officers predicted that the residents of New York State are expected to use remote medical care over 50,000 times by 2018. The emergence of user-friendly applications for all computerized gadgets, developments in clinical management and many people having health insurance policies that are high-deductible are the primary reasons propelling the remote medical care trend.

Telemedicine services are accessible to anyone, irrespective of having a health insurance or not. However, simple platforms are being established by most health insurance providers to make it easy to arrange for a telemedicine visit. The Univera Healthcare also found that ten medical conditions represented over 2 million annual visits to emergency rooms in the state of New York, and nine out ten appointments could have been avoided or taken care of elsewhere, including a telemedicine appointment.

If you are away from home for a family vacation this summer and one of you falls sick and is in need of medical attention due to minor illness, telemedicine offerings can address most natural conditions and also recommend medication once medically indicated.

Having a simple telemedicine app in your smartphone can salvage your family’s trip this summer. This app will give you access to a certified telemedicine doctor from your place of vacation in case of any medical eventualities.

Thomas Lee, MD, Children’s Hospital Los Angeles Uses Telemedicine To Treat Child Blindness

Armenia EyeCare Project

Many healthcare systems and hospitals have decided to leverage telemedicine to connect patients living in underserved locations with health care providers.

A particular group of pediatric ophthalmologists, subspecialists at Children’s Hospital Los Angeles are using technology to provide specialist care in various developing nations. Their main goal is to kick out preventable infant blindness.

Within the Children’s Hospital, Los Angeles, there is the Vision Center, which is a large multispecialty medical group operating within the facility. This facility works as a referral center for children who are suffering from complex eye illnesses and provides expertise in different pediatric ophthalmologic subspecialties.

Vision Center’s director is known as Thomas C. Lee, M.D., who is also a pediatric retina surgeon. He leads an innovative and professional telemedicine project that focuses on offering remote training for eye surgeons in Armenia. This is done in partnership with the Armenian EyeCare Project –AECP.

Together with a team of doctors, Dr. Lee traveled to Armenia to offer assessment, care as well as programming.

Their main aim is to assist in lowering the rates of preventable blindness mostly experienced in infants. This condition is known as retinopathy of prematurity. According to Lee, the condition happens three times as often in Armenia as in the USA and most western states.

Working with Armenian EyeCare Project for eight years has enabled Lee to understand some of the main challenges specialists face in dealing with complex eye illnesses. He began to diagnose and treat this kind of infant blindness through an affordable online remote training program, and the program has advanced with developments in the sector of health IT.

Since this telemedicine program began in 2009, over 4000 infants have been screened with retinopathy of prematurity. The number of procedures that have been completed to treat the ROP exceeds 309. About 40 operations have been performed so far.

In the beginning, Lee observes that there were certain limitations to this form of technology. Most of these problems were connected to latency since the system had first to buffer the signal before it could operate.

One of the reasons why this is the best option for treating infant blindness is because it enables sub specialists to work with other providers in a cost effective and accessible manner.

A diabetic patient will have a hard time trying to reach the city for a medical appointment. On the other hand, a doctor in Mexico requires a specialist in U.S for opinions. These are the just some of the many examples where telehealth can be of help in improving healthcare.

Two health organizations using telehealth technology in San Diego are the Telemedicine Program at UC San Diego Health and La Maestra Community Health Centers and have given positive reports concerning the invention.

Telemedicine is very convenient especially for individuals who cannot reach their physician probably due to lack of funds or due to their severe health condition, as stated by the Telemedicine Program at UCSD Health’s manager, Lisa Moore.

Moreover, considering a situation of busy people like parents, they need to work and also take care of their kids. It gets hard for them to work and take their children to the doctor, and this is where telemedicine comes in. Telemedicine provides them with access to see their doctor at anytime from anywhere.

The primary goal of telemedicine is to make health care more convenient and accessible for all patients. It is the same objective that drives telemedicine at La Maestra. It has four main clinics and two school based sites. They serve patients below the poverty level. Also, they serve patients who speak about 30 languages and dialects and therefore, they are trained cultural liaisons to assist them in the telehealth process.

The two organizations” leaders have overseen telemedicine as a success in healthcare. They believe that it will bring in positive results and will make things much easier for both the patients and the physicians. A study showed that previously, most patients did not turn up for appointments with their doctors. Some gave excuses like language barrier while others complained of the lack of funds, but this was going to end.

With telehealth, patients will have a video visit with a physician who speaks their language, and this reduces the no-show rate. The rate went down from 50% to 13% in the first year which is a great achievement for the health organizations. This will help in both primary and ICU health care where the patient is in severe condition.

According to a new study by TransUnion, two-thirds of hospital patients are not paying their hospital bills in full. TransUnion also suggests that, by 2020, this number may rise to 95 percent. This seems to be mostly due to the increase in deductibles that came with the Affordable Care Act. However, it must be noted that while the act did increase deductibles, it has also given more people access to health insurance.

This could have long-lasting consequences for many hospitals across the country. According to The North Carolina Rural Health Research Programs, 79 rural hospitals have closed between 2010 and the present. According to reports, hospitals in states who chose not to expand Medicare with the Affordable Care Act are under much higher pressure to either expand profits or close compared to hospitals in states that did expand Medicare.

John Yount, the vice president of product within the TransUnion’s healthcare division warn that this number will only increase if more and more patients choose or are not able to pay their bills. Yount believes the healthcare industry should both move to an outcome-based payment structure and help keep healthcare costs down in order to help keep hospital closures from happening, as studies show that the main reason that patients do not fully pay their hospital bills is due to the high healthcare costs. In fact, it has been reported that 99% of patients with hospital bills that total more than $3,000 do not completely pay their bills.

With this said, even though healthcare costs are high, hospitals are not making an overabundance of profit. Currently, hospital profit margins range from two to four percent, and that margin tightens when patients refuse or are not able to pay their bills. Lastly, while the repeal of the Affordable Care Act currently seems dead in the water, future healthcare laws and provisions may increase or decrease the severity of the aforementioned hospital related financial crises.

Telemedicine involves remotely treating and diagnosing patients. A study in the North Carolina Medical Journal has proven that patients who suffer from type 1 and type 2 diabetes benefited from a telemedicine program.

Working with over 10 care facilities in North Carolina, between the years of 2013-2016, the program featured a diverse group of physicians, psychologists and physical therapists who worked alongside the patients. The program also worked with pharmacists at critical steps along the way, treating formerly neglected patients whose type 2 diabetes had been allowed to run its course, without proper medical treatment.

The majority of these patients lived in rural areas and were unable to locate adequate health care practitioners. The Health Resources & Services Administration of United States sponsored the telemedicine program.

The patients engaged in multiple teleconference appointments, working with the health care team using telemedicine systems for various assessments. The patients were studied for adherence, insulin injection techniques and their general knowledge of diabetic conditions. Pharmacy experts were able to analyze the data within the patient’s medical records to further assist patients in knowledge of glucose and proper usage of diabetic medications.

Patients became knowledgeable about specific medications and correct self-management techniques, including addressing proper dietary issues and exercise techniques. The pharmacists worked on improving various aspects of the patients care plan, working on lifestyle interventions and condition monitoring.

Health care practitioners from a multitude of disciples would all focus on a single patient together and indicate effective interventions. Dietitians worked with pharmacists to create effective diet and insulin coordination efforts.

More than one thousand telecare visits were coordinated over the span of the program, and over 350 patients were assisted, with an average of 3 to 4 appointments per patient.

Health information such as weight, hemoglobin counts and lipoprotein densities were reported by the health team. They found that the majority of the patients showed signs of depression. However, towards the end of the study more than two thirds of those same patients noted a general improvement from these symptoms.

The same health care team was able to make comparisons between the telemedicine treatment and personal care. The results were almost identical.

Research has proven that there is no difference between the safety and efficiency of the telemedicine treatment and the official clinic visits for a chronic headache. A headache is one of the most common neurologic disorder, yet most people do not receive adequate treatment. The good thing is that a new technology is now available to diagnose people through telemedicine, but there have been various studies to determine if it is effective like the in office visits.

This study involved 402 individuals who suffered non-acute headaches or a problem that came gradually. These were people who were referred from a primary care physician to a neurologist. Half of the patients had a traditional office visit at a hospital, and the other half went to the hospital but saw the neurologist through a video call. The participants were asked to take questionnaires about the effects of the headache on their daily lives and also about the level of pain at the start of the study and after three months and after a year.

The researchers said that there was no difference between the patients treated via telemedicine and those who had clinic office visits.

This study, known as a non-inferiority study is designed to show that the new treatment is not clinically different from the traditional type. To conclude the safety of using telemedicine, researchers checked whether the participants experienced a secondary headache a year after the practice. A secondary headache means that it is a sign of another underlying condition.

The researchers imagined a situation where a patient has to travel for 40 km to the airport to reach the nearest airport and then take a flight to go for a consultation. There could also be other barriers like weather conditions which would prevent the patient attending the meeting.

The northern England covers a large area covered with mountains and valleys and thus, patients traveling to see a doctor can be challenging and cumbersome and expensive for many individuals. Telemedicine will be helpful and convenient to everyone suffering from headaches and wishes to see a specialist without any hassle. This will help in diagnosing and treatment of the condition before it worsens.

There has been a bill amendment that limits the time needed to create the doctor-patient relationship under the telemedicine technology. The bill states that the doctor and the patient should have a face to face meeting first before moving to the telemedicine platform.

This change was impelled by a group of physicians who do not have enough faith in telemedicine. This change caught the attention of the ERISA Industry Committee (ERIC) which is a national association that supports the large employers on the retirement, compensation and their health policies. The organization presented a written testimony in favor of the bill before the public hearing which was held on June 12, but it later withdrew its support on June 16 after having a thorough review of the amended bill.

The doctor-patient relationship is vital yet very tricky in telemedicine. Some doctors and doctor’s groups’ argued that new patients should meet with their doctors in person before switching to telemedicine. This debate caught people’s attention, and it obstructed the American Medical Association’s efforts to abstract ethical rules for telehealth until last year when the organization agreed to a document that was in favor of telehealth.

After the passage of this bill, Texas became the last state to eliminate the law that requires doctors to first have a face to face meeting with their patients before applying telehealth. Telemedicine advocates were happy with this decision since they argued that in-person meeting requirement limited the under-served communities from accessing telehealth.

Telemedicine is of many benefits to the residents of Texas as it saves time by minimizing the time that would have been spent by patients attending health centers to meet their physicians. It does a great favor to working individuals who strive to balance between working hours and time for family. This applies to busy parents who lack time to take their kids to health centers.

Telehealth also makes it easy for people living in rural areas to access health care. The elderly and retirees, disabled and those experiencing language barrier problems are also among the primary beneficiaries of these services. Individuals suffering from chronic conditions and transport problems are also beneficiaries of telemedicine. These benefits will be eliminated if telemedicine can only be applied to persons with a pre-existing patient-doctor relationship.

However, this bill excludes the use of electronic mail, audio telephone conversation, phone texting from being applied to telemedicine. The two-way communication is only allowed when combined with a store and forward technology; otherwise, people have to use video calls exclusively. The goal of telemedicine is to expand access to easy and affordable health care and ensuring high-quality services to patients.

The capabilities of hospital-based telemedicine and remote patient monitoring have significantly revolutionized the healthcare industry in recent years. Hospitals are rapidly increasing their remote patient programs citing decreased expenses, routine patient visits and hospital admissions.

According to a report by Berg Insight, there are about 7 million patients under some form of remote monitoring, a 44 percent increase over 2015. The use of healthcare remote monitoring systems has enabled physicians to track patients’ vital signs in real time from locations away from the hospital.

Patients use a medical device to track their health progress and forward their responses regarding their illness to health care professionals for remote assessment. The telehealth technology has helped many including the elderly or those recovering from major injury/illness to benefit from the convenience of decreased frequent doctor visits, access to better health and increased quality of life right at the comfort of their homes. Remote monitoring, therefore, ensures full recovery of patients without the need for any readmissions and other avoidable hospital expenses.

Thanks to the telemedicine technology, St. Vincent Hospital has begun to see patients at two new kidney transplant telemedicine clinics located within rural communities in Indiana. “Patients will only have to travel to Indianapolis for their initial transplant surgery and immediate post-transplant follow-up care”, said the hospital’s Abdominal Transplant Program Executive Director Mary Ann Palumbi, RN. Patients can receive care closer to home without having to endure lengthy drives and hospital stays.

Managing chronic conditions like cardiac disease, respiratory issues, and diabetes has become much easier as patients can be continuously monitored and catered for in case of slight deviations from their anticipated recovery. Whether it’s presenting their vital signs, or a graph of trends over time or just a summary of their daily care outlook, remote patient monitoring programs allow a patient to get that daily information and support that can make all the difference in the world in regard to their health outcomes.

More hospitals should be encouraged to embrace remote patient monitoring as it has proved to have the power to change the way we provide and receive healthcare.