Category Archives: Telemedicine

A business that is not lucrative is one that engages in unlawful web-based pharmacy network that has been dispensing unapproved, unfettered prescription drugs internationally for over a decade.

In accordance with The Hindu Businessline, Mape Advisory Group an investment banking firm is co-financing a new enterprise (“Netmeds”), which is set to get underway this week, from the Group of Companies known as Pradeep Dadha. The new online pharmacy venture from the PDGOC’S pledges a 24hour delivery of medication to any place in India, and Pradeep Dadha expects that by 2020 his company will be worth billions of dollars.

Does the Mape Advisory Group want to put their money in a venture that is engaged in unlawful online drug transactions?

LegitScript’s experience with PDGOC is based from one of its prohibited Internet pharmacy ventures: the InternationDrug Mart group of unlawful web-based pharmacies. Amid its other business ventures, Pradeep Dadha and his business acquaintances have run or supplied medicine for many years to many unscrupulous Internet pharmacies, like internationaldrugmart.com. Test buys by LegitScript have found out that in the past the venture has supplied medication to criminal gangs in Russia like the RX-Partners.

Under the pretext of various companies, counting TDP Healthcare Logistic, TDP Technologies and Global Healthcare Limited, Dadha currently has a substantial presence in the telemedicine world, maybe most noticeably via InternationalDrugMart. LegitScript presently scrutinizes over 90 online illegal websites related to Dadha and his many businesses, with many others being closed through our free of charge registrar notification program or concluded through natural wastage, characteristically then put back with new domain names.

Whatever kind of a fine investment an online pharmacy trade may or may not be, it is rare to see one that affirms part of its company model on failing to conform to pertinent laws and directives as a good bet.

Even though most websites ask for a prescription, LegitScript has in the past ordered prescription-only drugs from InternationalDrugMart without a compelling prescription. Additionally, the medicine was ordered to be shipped to states where Dadha’s “pharmacies” are not fully accredited.

Considering the false PDGOC’S online pharmacies adverts , the telemedicine pharmacy eurodrugstore.eu markets itself via its domain name on top of its web content as pharmacy based in the EU. Parts of its advertising is the reassuring photo of “Dr. J. Kayne, pharmacist,” on their website. The photo of a jovial, welcoming and European like pharmacist is meant to convince the site visitors that Euro Drugstore is EU-based. However, there is no “Dr. J. Kayne, pharmacist” it is just a photo purchased online from Getty Images.

The other issue is the medicine itself, it is offered at cut-rate prices to lure the client into purchasing a “generic” form of drug that is said to proffer a similar result as the genuine brand, however, these drugs are not even permitted to be sold. For instance, Kamagra is presented as sildenafil citrate and claimed to be its generic form. Most countries do not approve Kamagra; thus it is almost impossible to get a prescription. Of greater worry is the sale anti-cancer generic drugs: medication that, if prescribed by a genuine doctor and purchased at an approved pharmacy can save a life, but when bought at a website such as internationaldrugmart.eu it could be a risk, as there is no assurance that the medicine is authentic, or it contains the appropriate dosage.

Dadha operated websites, and his acquaintances like to market themselves as a public service that offers cheaper drugs via telemedicine. However, in the real sense they are just for-profit and do not care about the health risks or repercussions posed by illegal, untested and in some cases fake medications. Moreover, from a financier’s viewpoint, it should be an easy call: putting your money in a venture that is involved in unlawful activities should be seen as a gamble.

The Mape Advisory Group should thoroughly investigate InternationalDrugMart, TDP Healthcare, Pradeep Dadha and associated web-based pharmacies.

Obtaining the services of a doctor has been made easy with the inception of telemedicine. The use of this mode of service delivery is gaining popularity because patients can contact their doctors promptly.

CareSimple and MDLIVE have been awarded online patient consultations accreditations. This award was presented to them by the American Telemedicine Association (ATA). The program has up-to-date registered over 300 organizations since its launch this year with four among them being accredited.

CareSimple is operated and owned by Carena, Inc. The company provides imperative healthcare services for clients all over California and Washington. A group of therapists and doctors providing behavioral and medical health services across multiple states formed an online telemedicine network called MDLIVE.

As stated by the CEO of ATA, consumers in the current world have increased choices to obtain healthcare services. Telemedicine services have been made available for patients on their smartphone, tablet, computer, laptop and even a telephone. The patients have the ability to choose from a wide range of healthcare providers from their convenient place. Telemedicine has enabled consumers to find only the health care providers who follow all the laws and guidelines in the medicine world.

All U.S. healthcare entities providing online consultations directly to patients that meet particular standards are accredited by ATA. The ATA accreditation program enables patients to view pricing in a transparent manner. This telemedicine platform also allows patients to establish the licensing and qualifications of all registered health service providers.

Also, ATA’s program sets certain benchmarks for all online health service providers to build on. These benchmarks act as reassurance for payers who gain confidence knowing that the virtual services are top quality and safe. Both MDLIVE and CareSimple have been certified as legitimate and reliable telemedicine service providers.

ATA comprises of a diverse membership. Members include professionals, medical institutions, and technology and healthcare companies. All these organizations work together to enhance the quality, affordability, and equity in telemedicine healthcare services all over the world.

Seeing a doctor is easier than ever with the the breakthrough of telemedicine. While telemedicine first began about forty years ago to specialized locations, its usage has skyrocketed and is becoming more and more popular everywhere.

Anybody, from stay at home parents, disabled or elderly persons, people without access to transportation, to someone who just doesn’t have the time to drive out to an appointment, can now talk to a medical professional from their computer or phone, establish a diagnosis, and even have medical personnel make a home visit.

The service of telemedicine provides its users with live consultations via video chat with a board certified doctor. Available 24 hours a day, users can receive medical advice, have medicine prescribed to them, and request a nurse practitioner for any follow up care — without leaving their living room and, to the relief of many, without having to wait in a waiting room. For many people, the waiting and uncertainty can cause some panic, and being able to immediately speak to someone provides peace of mind.

Another benefit of utilizing telemedicine is starting a lasting relationship with a doctor. Many people who move around a lot have trouble with establishing a relationship just to have to move and find another one, but now the same team of doctors and nurses will be able to get to know their patients, even from far away.

In addition, the cost of telemedicine is generally more efficient than an in-person visit. On top of the reduced travel costs, numerous doctors charge less for consultations done this way.

However, despite the many benefits and conveniences, there are a few downsides to telemedicine. A common complaint is the possibility for electronic or network bugs and glitches. For example, some bad weather could interrupt or cancel an online appointment.

Another downside, from the doctors’ point of view, is the lack of being able to physically touch their patients for a full, proper assessment. Many doctors require that patients visit them in-person before agreeing to online appointments.

American Well has recently become a stumbling block to Teladoc’s IPO plans. The lawsuit was filed in Massachusetts District court. In this law suit, American Well requested for triple damage compensation and court fees. Also, they request the court to restrict Teladoc from continuing to do business related to the patent.

American Well through their CEO stated that Teladoc has continuously infringed their intellectual property. Though competition is essential for innovation, American Well believes that Teladoc have disregarded their ownership rights. American Well has vowed to protect all their patents and innovations. On the other hand, Teladoc have also vowed to the suit. They informed MobiHealthNews that they had already launched an official appeal to the patent board in matters regarding the patent in contest.

American Well advanced to respond to the relentless efforts by Teladoc to convince U.S. Patent & Trademark Office to nullify certain patents. According to Teladoc, the patent in controversy is invalid. Through their CEO Teladoc stated that they had been providing telehealth services prior to American Well being formed as a company.

Also, the patents are claimed to be too vast containing matters too obvious to be patented. Teladoc maintain that they will continuously defend themselves and consider the legal action as any other ordinary proceeding. They also stated that they will continue to pursue for the invalidation of American Well’s patent in question.

The controversial patent is numbered 7,590,550 that connect service providers with consumers. Included in the lawsuit is Teladoc’s S-1 form and the patent as evidence. It proceeds to highlight the similarities between the two documents. Further, there are tidbits of how American Wells declined a request by Teladoc to license them to proceed with the patent. Appeals by Teladoc to the registrations boards to nullify the patent are seen by American Well that Teladoc knowingly infringed the patent.

Though Teladoc was founded (2001) four years prior to American Wells (2006), the patent was granted in 2007.

A leading innovator in telemedicine technology, Arizona has made many advances in telemedicine that has saved lives, lowered health related expenses and improved outcomes for patients all over the world. Pivotal advances that have come from telemedicine include:

GlobalMed: Recipients of the W.P. Carey Spirit of Enterprise Award for Innovative Leadership in 2012 and an industry leader in telemedicine, telehealth hardware, software, research and design, GlobalMed is based out of Scottsdale, Arizona. Their transportable exam stations have been used in countries like Chile and the island nation of Cape Verde.

T-MedRobotics: Specializing in robotized tele-echography systems, their robotized system MELODY would become commercialized in 2013 after years of intensive research. Based out of Scottsdale, AZ, their tele-ecography system is showing 90% concordance with a regular echography.

Recognized as an innovator in telemedicine expertise, Arizona telemedicine professionals include over a thousand graduates who have done their training in telemedicine and have worked with affiliate programs like the SouthwestTeleHealthResourceCenter and the Northern Arizona Telemedicine Alliance. Pioneers in their field, these top leaders include:

• Dr. Ronald S. Weinstein, President and Founding Director, and known as a pioneer in telemedicine, he successfully runs the Arizona Telemedicine Program (ATP). He has completed many publications and received several awards for his work in telemedicine and the development of virtual slide telepathology systems.
• Elizabeth A. Krupinski, PhD, Vice Chair of Research in Radiology, she is a Professor at the University of Arizona and works as the Associate Director of Evaluation at the American Telemedicine Association

Arizona telemedicine has also been in the news for the many advances they have been making with successful programs which include:

The Mayo Clinic telestroke program: What started as a trial in 2007 has led to the development of 11 remote sites and networks in Arizona, Florida and Minnesota.

The Banner Health eICU program: This telemedicine program has helped to decrease hospital stays and offer better, more affordable care. Located in Mesa, AZ, the iCare center keeps track of 430 ICU patients from 20 different hospitals located in 5 states. It works successfully in conjunction with the doctors and nurses at their locations.

Telemedicine Training: As Arizona continues to make successful strides in telemedicine, we look for more news in the future on their endeavors. If you’re interested in finding out more about telemedicine school and training, the Arizona Telemedicine Training Program has been running its program now for over 17 years with programs offered in Tucson and Phoenix.

Telemedicine Directory: For more information on Telemedicine providers in your area, be sure to look for the ATP National Telemedicine Telehealth Service Provider Directory that has over 25 telemedicine companies with services offered in Arizona and other areas.

Startups have blended telehealth reality for both healthcare providers and patients. However, unlike other industries, telehealth applications may come into contact with HIPAA data protection since HIPAA defines health care rules. It is, therefore, important for developers to familiarize themselves with certain rules before coming up with these apps.

HIPAA (Health Insurance Portability and Accountability Act) is a law that regulates the management, storage, and transmission of PHI by healthcare professionals and their business associates (vendors or subcontractors who have access to PHI). PHI (protected health information) refers to any information in a medical record created, used, or disclosed while providing health care services that can be used to identify an individual.

Although the September 2013 Omnibus Rule Update clarified HIPAA, developers find it difficult to interpret its technical specifications. One of their primary concern is how to add HIPAA compliant video to a healthcare app. To address this, developers need to understand how this law works.

HIPAA compliance for Telemedicine Video Doctor Visits

There are two major sections that govern HIPAA; the Privacy Rule and the Security Rule. The Privacy Rule applies to PHI in any form. It requires covered entities to set up physical, technical, and administrative safeguards to protect PHI.

The Privacy Rule compliance is only applicable if your app creates, maintains and transmits PHI: If it does, then it is imperative for you to meet the requirements of the Privacy Rule and obtain satisfactory assurances.

Security Rule closely affects developers as it applies to E-PHI (protected health information in electronic form). The rule discusses acceptable ways to implement necessary security measures to protect E-PHI from unauthorized access, deletion, alteration, and transmission. It addresses video conferencing concerns in a straightforward way, stating that E-PHI excludes information that did not exist in electronic form before transmission such as video teleconferencing, paper-to-paper faxes and messages left on voicemail.

HIPAA defines electronic media as transmission media used to exchange information that is already in electronic storage. It means that your telemedicine app only need to meet the requirements of the Security Rule only if it has capabilities to record the consultation between the doctor and a patient.

A number healthcare apps often rely on another party to power the video calling feature making the other party a business associate as well. In such a case, you must obtain satisfactory assurances that the third party meets the requirements of the Privacy Rule.

How can telemedicine app developers reduce the burden of HIPAA compliant?

Choosing a video conferencing service that does not require PHI access can contribute to reducing this burden.

The health information of a patient is considered to be PHI only if it belongs to someone who can be identified. To reduce the burden of HIPAA compliance, telehealth app developers can use opaque user IDs to authenticate users to the video call anonymously.

Ensuring that you are not sharing PHI with a third party is also a vital factor to consider since it helps you avoid extending HIPAA applicability to the other party

Remember that all these are applicable in cases where there is no storage of conversations. Security measures set by HIPAA may not provide the level of privacy you aim to have for your app, and it is, therefore, important to consider other measures such as end-to-end encryption.

HIPAA compliance is ultimately the responsibility of telemedicine app developers, and they are required to take the necessary security and safety measures. However, developers should be in a position to determine if a telehealth app needs to be HIPAA compliant or not.

Telemedicine is a favorable mode of treatment for the rural population as it gives them a chance to access physical consultation as well as specialty health services without having to travel long distances. Telemedicine is the ideal equalizer for the people living in the rural areas who usually have to make do with inadequate services and less than ideal health outcomes in comparison to the urban populations that have large medical centers at its disposal.

Diabetes control is one of the most affected areas in Rural Arizona. Patients suffering from the illness have to take frequent trips to visit their specific healthcare providers and may spend between 1 to 2 hours one way on the road. Overall, doctors prefer to see diabetes patients regularly for not less than four times in a year. Diabetes patients must also have a regular appointment with a nutritionist, get tests done on their eye and feet every year, get their blood sugar regularly screened as well and get their medication supplies refilled. As much as the trips are necessary and may mean the difference between life and death, they can drain the patients’ resources due to the transport costs and time spent.

We will be launching a new project dubbed Tuba City Regional Healthcare Corporation or simply (TCRHCC) in the fall of 2015 in Tuba City to facilitate the expansion of telehealth services for diabetes care which will include screening and telenutrition services. The project will avail these crucial services to communities in the remote areas of Navajo Nation. It will involve using a telehealth vehicle to bring healthcare such as telenutrition visits, screenings and routine blood pressure tests closer to the people. This project was financed in 2014 by a lump sum grant from the charitable Special Diabetes program set aside for the Indians. It will enable people to get quality diabetes care through telemedicine while making fewer trips to the clinic. However, they will still have to visit the doctor occasionally for personalized care, but they can now go to the Chapter Houses for general check-ups like screening, eyes and foot tests and nutrition advice.

Limitations for the Rural Telehealth
Despite the fact that telehealth is an excellent way of easing health problems for rural patients, it is not without its share of challenges. The main challenge is the inadequate infrastructure in the rural Arizona in terms of internet reach, and impassable roads. The scattered population further compounds the problem, and the poor WIFI signals make video conferencing difficult.

Future prospects
TCRHCC plans to increase its telemedicine services in future with the help of the grant that has enabled the acquisition of better facilities. We are in the process of setting up a telestroke program in collaboration with the Arizona-based Mayo Clinic. We are also hoping to duplicate the ECHO project of the University of New Mexico in Northern Arizona that will offer specialized treatment like rheumatology, and pulmonology.

For those who have been living under a rock like myself, a Fibit is a physical performance tracker that you wear on your wrist that monitors all of the activity you do each day. The idea is for you to track progress toward a weight loss or fitness goal in increments, to show you that even with the littlest step you’re making progress. Now it seems that President Barack Obama is going to give the Apple Watch App Fitbit a try.

When recently interviewed President Obama announced that he would consider using the Apple Watch to track how he is progressing on his fitness goals, citing that it might be a good companion to his workouts. Although he wouldn’t endorse the product before he had tried it, he did acknowledge that it had gotten favorable reviews. The Apple Watch was shipped out in April 2015 and includes a built-in heart rate monitor and accelerometer operated through optical sensors.

President Obama has always had an interest in technology-driven communication. His notorious refusal to give up his Blackberry when he took office is proof of that. Now he has revealed that he stands behind mobile health programs like telemedicine or telehealth, and of course the FitBit. During his 2011 State of the Union Address Obama stated that he wished to have 98 percent of Americans covered by high speed wireless networks within 5 years in order to connect all parts of the country to the new digital age. While we are still a year from reaching his anticipated deadline, according to the Mobile Technology Fact Sheet, as of October 2014, 64% of Americans owned a SmartPhone.

It remains to be seen how President Obama reacts to the FitBit and its fitness benefits. As a wearable device that is both tech-savvy and sleek he should have plenty to talk about. And for the Fitbit, that means there will be plenty who will jump onto the Mobile Health bandwagon, including the use of telemedicine or telehealth to diagnose and treat illness.

Within stroke telemedicine, also called telestroke, doctors neurologists (or nerve specialists) distantly evaluate patients, who’ve experienced a possible stroke and make diagnostic and therapy recommendations in order to assist emergency room doctors. They communicate utilizing digital camcorders, Internet telecoms, robotic telepresence, smartphones along with other technology.

Possessing a prompt nerve evaluation boosts the chance you might receive thrombolytics (or therapy that dissolves clots) or some other method that find clots in time to lessen the chance of disability as well as death caused by the stroke. Within stroke telemedicine, the neurologist will offer care locally trying to avoid your transfer to a different medical center. This particular focus on local care frequently allows you to get quality stroke care in the area.

Stroke telemedicine usually operates in a large metropolitan medical center that serves as the main hub. Remote control locations, generally smaller local rural or even underserved private hospitals, serve as the actual spokes in this hub. Numerous regional private hospitals don’t have neurologists on call in order to recommend the best care. Therefore, the neurologists at the hub consult remotely with physicians and people that have had severe strokes.

Within telestroke, there is teamwork including a system manager, the clinical planner, vascular neurologists, neurosurgeons as well as radiologists in the hub, and unexpected emergency medicine physicians and other personnel. Radiology technicians, educational technology personnel, researchers, nurse practitioners, nurse professionals and other personnel also are essential team members of the stroke telemedicine team.

In telemedicine, if your doctor suspects an severe stroke, she or he will contact the stroke telemedicine hotline at the hub, with a dedicated hotline and team paging program with neurologists available 24 hours a day and throughout the year. The hub’s on-call neurologists usually reacts within 5 minutes. The neurologist works together with your doctor to look for the most appropriate therapy and transmits the treatment suggestion electronically.

Having a quick evaluation boosts the chance that which treatments that thrombolytics could be delivered quickly so as to reduce stroke-related disability. To work effectively, this treatment must be given 3-4. 5 hours once you experience stroke symptoms.

Technology has led to the advancement of service delivery in almost all industries and sectors of product and service delivery. In the medical field, this progress has resulted in the invention of telemedicine. That is a program that assists medics to monitor their patients remotely. According to statements made at the American Telemedicine Association 2015 Annual Meeting, telehealth has been significantly effective. This remote monitoring has minimized the readmission rate of patients quite alot.

Readmissions lead to increased costs that may hinder the efficient operations of medical facilities. Currently, this telemedicine program is in its initial test stages and so far it has posted successful results. Telehealth technology is highly reliable in the reduction of value-based billing. A majority of the patients are incorporated into the program while they are in the hospital. On discharge, the patients are continuously monitored via this telemedicine and catered for incase of slight deviations from their anticipated recovery.

The program ensures that there is constant communication between patients and clinicians. A majority of patients are comfortable and fully satisfied with this program. Since inception, the rate of readmissions has reduced with cases of hip and knee injury readmissions almost being eliminated entirely. Though this program requires many staffs in a medical institution, when implemented it significantly decongests the hospital. Telemedicine has solved the problems that arise as readmission penalties.

This program transmits electronic medical data records to a platform from which the clinicians may access them in real time and assess the recovery of the patients enrolled in the program. Within a period of just 30 days, the readmission rate at the University of Virginia Centers for Medicare and Medicaid had decreased. Through this test program, doctors and clinicians alike are confident that this remote monitoring technology will reduce costs and readmissions in hospitals all over the world. This remote monitoring ensures full recovery of patients without the need for any readmissions and other avoidable hospital expenses.