Category Archives: Telemedicine

Residents of North Carolina now have access to a secure, HIPAA-compliant, medical service – all available from the comfort of their homes. This new telemedical service, called RelyMD, connects patients to doctors through a secure videoconferencing line. Patients are diagnosed, prescribed medicine, and are able to have their prescriptions renewed, all without leaving their house. For those who are very ill, or have mobility challenges, this service is a godsend for medical treatment.

This service was launched three years ago by emergency medical doctor Bobby Park. He now sees patients every day. “It is really convenient especially when you have bad weather, you can’t get to the physician’s office cause they’re closed,” said Park. For those suffering from the flu this winter, yet trapped due to icy and treacherous roads, this is a safe way to receive necessary treatment.

Patients can access the service online through their laptop or desktop, along as they have a webcam, or through an app on their smartphones. Just make sure that you are video-conferencing capable, and you’ll be seeing your virtual doctor in no time.

Patients that have used the service report short wait times, and a comprehensive, yet not lengthy, doctor visit. Sick children were able to be examined in their pajamas, and families didn’t have to brave the snow and ice in order to have urgent care needs to be met. RelyMD is like a twenty-first-century house call.

The process is similar to Facetime, and even physical exams can be conducted with the video capabilities. All transmissions are through a secure website and any conversation or video recording is protected under HIPAA privacy regulations. Many times, the physicians able to give patients clear direction to conduct the exam through the video link.

Doctor service is not covered by insurance, but the prescriptions from the physicians should be covered under your existing insurance plan. Anyone in North Carolina with the technical requirements can access RelyMD. Each patient visit costs $50.

Telemedicine has proven to be a highly effective means of improving care quality and access in rural areas. According to a recent study by the University of Iowa, patients were seen six times more quickly at rural hospitals using telemedicine in their emergency department than in hospitals without a telemedicine program. Many rural hospitals and healthcare systems are currently using telehealth programs in their emergency departments to triage patients, reduce wait times, and extend care into rural or remote areas.

Telemedicine has the ability to replace in-person visits to a physician’s office, an approach that expands access to care. It also reduces the amount of time a patient spends in emergency departments(ED). With the help of the ED physicians on site and an added telemedicine physician, patient care is significantly expedited. Often, on-call doctors cannot arrive immediately to see patients, but through sound and video technology they are available at the push of a button to assess patients and initiate care.

Patients are connected to off-site physicians who can begin ordering labs and other tests before a patient is even taken back to a treatment room so that by the time they get into the room, a lot more information is available. This helps to treat people faster and get that next patient into a room while providing an enhanced patient experience to all who visit the ED.

Rural hospitals that use telemedicine in their Emergency Departments have significantly reduced workforce shortages and the burden on patients who might otherwise have to travel long distances for specialty care. It has enabled patients especially those with critical time-sensitive conditions to have remote consults with specialists (who are mostly absent in rural communities).

Though telemedicine has dramatically improved rural health care, the loss of net neutrality could slow telehealth access. The move to repeal the net neutrality rules could have serious ramifications for telehealth services, particularly in rural and underserved communities. Not all health systems will afford to pay for bandwidth access resulting in a weakened ability to provide quality care.

Telemedicine allows healthcare professionals to evaluate, diagnose, and treat patients remotely – and it has been an essential benefit in obesity management. With telemedicine, patients can have direct access to diagnostic tools and assessment with less time and travel, all while having their privacy respected. For the healthcare provider, telemedicine provides improved efficiency, and better patient follows through.

Telemedicine and Weight Loss Management

Healthcare coaching via telemedicine has been noted to be effective at reducing body weight in obese adults. Programs that use telemedicine combine three key elements that have helped support sustainable weight loss: a low-calorie diet, the remote monitoring of physical activity, and on-call support. The most equipped dietitian won’t always be live to help a patient with their nutritional questions or whenever they feel like they have plateaued. Telemedicine has galvanized the relationship between healthcare provider and patient.

The Studies

A study published in the Journal of Telemedicine and Telecare, observed the effects of telemedicine on those going through a weight loss journey. An intervention group lost an average of 7.16% of their weight, while the juxtaposed control group only dropped 1.5%.

A total of 30 participants between the ages of 23 and 64 were enrolled in the study. The results showed that 25 participants completed the study, did not have any metabolic ailment, and weren’t using any sort of medication or supplements that could have inadvertently affected their metabolism. Everyone completed a 12-week telemedicine weight loss program, which included a blood pressure monitor and a body composition scale. These peripherals monitored real-time feedback.

Assessments were delivered remotely via a video conferencing app. Doctors were able to use this form of telemedicine to assess a weight-loss journey of 1 to 2 pounds a week. Patients were assigned a health coaching via the telemedicine, while the control group had none. The intervention group also had access to an online curriculum that addressed weight loss goals, triggers, and goal setting.

The results. The study has found that most people who download these weight loss apps are most interested in monitoring their eating habits, not losing weight. With the help of direct feedback from a healthcare provider, self-monitoring was launched into a production cycle that promotes long-term engagement. Participants that have access to a coach increased overall weight loss, as well as average steps for a week, in comparison to the control group that did not have access to a coach.

Even though there are independent factors like social-economic conditions and limitations with technology, telemedicine has been shown it to be a promising feature in future weight loss management plans.

There has been a predicted low number of cardiologists that is causing the Mayo Clinic to look into telemedicine to try some slightly invasive coronary interventions… one of those happens to include entering stents.

The health system that is based in Minnesota recently made an announcement of multiple phases, multiple year partnerships that will take place with a Corindus Vascular Robotics company that is based in Waltham, Massachusetts. There will be a charitable grant in the amount of $3.3 million that will be funded. This grant will be used to develop a platform for telemedicine that will have a remote doctor that will be able to perform percutaneous coronary interventions or PCIs.

Mackram E. Eleid, MD will lead the stent project, which will be called “telestenting”. He is an Interventional Cardiologist at the Mayo Clinic and works in the Department of Cardiovascular Medicine. He is also an Associate Professor of Medicine at the Mayo Clinic College of Medicine. He will be working with the Corindus CorPath GRX System. The process that will enable a remote doctor to guide a telemedicine robot to be able to conduct the procedure for them.

This is a preclinical project that has the backing of the U.S. Health Resources and Services Administration. They are helping in driving this project, and they have also done a study that shows there will be a large shortage of physicians by 2025… this shortage of physicians will include a loss of 7,000 cardiologists. There will also be a shortage of global specialists that will be able to do PCIs.

“Corindus has made a commitment to develop a cardiovascular model that is high tech and that will be able to improve efficiency, put in the latest technology and it will overall improve the care that patients see” according to comments made in a press release by Mark Toland who is the CEO.

He also feels the platform that was given the U.S. Food and Drug Administration approval in 2016 for robotic-assisted PCI in putting in a cardiac catheterization lab, will, in turn, be able to help with the remote treatment that you will need for endovascular disease and stroke. He also stated that “telestenting is at the core of the strategy that is set forth”.

Telemedicine for Mental Health Treatment

While Texas as a state has been suffering from a shortage of physicians, the same issue applies in prison. This is unfortunate since the need for mental health care is increasing rapidly. Fortunately, there is an alternative for healthcare services. Telemedicine has made everything easy for both the prisoners and physicians.

Take a situation where the healthcare provider is seated on one end, and the prisoner is seated on another, miles away, with a screen, yet the patient can receive the mental treatment required. Telemedicine brings the two parties together without an actual face to face meeting. Before the introduction of telemedicine in prison in Texas, psychiatrists would spend a lot of time in jail which was not easy for them. This is because they have to adapt to the sense of the environment of the prison.

The diagnoses

The telepsychiatry provided to Texas inmates focuses mostly on diagnoses and managing medications, putting less focus on therapy. Telepsychiatry has improved access to continuous care, and it is time-saving allowing the physicians to attend to the patients timely.

There are few problems that physicians face when providing care in person. One of them is transportation. These are potentially dangerous individuals, and they can easily escape once they are let outside the prison which poses a danger to the community. Telepsychiatry minimizes those risks.

Moreover, some physicians feel threatened to be close to the inmates. Seating on the other side of the screen offers them a sense of safety since the patients cannot do anything terrible to them once they feel offended or they do not like the treatment. There have been cases of clinical staff being assaulted and, therefore, having them sitting next to the inmates is dangerous.

Texas has had this program since 1994. The psychiatrists get a list of the patients they are supposed to see virtually before the encounter day. The physician goes through the patients’ records to get prepared for the session ahead of them.

Growth in California

Just like in Texas, California has also been providing mental health through telepsychiatry, and this has proven to be of many benefits to the state. It has helped in eliminating staff shortage while at the same time ensures the provision of quality healthcare services.

Some people are afraid that this program hinders the inmates from experiencing the human touch which could lead to loss of connectivity. This has made some people hesitant in adopting the practice. Also, if the connectivity is reduced, the physician might have to cancel the session due to audio issues. However, most inmates love the program, and in some ways, it creates a secure connection between them even if they do not have a face to face interaction.

Asthma is one of the most common childhood chronic diseases in the United States. In fact, about 10% of all children in the United States have asthma. Although asthma, once diagnosed, can be managed by taking the necessary medication regularly, minority children from low-income families may not have access to these medical interventions. Consequently, such children can end up suffering from life-threatening flare-ups necessitating costly emergency room visits and even hospitalization.

According to the research study that expanded a study previously done by URMC and published in JAMA Pediatrics, asthmatic children taking medication in school under the care of their school nurse are less susceptible to severe asthma attacks.

The study further indicated that the telemedicine component of the program makes it more sustainable and effective since it allows children’s primary care providers to more readily get involved in the children’s care.

The research study involved some 400 children aged between 3 and 10. The researchers divided their sample into two groups. The children in the first group were given an initial asthma assessment and given medication by school-based nurses. The children in this group then received follow up primary care via telemedicine. The children in the second group were only given the necessary recommendations for primary care.

They were not enrolled in the school-based care, and there were no follow-up visits through telemedicine. After the study, it was established that children in the first group were less susceptible to the symptoms of asthma. In fact, only 7% of them required hospitalization or emergency room visit in the course of the study, compared to 15% in the second group.

Jill Halterman, Chief of the Division of General Pediatrics at URMC, indicated that although researchers and clinicians around the country are making deliberate efforts to reach the underserved asthmatic children in their communities, there are still children who suffer from dangerous asthma issues for failing to take their medication regularly.

Fortunately, the integration of telemedicine with the school-based care is significantly enhancing the consistency and effectiveness of asthma treatment among children. This model can, therefore, be employed to children all over the country to ensure that they get adequate asthma treatment at the minimum cost possible.

The New Oklahoma Law about Telemedicine Expands Availability but Raises Questions

With time, telemedicine is increasingly growing in popularity as an excellent option for individuals to receive health care services. It involves an indirect meeting between patients and health caregivers. Recently, the Oklahoma Legislature has passed a new law aiming at making telemedicine more available to individuals across the state.

What is telemedicine?

Oklahoma law defined telemedicine as a means of providing healthcare, diagnosis, treatment, provision of consultation and medical education through real-time interactive communication between the patient and the physician. The services are offered after the doctor has access to and reviews the patient’s essential medical information before the telemedicine visit.

What are the requirements for telemedicine providers in Oklahoma?

The newly initiated law allows telemedicine visits between the physician and a patient in Oklahoma even if it is the first time contact as long as the telemedicine provider fulfills all the requirements of the state. Some of the requirements are;

The provider must be certified and permitted to provide the services in Oklahoma. The provider must show the license document. The provider can be in another state during the telemedicine, but the patient must be in the state of Oklahoma during the encounter.

The telemedicine healthcare providers should provide the patient with their full identity and credentials to prove that they have the required experience. On the other hand, the patients have to submit their identity and location showing that they are in Oklahoma.

The provider must have a system that fulfills all the requirements to conduct telemedicine. A system that only offers means for audio phone calls, texts messages and electronic mail are disqualified.

What restrictions are made by the new law?

The new law has brought up some restriction on telemedicine especially on some drugs such as opiates, synthetic opiates, carisoprodol or benzodiazepine. There has to be a face to face meeting between the patient and the physician for the provider to prescribe such drugs. However, opioid antagonists and partial agonists can be prescribed without a prior face to face encounter between the two parties.

This new law does not specify who else is allowed to provide telemedicine services other than medical or osteopathic doctors. This way, although the law is expanding the availability of telemedicine across Oklahoma, it has left people with some unanswered questions.

Teledoc Drops 2011 Lawsuit as Texas Passes New Telemedicine Bill

Telemedicine, which is the latest medical technology trend, recently got a boost from some of the biggest technology and health firms. Among the companies that have outlined their plans to use this virtual consultation plan in their services are Apple Inc., CVS, and Aetna. With these giant companies on board, telemedicine can now safely take off.

Telemedicine or virtual medicine as it is commonly known consults patients by video or phone, and it has been one of the milestones the industry has achieved. Lack of awareness has been one of the setbacks that this technology has faced over the years. Aetna has merged with CVS to deliver the best in this sector. Aetna’s strategy is not only to enable this technology looks after patients from home, but also to introduce more apps that will help patients when their levels of glucose are low.

Apple, on its part, has great plans for its new heart-health study. In what can be seen as a well-calculated move, this giant electronic company opted to work with American Well, an established telemedicine startup to give access to those who aren’t able to get to the doctor’s office. Apple Inc. through its COO, Jeff Williams had earlier advocated for a virtual medicine when he unveiled their plan for a new heart-health study.

This Apple/Aetna deal has been applauded by various key players in the sector especially the developing crop of venture-driven firms who specialize in home-health monitoring, virtual consultation as well as the creating of digital health apps. This new development has made people aware of a particular technology that has been in existence for quite some time. It provides a cheaper alternative as compared to driving for long hours to reach a health center.

The challenge, however, lies with the adoption. Even though several doctor’s offices and hospitals may begin providing this service, they {services} still remain unknown to quite a number. In addition to that, very few will also find their employers or insurance firms to see if the whole service is a benefit.

Telemedicine is a new concept in the world of internet but it is developing at a very high speed. Doctors running a virtual medical practice is not simple as it encompasses more than just technology. According to Micheal Nochomovits, MD, chief clinical integration and network development officer at NYP the concept of telemedicine is growing and there is need to come up with a sophisticated approach. The execution of the idea is not as simple as it sounds. According to Micheal Nochomovits, telemedicine started out simple handling common diseases such as coughs and colds but it has been rapidly expanding to handle even more serious diseases. This comes with its own set of challenges.

A telemarketing visit is no ordinary video call and should not be taken lightly since it involves serious medical interaction between the patient and the medical practitioner. There are a few standards that have been put in place by different individuals but there has not been an agreement on the basic standards for which to stick to. It telemedicine is successful, there will be people who will solely depend on telemedicine for income. That will be their career. Their typical day at the office will not involve the traditional way of doing things where the patient has to be physically present in the office. However to make this work there is need to have a set of core competences in place. Medical virtualist is the term they have come up with but it is not set since they are still playing around with the name.

Telemedicine idea is new and some fear that this new technology will be disruptive. While the path ahead is unclear, it would not be wrong to say that it is exciting to see the impact that telemedicine will have on the health care system.

OIG’s November Plan on Opioid Prescribing and Telemedicine

Following the previous two work plan publications this year, OIG has come up with another strategy where it will be updating its work plan on a monthly basis. In November, the four plans are;

• OIG will be evaluating the prescriptions for opioids to Medicaid. Their observation was that Medicaid beneficiaries mostly the disabled are more vulnerable to abuse of opioids since they tend to suffer from conditions that require pain relief. OIG will be examining the issue by considering both the prescriber and the beneficiary side. The prescriber may include doctor or pharmacy. The study aims to come up with a baseline of beneficiaries receiving extreme amounts of opioids and identify the prescribers who are giving excessive or too much of opioids to recipients.
• OIG wants to study if Medical payments made for services provided through telecommunication systems fulfilled the requirements of Medicaid. The OIG will determine if all the telehealth services that may be delivered through audios and videos and any services that beneficiaries get through interactive transmissions are all paid for in the required manner.
• The Medicaid Managed Care Organizations (MCOs) will be examined by the OIG to check if it is using Medicaid funds to offer proper care to the Medicaid MCO enrollees. These are funds that MCOs receive inform of capitation payments which come from over 40 percent of federal Medicaid expenditures. The OIG aims to ensure that the capitation rates are set appropriately so that they can provide adequate services to the beneficiaries.
• OIG will be determining the way hospitals are billing for severe malnutrition. The condition is common among the elderly especially those who are seriously ill. Malnutrition can be as a result of inadequate treatment, treatment of a different disease, negligence or general worsening of the patient’s health. Hospitals are expected to bill for the treatment of this condition based on how serious the state is, which can be mild, moderate and severe. Severe malnutrition is a significant complication and increases Medicare reimbursement. OIG will be reviewing the precision of the claims to Medicare for the treatment of acute malnutrition.