Hartmut Gross was in a computer store when the Augusta stroke doctor got an emergency call. A patient at a rural Georgia hospital had stroke symptoms but the ER didn’t have a neurologist. So doctors there called Gross to do a remote consultation.
With help from a manager who let him through the firewall, Gross used a store computer and broadband Internet access to connect to a two-way audio/video tool in the ER and examine the patient.
“I did the consult in the back aisle of the store,” Gross recalls. Such speed is critical in stroke cases, as a patient can lose thousands of brain cells each minute and delay can mean disability or death.
The remote care Gross provided is an example of the potential benefits of telemedicine, which essentially marries healthcare with some of the same kinds of technology that enable Skype or FaceTime sessions.
Telemedicine is roughly defined as using Web-based systems to facilitate the doctor-patient consultation in a way that recreates the bedside experience for both.
Its growth is being spurred not just by technology but also by shortages of specialists in many areas and the need to restrain spending.
A recent report says the global market for telemedicine products and services was $14 billion in 2012 and is projected to have a compound annual growth rate of 18.5 percent through 2018.
“It’s at the heart of what we’re talking about when we say we’re transforming health care,” said Jonathan Linkous, CEO of the American Telemedicine Association.
“It’s one of those fast-moving areas, and it’s going to be more significant in the future,” said Tino Mantella, president of the Technology Association of Georgia. Mantella said more than 200 physician offices and clinics in Georgia use telemedicine or telehealth solutions.
Range of services
Telemedicine services range from remote patient analysis in acute care situations to patient self-monitoring in which a person might take his own vitals and transmit them to caregivers.
The need will grow with an aging population, advocates say. Telemedicine can also help serve small, rural communities without physician specialists, but adoption should grow in urban areas, too, as consumers tap mobile health applications on smart phones.
The technology could also come in handy in congested cities like Atlanta where traffic can delay on-site diagnosis and treatment.
Telemedicine has spawned a new segment of the healthcare industry that provides hardware, software and services.
Atlanta-based REACH Health, for example, provided the software that Gross used to diagnose and treat his patient. Gross, a professor of emergency medicine and neurology at the Medical College of Georgia/Georgia Regents University, was among a group of doctors that launched the company in 2006.
He said he has performed nearly 600 remote consultations, many from his home when he is on call. REACH software is used in cardiology, pediatric and other areas, but stroke patients are the most common.
The patient is placed in front of a specialized cart with high-resolution, two-way video and audio. A specialist at another location conducts the exam remotely, using software tools that guide the process and help to obtain all the clinical information needed to make a diagnosis and recommend treatment.
Otherwise, said REACH CEO Steve McGraw, stroke patients likely would be stabilized and transported to a larger facility with a neurologist on staff.
Neurological care is regarded as one of the most likely areas for telemedicine growth, along with psychiatry, dermatology and cardiology, said Matthews Gwynn, a neurologist and CEO of AcuteCare Telemedicine in Atlanta, a physician practice that provides telemedicine services.
Telemedicine development, McGraw said, is being sped by “faster and more powerful computers, cheaper bandwidth and storage, and more widespread comfort with technology.”
Unfamiliarity a hurdle
Obstacles to telemedicine’s growth include a lack of familiarity among patients, many of whom still prefer to see a doctor in person. There is a financial sticking point, too. Medicare and Medicaid provide only partial reimbursement under certain circumstances
Still, economic factors could drive its growth.
“Hospitals, rehabilitation centers, and skilled nursing facilities are increasingly focused on the prevention of hospital readmissions — not only for the improved health of the patient, but also because of the penalties for readmission within the first 30 days for some conditions,” said Keith Speights, CEO at RosieConnect, a Savannah firm that provides remote monitoring of patient vitals along with medication reminders.
The company’s telemedicine focus is on patients moving to a home from a hospital or skilled nursing/rehabilitation facility. That means close monitoring of the patient’s vitals and making sure the patient takes his medicine.
Eagle Hospital Physicians, an Atlanta-based physician management company, helps doctors and hospitals expand their practices by offering remote patient exams.
Even though Eagle physicians say they have used telemedicine technology to care for more than 10,000 patients, vice president Rich Sanders said, “We still have a ways to go … in really mainstreaming telemedicine into physician practice. Right now telemedicine is viewed as a separate silo within health care delivery.”
New policies and market pressures, Sanders said, “will likely force health care organizations to adopt more efficient models for care delivery and that will naturally include telemedicine.”
Atlanta-based LightSpeed Health puts in place telemedicine systems including hardware and software, and sets up work flow, policy and procedures. It helps doctors and other clients identify ways to use telemedicine.
That’s necessary, said CEO Michael Justice, because many health care providers still aren’t aware how telemedicine could benefit their practice or their patients.
To some, he said, “Telemedicine is science fiction. We believe that our services help make it just another way to care for patients.”
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