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Telemedicine

How Technology, Medicine And At-Home Devices Can Improve Healthcare Access And Cost

February 15, 2020

How Technology, Medicine And At-Home Devices Can Improve Healthcare Access And Cost

Healthcare is changing. After years of stagnation and inadequate innovations, the call for care that is higher quality and more accessible and that costs less is beginning to be answered. We're starting to see incremental progress toward meaningful healthcare technology and reimagined delivery models. New developments in digital medicine, DIY care and AI are emerging, with the potential to advance the industry in ways that previous attempts have failed.

Despite signs of progress, doctor's office wait times continue to rise. Middle- and low-income patients are in critical need of more affordable primary and specialty care. Across the country, critical access and other rural hospitals are closing at an alarming rate, leaving people in those areas struggling to find the time, transportation and money needed to see a physician. Primary care visits are declining, while our overall population health continues to lag behind most developed countries.

These issues are the impetus for momentum in digital medicine and direct-to-consumer healthcare. Consumers today expect more from all of the services they use, and healthcare is no exception. New, niche providers and technology focused on patient experience are setting a new standard for healthcare delivery. Some solutions—those that offer unprecedented convenience alongside real medical expertise—have the potential to improve outcomes.

The full Forbes article can be viewed at this link.  

Name: 
Anna

Tele-transitions of care (TTOC): a 12-month, randomized controlled trial evaluating the use of Telehealth to achieve triple aim objectives

February 12, 2020

Tele-transitions of care (TTOC): a 12-month, randomized controlled trial evaluating the use of Telehealth to achieve triple aim objectives

Poor transitions of care leads to increased health costs, over-utilization of emergency room departments, increased re-hospitalizations and causes poor patient experiences and outcomes. This study evaluated Telehealth feasibility in improving transitions of care.

This is a 12-month randomized controlled trial, evaluating the use of telehealth (remote patient monitoring and video visits) versus standard transitions of care with the primary outcomes of hospital readmission and emergency department utilization and secondary outcomes of access to care, medication management and adherence and patient engagement. Electronic Medical Record data, Health Information Exchange data and phone survey data was collected. Multi-variable logistic regression models were created to evaluate the effect of Telehealth on hospital readmission, emergency department utilization, medication adherence. Chi-square tests or Fisher’s exact tests were used to compare the percentages of categorical variables between the Telehealth and control groups. T tests or Wilcoxon rank sum tests were used to compared means and medians between the two randomized groups.

The study conducted between June 2017 and 2018, included 102 patients. Compared with the standard of care, Telehealth patients were more likely to have medicine reconciliation (p = 0.013) and were 7 times more likely to adhere to medication than the control group (p = 0.03). Telehealth patients exhibited enthusiasm (p = 0.0001), and confidence that Telehealth could improve their healthcare (p = 0.0001). Telehealth showed no statistical significance on emergency department utilization (p = 0.691) nor for readmissions (p = 0.31). 100% of Telehealth patients found the intervention to be valuable, 98% if given the opportunity, reported they would continue using telehealth to manage their healthcare needs, and 94% reported that the remote patient monitoring technology was useful.

Telehealth can improve transitions of care after hospital discharge improving patient engagement and adherence to medications. Although this study was unable to show the effect of Telehealth on reduced healthcare utilization, more research needs to be done in order to understand the true impact of Telehealth on preventing avoidable hospital readmission and emergency department visits.

The full article can be downloaded below.  

Name: 
Anna

Designing a multifaceted telehealth intervention for a rural population using a model for developing complex interventions in nursing

February 07, 2020

Designing a multifaceted telehealth intervention for a rural population using a model for developing complex interventions in nursing

Telehealth interventions offer an evidenced-based approach to providing cost-effective care, education, and timely communication at a distance. Yet, despite its widespread use, telehealth has not reached full potential, especially in rural areas, due to the complex process of designing and implementing telehealth programs. The objective of this paper is to explore the use of a theory-based approach, the Model for Developing Complex Interventions in Nursing, to design a pilot telehealth intervention program for a rural population with multiple chronic conditions.

In order to develop a robust, evidenced based intervention that suits the needs of the community, stakeholders, and healthcare agencies involved, a design team comprised of state representatives, telehealth experts, and patient advocates was convened. Each design team meeting was guided by major model constructs (i.e., problem identification, defining the target population and objectives, measurement theory selection, building and planning the intervention protocol). Overarching the process was a review of the literature to ensure that the developed intervention was congruent with evidence-based practice and underlying the entire process was scope of practice considerations.

Ten design team meetings were held over a six-month period. An adaptive pilot intervention targeting home and community-based Medicaid Waiver Program participants in a rural environment with a primary objective of preventing re-institutionalizations was developed and accepted for implementation. To promote intervention effectiveness, asynchronous (i.e., remote patient monitoring) and synchronous (i.e., nursing assessment of pain and mental health and care coordination) telehealth approaches were selected to address the multiple comorbidities of the target population. An economic evaluation plan was developed and included in the pilot program to assess intervention cost efficiency.

The Model for Developing Complex Interventions in Nursing provided a simple, structured process for designing a multifaceted telehealth intervention to minimize re-institutionalization of participants with multiple chronic conditions. This structured process may promote efficient development of other complex telehealth interventions in time and resource constrained settings. This paper provides detailed examples of how the model was operationalized.

The full article can be downloaded below.  

Name: 
Anna

Telehealth: Is It Only for the Rural Areas? A Review of Its Wider Use

February 07, 2020

Telehealth: Is It Only for the Rural Areas? A Review of Its Wider Use

Telehealth (also known as telemedicine, digital medicine) is a relatively new concept in healthcare provision, which is perceived as a useful mode of managing patients at remote locations. As this technology evolves, the need arises to explore telehealth as part of holistic care. Much literature on telehealth is available but most are specialty-based or focus on one or two aspects of care provision. This article focuses on the four main building blocks of telehealth: perception by healthcare staff, perception by patients, quality of Internet and technology, and cost effectiveness based on 2 years of published literature.

The full article can be downloaded below.  

Name: 
Anna

Predictions for Telehealth in 2020: Will This be the Takeoff Year?

February 07, 2020

Predictions for Telehealth in 2020: Will This be the Takeoff Year?

In order to place predictions for telehealth in proper perspective, consider that like all new industries, telehealth is characterized by disparate ideas developed by different people, often for the same medical specialty and/or medicine-related activity. Over time, these ideas must coalesce to provide growth and economies of scale. This occurs at multiple levels. One need only look at the history of banking and finance for an analogous situation that is highlighted by innovation, mergers, and integration. In healthcare, the overall experience with an array of disparate health information exchanges has been less than satisfactory for most observers. While the trend towards consolidation has begun in the telehealth arena, it is at an early stage. With this in mind, our invited experts looked into the future from their shared and unique perspectives to offer their view on the next big thing(s) in telehealth in 2020.​

The full article can be downloaded below.  

Name: 
Anna

Measures of Effectiveness, Efficiency, and Quality of Telemedicine in the Management of Alcohol Abuse, Addiction, and Rehabilitation: Systematic Review

February 06, 2020

Measures of Effectiveness, Efficiency, and Quality of Telemedicine in the Management of Alcohol Abuse, Addiction, and Rehabilitation: Systematic Review

More than 18 million Americans are currently suffering from alcohol use disorder (AUD): a compulsive behavior of alcohol use as a result of a chronic, relapsing brain disease. With alcohol-related injuries being one of the leading causes of preventable deaths, there is a dire need to find ways to assist those suffering from alcohol dependence. There still exists a gap in knowledge as to the potential of telemedicine in improving health outcomes for those patients suffering from AUD.

The purpose of this systematic review was to evaluate the measures of effectiveness, efficiency, and quality that result from the utilization of telemedicine in the management of alcohol abuse, addiction, and rehabilitation.

This review was conducted utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The articles used in this analysis were gathered using keywords inclusive of both telemedicine and alcohol abuse, which were then searched in the Cumulative Index to Nursing and Allied Health Literature, Cochrane, and MEDLINE (PubMed) databases. A total of 22 articles were chosen for analysis.

The results indicated that telemedicine reduced alcohol consumption. Other common outcomes included reduced depression (4/35, 11%), increased patient satisfaction (3/35, 9%), increase in accessibility (3/35, 9%), increased quality of life (2/35, 6%), and decreased cost (1/35, 3%). Interventions included mobile health (11/22, 50%), electronic health (6/22, 27%), telephone (3/33, 14%), and 2-way video (2/22, 9%). Studies were conducted in 3 regions: the United States (13/22, 59%), the European Union (8/22, 36%), and Australia (1/22, 5%).

Telemedicine was found to be an effective tool in reducing alcohol consumption and increasing patients’ accessibility to health care services or health providers. The group of articles for analysis suggested that telemedicine may be effective in reducing health care costs and improving the patient’s quality of life. Although telemedicine shows promise as an effective way to manage alcohol-related disorders, it should be further investigated before implementation.

The full article can be downloaded below.  

Name: 
Anna

How Telepsychiatry Is Improving Access to Mental Health Care

January 23, 2020

How Telepsychiatry Is Improving Access to Mental Health Care

As an adolescent healthcare provider at Seattle Children’s Hospital, where she sees youths facing issues such as eating disorders and gender dysphoria, Evans has kept those concerns top of mind since joining the faculty in 2011.

“I knew that I wanted to try to serve more rural patients,” she says. “I understand the needs in these communities.”

Remote areas often lack specialists to provide counseling and intervention: A 2017 Merritt Hawkins report found 77 percent of U.S. counties reported a severe shortage of psychiatrists. The Association of American Medical Colleges notes that nearly two-thirds of practicing psychiatrists are 55 or older, setting the stage for a substantial retirement drain.

Meanwhile, 1 in 5 Americans will experience a mental illness in a given year, federal data shows.

It’s why Evans and some colleagues are using videoconferencing technology to reach patients outside a clinic’s walls. Seattle Children’s offers telepsychiatry services not only in Washington state but also in Alaska, Idaho, Montana and Wyoming.

The full HealthTech article can be viewed at this link.  

Name: 
Anna

Nine Experts On The Trends That Changed Healthtech In The Last Decade, And The Innovations To Expect By 2030

January 16, 2020

Nine Experts On The Trends That Changed Healthtech In The Last Decade, And The Innovations To Expect By 2030

As we enter 2020, it seems like a good moment to reflect on how technology has reshaped the way we think about, and deliver, healthcare in the last 10 years, and to look forward to the innovations that might transform our sector in the decade ahead. 

I asked some of my peers to share their views on the biggest developments in digital health during the 2010s, and their predictions for what the 2020s will bring.

The full Forbes article can be viewed at this link.  

Name: 
Anna

Cigna Expands MDLive Telehealth Partnership To Primary Care

January 13, 2020

Cigna Expands MDLive Telehealth Partnership To Primary Care

Health insurance giant Cigna is expanding online access to primary care physicians via its telehealth partner MDLive for the insurer’s employer-sponsored plan clients.

The move is significant because it greatly expands the use of telehealth and “virtual access” to doctors from the already existing behavioral health and urgent care services MDLive offers Cigna employer-sponsored health plan enrollees. The existing efforts could be considered more as a way to help patients avoid an unnecessary trip to the emergency room or get someone with mental health access quickly to avoid an adverse mental health outcome.

But with a primary health offering from MDLive, executives involved say Cigna is helping doctors more proactively manage the employee’s health, beginning with wellness screenings. MDLive says Cigna will be its first health insurer partner to “offer virtual care for preventive checkups, beginning in the second quarter of 2020.” The deal is a big one for MDLive, which is amid a competitive environment of telehealth companies that include American Well, Teladoc, Doctor On Demand and a host of other companies that include startups.

The full Forbes article can be viewed at this link.

Name: 
Anna

The Rise of the Data-Driven Physician

January 11, 2020

 The Rise of the Data-Driven Physician

Since its inception, the Stanford Medicine Health Trends Report has examined the most consequential developments and technologies that are changing health care delivery. Our 2020 report describes a health care sector that is undergoing seismic shifts, fueled by a maturing digital health market, new health laws that accelerate data sharing, and regulatory traction for artificial intelligence in medicine.

The full report can be downloaded below.  

Name: 
Anna