Does Telemedicine Replacing your Physician ?

Does Telemedicine Replacing your Physician ?

Physicians have many years of training and can diagnose with reference to the specific needs of the patient." Building a close relationship with your GP may prevent you feeling embarrassed.

 

Australian national online survey by health insurer HCF found 62 per cent of women and 52 per cent of men went online as soon as an unfamiliar health issue arose. More than half of those aged 18-34 said they were too embarrassed to talk to a GP. Twenty two per cent of 55 to 64-year-olds said they, too, were scared to see the doctor, so went online. Despite the trend, 65 per cent of people said they didn't trust the online advice so went to the doctor anyway.

 

As an advice, it’s important to treat the internet as an information tool and not as a substitute for medical care. Always see your doctor for professional diagnosis and treatment. Otherwise, you may be wasting time, money and emotional energy taking care of a disease that you don't actually have. "Always see your GP if you have any health concerns.

 

In the advent of Telemedicine research, there are many more concepts that people may misunderstood, as a contrary it’s just an media – Telemedicine / Telehealth or in broader sense e-health is not something robotic – and make your physicians decision …

 

You may be interested on various types of telemedicine being offered by many organizations.

 

Types of telemedicine

 

Telemedicine can be broken into three main categories: store-and-forward, remote monitoring and interactive services.

 

Benefits and uses

 

Telemedicine is most beneficial for populations living in isolated communities and remote regions and is currently being applied in virtually all medical domains. Specialties that use telemedicine often use a 'tele-' prefix; for example, telemedicine as applied by radiologists is called 'teleradiology'. Similarly telemedicine as applied by cardiologists is termed as 'telecardiology', etc... Telemedicine is also useful as a communication tool between a general practitioner and a specialist available at a remote location.

 

Telecardiology

 

ECG or electrocardiograph can be transmitted using telephone and wireless. Einthoven, the inventor of the ECG, actually did tests with transmission of ECG through telephone lines. This was because the hospital did not allow him to move patients outside the hospital to his laboratory for testing of his new device. In 1906 Einthoven came up with a way to transmit the data from the hospital directly to his lab

 

Teleradiology

 

Teleradiology is the ability to send radiographic images from one location to another. For this process to be implemented, three essential components are required, an image sending station, a transmission network, and a receiving / image review station. The most typical implementation are two computers connected via Internet. The computer at the receiving end will need to have a high-quality display screen that has been tested and cleared for clinical purposes. Sometimes the receiving computer will have a printer so that images can be printed for convenience.

The teleradiology process begins at the image sending station. The radiographic image and a modem or other connections are required for this first step. The image is scanned and then sent via the network connection to the receiving computer.

Telemedicine, Gen Y and Internet An Exponential Growth

As the leading research shows, More than 75 per cent of Australians use the internet to self-diagnose, with Gen Y and women the busiest web medicos. Research reveals increasing numbers of young people are using the internet to find out what is wrong because they are embarrassed to share intimate details with a doctor.

Telemedicine generally refers to the use of communications and information technologies for the delivery of clinical care. Care at a distance (also called in absentia care), is an old practice which was often conducted via post. Telemedicine is a rapidly developing-developed application framework of clinical medicine where medical information is transferred – shared through interactive audiovisual media for the purpose of consulting, and sometimes remote medical procedures or examinations.

Telemedicine may be as simple as two health professionals discussing a case over the telephone, or as complex as using satellite technology and videoconferencing equipment to conduct a real-time consultation between medical specialists in two different countries. Today’s Information and communication giant’s are offering many more feature driven off-the-shelf products and services to deliver and ease of these platform. There has been a long and successful history of in absentia health care which, thanks to modern communication technology, has evolved into what we know as modern telemedicine. In its early manifestations, African villagers used smoke signals to warn people to stay away.

The survey also revealed 70 per cent of Australians were happy with their health.

How to improve healthcare services with Communication Technology

Amongst the one-and-a-half billion people around the world surfing the Internet regularly, millions have gone online seeking medical information. The widespread access to broadband Internet, together with the evolution and increased adoption of visual communication technology, are taking this trend one step forward: according to recent researches, 78% of healthcare consumers are willing to interact with physicians online, over 85% of physicians would rely on web services to simplify their operations and 90% of them see the Internet as a source of competitive advantage.

A hypothetical view could be illustrated as,

With such premises, the delivery of health-related preventive, primitive and curative services over convergent networks, also known as Telehealth, appears to be a great response to the supply-demand mismatch in the health market, while representing a challenging opportunity for service providers in the visual communication space.

Among the others this concept may take a revolutionary concept on the growing healthcare demand…

Health Care Management

Today the topics will follow toward some of the well known concept and their application used today’s healthcare systems.

Health Care Management focuses on delivery of care as an organizing manner rather than the disease.

The Disease Management Association defines Disease Management as "a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant." The term disease management emphase a single disease process over care needs of individual patients who often have significant co-morbidities. However, while Disease Management initially tended to focus on only one condition at a time, in most circumstances now a spectrum of common chronic conditions can be addressed concurrently to better align with the multiple and complex needs of larger patient populations.

Disease Management organizations have introduced in the last several years focused exclusively on providing supported care, Disease Management services for the chronically ill patients. Apart from hospital Care and in-house patients care disease management care delivered by a health plan and by a managed care organization.

Population care is often used to capture a broad view of the entire spectrum of care needs and interventions for populations of patients, seeking differentiation from a central disease focus. A population encompasses the most impaired and ill through to those in the earliest stages or even just at risk for a condition. Implied in optimal population care across this range of need is the ability to stratify the members of a population for their severity of illness and needs and use this information about risk in planning and delivering care. Care management and disease management programs as commonly practiced in 2005 generally address a wide scope of population needs including risk assessment and allocation of appropriate interventions across multiple and often co-morbid diseases

Healthcare Community Integration

Health Professionals believes that the fundamental relationship within healthcare is between the patient and their doctor.  The service extends the reach of this care and we will collaborate to actively engage local doctor involvement in the program.  To ensure the success of our approach worldwide we have already had successful meetings with various Australian medical bodies, the government, the Privacy Commissioner and other relevant groups who all see the validity of our work within the Australian context.

To help us to fully localise the service, Healthcare system is also build an Australian Medical Advisory Council to help incorporate the medical community into our quality assurance programs. Through the Medical Advisory Council, top doctors and recognised practice area experts from the leading hospitals, group practices and Universities will be asked to review and update the clinical best practices and evidence-based protocols utilised in our tailor made and world class systems.

Through employ Provider Service Managers (PSM) to work in the local community and with physicians who care for individuals in Healthcare programs. PSMs will make regular visits to the physician practices and to all other relevant local medical providers to review the progress of disease management program participants, promote the value of the service to individuals, and collaborate on supporting the provider’s patients who are enrolled with the system.  Through these efforts, we ensure regular contact is maintained with treating physicians and we ensure reporting is available to provide focus for this activity.

Individuals enrolled in our disease management program will each have a personalised care action plan.   These care action plans are driven by unique patient requirements and follow the patient throughout the course of their participation in the program.  The patient’s General Practitioner and primary care team as well as other health, social and preventative care services will be embedded in our system as resources in an effective and systematic approach to the care management of individuals with a chronic condition. Next appointment dates with providers are captured and member phone calls are scheduled accordingly. 

In addition, for “Supported Self Care” approach to work effectively, a high degree of localisation is needed such that our specially trained nurses and health coaches working over the telephone and all relevant written communications can emphasise local best practice, initiatives, help groups, resources etc.  I believe this is an important component in helping individuals best manage their on-going care.  The well designed system will be embedded with local and relevant patient resources pertinent to the geographic spread of any members and we will work together with you to maximise this information. 

Healthcare and Telehealth Systems

Given the opportunity presented by such solutions to improve outcomes, Healthcare system now sees the need to expand its customer offer to include telehealth and to deploy the remote technologies that underpin it.  Therefore needs to select a suitable vendor.

This project will analyze three telehealth vendors (Ideal Life, Robert Bosch and Tunstall) to determine which solution best meets our needs in terms of vendor partnership and product offering.

Although TeleHealth monitoring is not a new concept or new technology, demand is emerging with significant potential in specific international markets, such as Europe, India, China and several Middle Eastern countries.   Healthcare system therefore intends to run a twelve month telehealth pilot to confirm how this solution can add value to our own services in both Australia and Germany.  As such, it will involve all functional areas of the Healthcare system organization.

Telehealth is defined as healthcare services, consultation and expertise delivered via telecommunications medium, over any distance. Telehealth uses equipment to monitor people’s health within their own home. So, for example, equipment can be used to coach patients to improve their self management, monitor vital signs such as blood pressure, blood oxygen levels or weight. The responses and measures are then automatically transmitted to a clinician who can observe health status without the patient leaving home. The clinician monitors daily readings to look for trends that could indicate deterioration in condition.  Feedback or readings that are out of the range expected are flagged to the clinician using a traffic light system.  Telehealth solutions offer a way of delivering tailored care for patients with long term chronic conditions, which helps improve quality of life and prevent avoidable hospital admissions. 

The advantages of the inclusion of telehealth build upon some of the arguments that are made for Disease Management. Telehealth offers improved access to earlier reported (‘real time’) and more accurate medical data from the patients, increase touch points with users, improved patient health outcomes and decision making, reduced hospitalizations and healthcare costs, redundant diagnostic procedures or tests and reduced patient travel and waiting time.

Telehealth services and markets have been available for more than two decades now but have not seen significant growth in penetration rates as the technical solutions offered were not regarded as entirely credible until more recently.   Following the success of telecare, (Telecare uses a combination of alarms, sensors and other equipment to help people live independently) telehealth is now considered as a major opportunity for the management of patients with chronic diseases and telehealth providers can now demonstrate strong evidence in satisfaction, clinical improvement and ROI.  As such, the global telehealth market is estimated to grow to more than $8bn by 2012.   

        

         Shown below is the general development of telehealth over the last century.

                         

Although potential teleheath markets around the globe have been slower in penetration and growth than has been experienced in the USA, there are now a range of pilots underway in various countries and the growth rate of the European markets gained significant momentum after 2000.  


For example, in the UK telehealth services are relatively extensive (though often small scale) and a major tender exercise to secure telehealth monitoring for 5000 patients is currently ongoing in Northern Ireland.  The UK Department of Health is also running an evaluation as part of its Whole Systems Demonstrator (WSD) pilots which are analysing 3 controlled trials.  There has been less progress in Germany, France, Spain and Italy although all European countries have adopted telecare enthusiastically and are beginning to experiment with telehealth.  One of Healthcare system’ short listed vendors, Tunstall Limited (based in the UK) has been at the forefront of this charge.  


The market potential has seen the German company, Robert Bosch (the 8^th most recognized Brand in Europe) also enter this space with acquisitions of US players.  In Asia, Latin America and the Middle East, various trials are also being developed and there is significant potential for telehealth in markets like India and China.