Telemedicine becoming the new house call

Travis Proctor logged onto his computer, turned on his new webcam and clicked his mouse. Within seconds, the 42-year-old father of three was face to face with Dr. Kelvin Burton, his primary care physician.

Just months ago, Proctor would have had to drive for nearly an hour round-trip from his home in Powder Springs to Burton’s Douglasville family care practice just for a checkup. Not anymore. (Read more at The Atlanta Journal-Constitution).

The referenced article by Gracie Bonds Staples prompted a Linkedin discussion where I couldn’t help but respond. Here’s what I said:

• Telemedicine includes video calls with patients, video consultations among specialists, remote monitoring of sensor devices, and more, all aimed at increasing service, improving outcomes, and lowering costs.

• It doesn’t just reduce travel in rural communities but in urban ones as well, eliminating the need for a caretaker to take off time from work or for the elderly to seek other means of transportation.

• Many physician tasks can be performed by PAs, nurse practitioners, nurses, and aids if they have remote access to experts through their smartphones and tablets, and those experts can be supported by big data supercomputers (e.g. IBM’s Watson) that do the analytics and help with diagnostics.

• And many of these tasks can be done in retail clinics or homes, reinvigorating the House Calls concept.

• Regulations must change to allow tasks to shift with new technologies and to allow remote care that extends across state lines. If it’s OK for a patient to call their primary care physician while on vacation, or when the physician is at an out of town conference, shouldn’t it also be OK for the patient to sign up  with a service that provides remote care from anywhere? For that to work, some functions of state medical boards may need to transition to federal agencies, and there are many stakeholders who will fight to protect the status quo.

• Regulations must also change to allow video conferences in some cases. It makes no sense to require regular in-person visits to renew prescriptions for lifelong conditions such as enlarged prostrate when a video call would due. Instead, public health policies should promote and encourage the use of appropriate telemedicine solutions.

• For maximum market reach, providers should adapt to whatever technology individual consumers already have and know, including a PC with Skype, iPhone’s FaceTime, xBox Kinnect, etc. Several cloud-based services are starting to provide the necessary transcoding to do that. See https://www.mhealthtalk.com/2011/03/video-conferencing-for-home-healthcare/.

• Telemedicine is just one reason why our National Broadband Policy must close the digital divide, promote BIG Broadband, encourage open competition, and allow municipalities to install public broadband services when others refuse to provide competitive services. Another reason is Telecommunting to save fuel and highway congestion while allowing employers to hire the best workers no matter where they live and giving workers access to new employment opportunities without uprooting families. And other reasons include lifelong Distance Learning to address skills gaps as technologies evolve, e-commerce even from rural towns, e-government, and improved national security. See http://cazitech.com/big_broadband.htm.

• From another Linkedin discussion: “With over 72% of the globe connected via mobile technology and over 80% of US physicians owning tablet devices, the promise of mobile health to profoundly impact the delivery of healthcare cannot be understated.” (added to our Statistics page)

You can participate in the discussion by posting a comment below or visiting this Linkedin group.