Telemedicine’s Impact on Telemedicine’s Impact on Healthcare OptionsHealthcare Options

By Karen McLeod, Lilliana Rodriguez, Adam Storm, By Karen McLeod, Lilliana Rodriguez, Adam Storm, Madeleine Wolfe & Jennifer WorthMadeleine Wolfe & Jennifer Worth

… from patient monitoring in the “granny-pod” to robotic-assisted surgery on from patient monitoring in the “granny-pod” to robotic-assisted surgery on distant battlefields.distant battlefields.

Telemedicine has been around for about 30 years. Improvements in its Telemedicine has been around for about 30 years. Improvements in its scope have grown exponentially along with all of technology.scope have grown exponentially along with all of technology.

* There may be an unforeseen opportunity for poor quality of care. * There may be an unforeseen opportunity for poor quality of care. * The role and status of rural/isolated healthcare practitioners may actually be * The role and status of rural/isolated healthcare practitioners may actually be

challenged rather than supported.challenged rather than supported. * New Medical-legal issues and risks may come into play.* New Medical-legal issues and risks may come into play. * Establishing standards for credentialing and compensation is controversial and * Establishing standards for credentialing and compensation is controversial and

complicated. complicated. * Ever important Doctor-patient relations may be further jeopardized.* Ever important Doctor-patient relations may be further jeopardized.

In the end we have found with our own inquiries the pros In the end we have found with our own inquiries the pros outweigh the cons. outweigh the cons.

Contraindications and PrecautionsContraindications and Precautions

While it is clear telemedicine is here to stay many new complications While it is clear telemedicine is here to stay many new complications accompany it:accompany it:

Telemedicine Can Increased Telemedicine Can Increased Access to Health CareAccess to Health Care

• Increased access to healthcare for children.

• Increased access to physicians for those in rural areas.

• Increased access to specialists across the board.

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• Study by University of Rochester Medical Center installed Telemedicine Equipment in 3 daycare facilities. In 2006 the program expanded to 10 daycare facilities and 11 elementary schools.

• Oregon is using telemedicine to connect rural communities to better healthcare. Providence Health, OHSU and Legacy are all using telemedicine to link their facilities.

• This creates better access to healthcare for everyone and increases access to specialists.

Studies and Support of Increased Studies and Support of Increased AccessibilityAccessibility

Alternative Use of Telemedicine

• In Providence Newburg, OR a mother and child meet for the first time via a robot. This Robot (that was named Wally) is usually used by Providence Neurologist to diagnose and treat stroke victims in rural hospitals. The mother and baby’s heart stopped beating. The doctors then re-started her heart and preformed and emergency C-Sections to then re-start the baby’s heart. The baby was flown to another hospital to be treated. Both are ok.

Telemedicine to treat prisoners?

Yes! the government is testing out telemedicine not just for security reasons but for convenience. Dermatologists with Fletcher Allen Medical Center gives weekly exams to inmates in upstate New York with trauma doctors and Ers of rural hospitals in New York And Vermont. There is two- way audio and one-way video. In the rural hospitals camera’s are mounted in the Ers the doctors that need help then phone a toll free number where they find help with one of the eight medical-center doctors that have the videoconferencing gear in their office and their homes as well. Fletcher Allen has received government grants to test out other uses for telemedicine for example videoconferencing gear in ambulances.

Physician to Client and remote monitoring

• Remote monitoring• Chronic care• Post acute care• Cardiac care• Store and foreword• Interactive• Remote

Client and Provider Response to Client and Provider Response to Remote CareRemote Care

• Patients have a high satisfaction rating on tele-monitoring.

• More convenient

• Gain ownership and control over health

• Low cost

• Providers satisfaction is good but with concerns.

• Lack of hands on

• Whether the patients are truthful in online complaints.

• OT providers have a low satisfaction due to lack of personal contact.

Financial Aspects of TelemedicineFinancial Aspects of Telemedicine

Industry trendIndustry trend

• Better reimbursement legislation. Better reimbursement legislation. • 2007 - $900 million by 2012 $6 billion2007 - $900 million by 2012 $6 billion• 78 million baby boomers - Majority reach 65 yrs of 78 million baby boomers - Majority reach 65 yrs of

age by 2015age by 2015

Benefits to patients and providersBenefits to patients and providers • Providers - greater and easier collaboration Providers - greater and easier collaboration • Patients - better service for lower costsPatients - better service for lower costs

Financial Aspects of TelemedicineFinancial Aspects of Telemedicine

Obstacles and solutionsObstacles and solutions1. Lack of reimbursement policy1. Lack of reimbursement policy2. More favorable federal and state legislation2. More favorable federal and state legislation

In regards to OTA’sIn regards to OTA’s1.1. Greater responsibilitiesGreater responsibilities2. 2. New OTA specializationNew OTA specialization - Telemedicine Technologist - Telemedicine Technologist

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Oregon projectsOregon projects 1. Oregon Health Network1. Oregon Health Network 2. LBCC Class of 2012 2. LBCC Class of 2012 http://www.gnrmall.com/ot/http://www.gnrmall.com/ot/

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ReferencesReferences

• Samaritan Health, http://www.samhealth.org

• “Planning and Implementing a Statewide Telehealth Program”, http://endowmentforhealth.org

• Breen, Gerald-Mark, and Jonathan Matusitz. 2010. "An Evolutionary Examination of Telemedicine: A Health and Computer-Mediated Communication Perspective." Social Work in Public Health 25, no. 1: 59-71.

• Rheuban, Karen S. "The role of telemedicine in fostering health-care innovations to address problems of access, specialty shortages and changing patient care needs." Journal of Telemedicine & Telecare 12, (September 2, 2006): 45-50. Academic Search Premier, EBSCOhost (accessed September 20, 2010).

• New York Times, Doctor & Patient:” Are Doctors Ready for Virtual Visits”, By Pauline W. Chen, MD, Jan. 7, 2010

• http://www.kgw.com/news/Providence-technology-helps-sick-mom-meet-baby-101470714.html

• http://www.informationweek.com/news/global-cio/showArticle.jhtml?articleID=20301362

• Fleming-Michael, Karen, “Researchers Make Progress with Robotic Telesurgery”, Army News Service , May 12, 2006, http://www.military.com/features/0,15240,97023,00.html

• Cris Rowan, OT (Reg), BScOT, BScBi, SIPT, Approved Provider for ACTBC, AOTA and CAOT

• http://www.zoneinworkshops.com/articles/telehealth-%E2%80%93-what-is-it-who-is-doing-it-and-does-it-work/

• “9 Killer Telemedicine Apps That Will Revolutionize Healthcare”, by Ryan Winter on July 21, 2009: http://blog.soliant.com/

• “Types of Telemedicine” By Sandy Taylor Published: 4/23/2010, http://www.buzzle.com/articles/types-of-telemedicine.html