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Earlier this month the Ohio Medical Board passed two rules that enable physicians to issue prescriptions for both controlled and uncontrolled substances to their patients via telemedicine, rather than in-person at the doctor’s office, given they adhere to an extensive list of rules.

Ohio is another of several states to loosen laws regarding telemedicine to allow for further growth of virtual doctor visit platforms. Most states currently allowing the use of telemedicine for both doctors visits and prescribing medication require the patient to first meet the doctor in person, along with other several guidelines. However, in Ohio the physician must only meet the following criteria to prescribe non-controlled medications:

• Authenticate the patient’s location and identity;
• Obtain consent for remote exam treatments;
• With consent, forward medical records to the patient’s providers or refer the patient to a new provider or facility;
• Meet the minimal standard of care needed for the patient’s condition(s);
• Develop a treatment plan that includes documenting the need for the prescription drug and any contraindications to the treatment plan;
• Document in the patient’s record with all medical information, provided care, patient’s consent, and any referrals made to other providers;
• Recommend or provide any necessary follow-up care for the patient;
• Make the medical record of the visit available to the patient; and
• Use “appropriate technology sufficient for the physician to conduct the above as if the medical evaluation occurred during an in-person visit.”

While most states exclude physicians from prescribing controlled substances via telemedicine, Ohio’s new regulation permits prescribing of controlled substances to a patient located remotely from the provider in the following instances:

• The person is an “active patient” of one of the physician’s colleagues, and the substance is being prescribed through an on-call or cross-coverage arrangement;
• At the time of prescribing the patient is at a DEA-registered hospital or clinic;
• The patient is in the physical presence of and being treated by, an Ohio-licensed physician registered with the DEA;
• The practitioner has obtained a DEA special registration for telemedicine;
• The physician is the medical director, hospice physician, or attending physician for a “hospice program” or “institutional facility” licensed in Ohio and in either instance: the patient is enrolled in that hospice program or institutional facility and the prescription is transmitted to the pharmacy consistent with Ohio board of pharmacy rules.

Advocates for telemedicine note regulations from the federal Ryan Haight Act, which severely restrict when and where physicians can prescribe controlled medications. However, encouraged by the American Telemedicine Association, the DEA is expected to amend the Ryan Haight Act to create a special telemedicine registration for healthcare providers.

Just when you thought technology couldn’t get any better, along comes a healthcare tablet that takes your vital signs and reports them to your doctor. A New Jersey Health Tech firm designed and developed Bluetooth-enabled devices that patients can use remotely to telecommute and teleconference with their doctors. The devices also take your pulse, blood pressure, blood oxygen levels, digital weight (no, you do not stand on the tablet!) and a “stethoscope” feature that can read lung and heart functions.

There’s just one catch- the tablets are currently only available to seniors living in their own homes who live too far away from immediate mediical care to get to a doctor on time. The tablets are part of a home health care group that takes care of these patients and monitors their health regularly. Then the elderly and senior patients can remain in their homes for much longer than previously expected.

The tablets do provide the patients with a sense of security, given their distant locations from doctors, hospitals, clinics and family members. Family members are also comforted by the fact that these tablets can send them alerts to their connected phones anytime there is a serious health concern with their elderly relatives.

Of course, the patients do have to “opt in” to notify certain family members of their immediate health concerns, but it is something that definitely could cut rescue help time way down because the patients data would warn everyone before a major health risk occurs. Patients are also able to call for help from the tablets simply by activating the conferencing call feature.

The devices are still in production, so it may be a year or more yet before patients begin receiving their devices in conjunction with this home health care group. As for the rest of the nation, teleconferencing your doctor your vital signs may take a few more years. Until then, a phone call or an office visit may still be the only ways you can talk to your doctor or your doctor’s nurse.

Telemedicine is one of the fastest growing methods of healthcare in America today. Many people use telemedicine for the ease and convenience of not having to make an appointment at a physical doctor’s office. However, as with all types of medical care, there are often some drawbacks. Telemedicine is no exception. Patients are finding out that there are some drawbacks to using the features of telemedicine that they did not realize existed. However, there are some big perks that come along with it, as well. In fact, some that may benefit not just consumers, but also providers.

In a recent article on MedPage today, a payer cannot legally discriminate against clinicians who provide care via telemedicine. This is probably one of the best-kept secrets about Telemedicine that is not widely known about to many people. Not that the clinician themselves is discriminated against, but more the service. Especially, in instances where the consumer pays for the service up front and is later reimbursed the fee that they paid to the telemedicine provider.

It does not matter whether the type of telemedicine is provider to provider, remote monitoring, or provider to consumer. The laws are regulated in the state where the patient is located. A prime example would be with provider to consumer. Let’s say that the medical provider is in a remote area far away from where the patient lives. They are treating the patient via telemedicine rather than a traditional brick and mortar medical office. Neither the patient nor the insurance company can dispute the treatment just because it is given to the patient via telemedicine.

In other words, the patient cannot refuse to pay for services. Nor, can the insurance provider refuse to either pay for the service to the telemedicine provider. They also cannot refuse to reimburse the patient the fee they may have paid upfront just because the care was provided via telemedicine. This is a profound law that makes the insurance providers responsible for covering more services.

One of the biggest problems for people with serious medical conditions is being unable to leave the hospital, which can make their pain, their depression, and their feelings of anxiousness all the worse. As a result, doctors and other medical professionals have been using a wide range of tools and methods to combat the problem, with the latest example being virtual reality.

In brief, Cedars-Sinai Medical Center in Los Angeles, CA has been helping their patients cope with chronic pain by delivering content to them via virtual reality. Some of the content is exotic in nature whereas the rest is much more familiar in nature thanks to the 360 degree cameras brought to the patients’ homes by their families.

Unfortunately, there is no systematic data comparing the effectiveness of virtual reality to the effectiveness of its 2D counterparts at the moment because the randomized trials are still ongoing, but some interesting insights have been revealed so far.

For example, a smaller study under controlled circumstances has revealed that virtual reality devices seem to be better at alleviating pain than their 2D counterparts, as shown by a reduction of the self-reported pain score from an average 5.4 to 4.1 and 4.8. However, it is important to note that the virtual reality devices were not effective for all of the patients.

Sometimes, this was because the patients had some kind of medical condition that make it difficult for them to use the virtual reality devices, with examples including but not limited to delirium, epilepsy, and nausea. Other times, this was because the patients were uninterested in the virtual reality devices, with older people being likelier to do so than younger people.

Furthermore, the people at Cedars-Sinai have learned to be careful with the content when working with people with PTSD because even what can seem like a harmless choice has the potential to bring up traumatic memories.

Summed up, virtual reality is another excellent example of how digital health can improve outcomes for a wide range of patients. However, it is still in the early stages of adoption, meaning that it will take time to see whether its costs are worth its benefits from an economic perspective as well as work out the best ways to use its potential.

Texas has been undergoing a series of revision of its telemedicine regulations. It is among the last states which have mandated that in-person relationships between the medics and the patients be enhanced before offering telehealth services. Several bills have been debated upon, all with an intention to harmonize these regulations.

For a long period, it has been a requirement that the physicians should meet their patients physically before administering any telemedicine services. While it appears safe, especially because the patients relate with their doctors face-to-face, it is also quite inconveniencing as it is not all that necessary.

The truth remains that the medical telemedicine services reach the patients as efficient as they would if the doctors met them in-person.

The battle against telemedicine rules in Texas kicked off in 2011. It began shortly after the state’s medical board warned the health practitioners of losing their licenses if they failed to establish the in-person appointments with their patients before making any other transaction like prescribing medicine online or over the phone.

Since then the board has been trying to amend the laws to enhance these restrictions. Despite the strict regulations, some telehealth companies objected to these rules saying that the board’s intention was to curtail their services.

Texas telemedicine advocates and medical groups have relentlessly held discussions with an attempt to lighten the weight of these rules. Among the many things they want to be implemented is the reduction of the strictness of the medical board regulations and the harmonization of the telemedicine prices.

They also seek to enforce a modernization of the state’s telemedicine services which they say that majority of them are outdated. With the implementation of their recommendations, telemedicine services will become much smoother for the physicians translating to more satisfied patients.

Many hospital councils in Texas are also in support of the bipartisan bill to eliminate the regulations saying that if implemented, it will be of great benefit to all Texas residents.

Telemedicine Gives Rural Hospitals 24 Hours Availability

Kings county memorial hospital was forced to reduce its emergency hours from 24 hours to operating from 8 am to 10 pm last year which did not go well with the residents. The officials are now considering the use of telemedicine technology in the hospital so as to keep the emergency department open for 24 hours a day. The hospital is a small community hospital with 30 beds. In July last year, the Montague town council supported a local business man’s idea about telemedicine.

Ray Brown told CBC News that the technology was already there and it is nothing they had to worry about since it had already proven its capabilities. The project was estimated to cost about $20,000 to $28,000.He termed the technology as the best available in the world. He compared the case of a person who falls ill at a space station and is immediately attended to through telemedicine and wished the same done for Montague.

The small hospitals in North America have been facing competition from the online telehealth platforms, retail health, and urgent care clinics. Some hospitals like St. Luke’s Cornwall Hospital and the Baptist Hospital in Orange, Calif shut down the emergency departments due to business decline since many patients now depend on telemedicine.

It is ironic how small hospitals are striving to get telemedicine programs in their hospitals to enable emergency activities to keep on for 24 hours and to enable their patients to get health care near their homes while large hospitals are doing it to boost their businesses and reduce stress in the emergency department.

Research by the University of Mississippi Medical Center showed that if small hospitals adopted this technology, they would save their staffing cost by a quarter and increase patients’ admission by 20% since they will now keep the patients they could have transferred to the large hospitals.

According to Montague Town Councilor, JIM Bagnall, telemedicine is not something new as it has been used in other parts of Canada and it would be a great opportunity for the residents of Prince Edwards Island.

Improved Education System with Telemedicine

Telemedicine, which is mostly used in prisons, nursing, and remote areas has become more beneficial even to school students. Sick students do not have to miss their classes like they did before whenever they got ill and had to be rushed to the doctor. The American Telemedicine Association revealed that at least 18 states had authorized reimbursement for Telemedicine services in schools and 28 of them requires private insurers for telemedicine appointments.

Last November, at Ducketts Lane Elementary School, a second grader student got ill and had trouble breathing. Veronica DeSimone who is the school nurse did some examinations on the girl and diagnosed that she was having an asthma attack.

Like the norm, the nurse could have administered some medication to the girl to save time, but the parents had not yet signed the authorization form and had not delivered the kid’s medication to school. Moreover, the child’s father was busy, and it could take time for him to get the girl from school. Also, the nurse could have called an ambulance to take the girl to the emergency room, but this would force her to miss the rest of the day’s classes.

Things got easier with the school’s telemedicine as the girl’s parent had authorized permission for participation in the telemedicine program. All the nurse had to do was to set up an online video and audio link to an emergency pediatrician from Howard County General Hospital, then examined the girl with a digital stethoscope and the pediatrician was able to listen to the girl’s lungs from her station. The doctor diagnosed the girl and directed the nurse on which medication to administer to her, and within 10 minutes, the girl was okay and back to class.

Educators and lawmakers in the country have said that telemedicine is a game changer in matters concerning the children’s health. It will help to keep them in school which will improve their education outcomes.

According to David Monroe, a medical director at Howard County General’s Children Center, telemedicine is more efficient than the face-to-face children examination. He said that the images provided by telemedicine equipment are better than those from conventional instruments.

Telemedicine has become vital for people who have diabetes. A study has shown that those patients who cannot get a chance to visit their doctors but use telemedicine still benefit and helps to improve blood glucose levels.

After a research was conducted, there was a suggestion for texts and portals to be improvised, expressly meant for patients with diabetes. They can be sent short text messages to motivate them and encourage them never to lose hope. This can bring in better and positive outcomes.

There was a random system review conducted by Marcello Tonelli, MD, SM, and his colleagues from the department of medicine at the University of Calgary, Canada, meant to determine the impact of telemedicine compared to the other health care methods in people who have diabetes.

With telemedicine, communication was done by text messages, images, and voice and by the clinical decision-support system but when it comes to health providers; contact was made only by voice, transmission of data and text messages. The care provider’s method was more efficient as it reduced HbA1c in less than three months.

In general, there were 23 studies conducted, that used instruments to give results on quality life. Some of the tools used included Diabetes Distress Scale, the Problem Areas in Diabetes, Diabetes Quality of life, social functioning, physical functioning, the European Quality of Life Survey with Five Dimensions and Hypoglycemia, which represented the percent of individuals affected.

According to the reports, the study that showed highest improvement was in the Problem Areas in Diabetes score with telehealth with a difference of 2.86 mean within 4-12 months. The worst performed study was in social functioning, physical functioning and European Quality of Life Survey with Five Dimensions.

No proof showed that telemedicine had an impact on hypoglycemia and severe hypoglycemia studies. The systematic review showed that this technology will have a significant impact and will act as a supplement to the usual clinical care control HbA1c. However, the method will be more efficient if more interacting tactics are used on patients such as portals and text messages as it can help them in self-management.

The Massachusetts Institute of Technology (MIT) and over the counter drug manufacturing giant GlaxoSmithKline Plc (GSK) recently launched an app to aid their researchers to monitor flu conditions and symptoms digitally. The new app, Flumoji, runs on an Android platform and is meant to track data from different individuals using crowdsourcing applications.

Consumers can then monitor their flu conditions relatively faster and share data with other app users including MIT and Glaxo researchers. The main aim of using the app is to try and identify flu outbreaks in a faster way than having to wait for reports from health practitioners who report to the Centers for Disease Control and Prevention (CDC) after testing numerous patients for flu-like symptoms. Patients can share updates with family and friends on Facebook.

Flumoji asks its users questions in the line of symptoms, mood, activity and how they feel. It then allows them to share data with each other and designated friends on Facebook. The data is later used to calculate for fluctuations and analyze if the symptoms may lead to the flu-like an outbreak in a particular region.

According to Glaxo’s spokeswoman, using real-time data from users is an efficient way of identifying flu outbreaks, and it is enough to carry out clinical trials and potential flu treatments.

Flumoji has close to 5000 downloads on the app store, and its reviews are calling for fixing of a few hitches such as battery and data consumption. The MIT connect science branch, however, reports to continually improving the quality of the app with every version it launches.

Glaxo also has a similar app for tracking cold and flu (available for download on weather.com and Theraflu.com) for iPhone, iPad and Android users. Unlike Flumoji, this app uses social media updates to notify the users of any impending flu and cold outbreaks. Users can use the app to read local and previously analyzed CDC flu data. Glaxo’s spokeswoman noted that the drug maker is looking to expand into digital healthcare.

The Excellus health insurance is expected to unveil digital doctor visits in different parts of the country. The insurance company which covers 1.5 million in New York expects 50,000 visits to the telehealth service scheduled to be launched soon. Excellus will introduce a telemedicine program come January which will entail MDLive Medical group services. The program will have 800 doctors.

Excellus is excited about the news and expects to receive many calls. If an individual has a minor medical condition, s/he is supposed to see the doctor, but if the doctor is not available, he can offer a telehealth service. Fortunately, if that is not available, other providers like MDLive can provide the telemedicine service successfully and prescribe medication where required.

The program is set for all insured members of Excellus and all plan members. The program will be beneficial to those people under Medicare Advantage too. This program offers consumers more medical choices. Telehealth payments will depend on the amount of every member’s coverage in Excellus. Some members will pay more than others based on whether they have coverage in the insurance company.

Although people need health-care from a doctor, they should also realize that technology is advancing and will have a great impact on the health-care system in New York. The system is affordable for all residents in New York. The program will reduce the many emergencies in hospitals since most of the emergency visits are common conditions such as ear problems, but with telehealth, the situation can be addressed before turning into an emergency.

This program will be introduced as a result of the information gathered after an internal pilot project showed that a lot of their employees were interested in the program. This program is a medical alternative, and it is expected to gain popularity in New York. It will allow people in rural areas to get the medical attention they deserve. It will also be of help to patients who cannot get time to see a doctor due to their occupation or family matters.