Arizona studies envision telemedicine on smartphones

By: Lorri Allen
Cronkite News Service
Originally published: Nov 21, 2012


Until now, telemedicine has largely involved capital-intensive studios and cameras isolated to one area of a hospital. But the Mayo Clinic and a University of Arizona center dedicated to telemedicine are pioneering work aimed at moving care to smartphones.

That means practicing medicine in remote and underserved communities will become cheaper, quicker and more effective, according to Dr. Bart Demaerschalk, a neurologist at Mayo Clinic Hospital.

"What we're attempting to do is to make it even easier for the clinical specialist to insert themselves in a virtual manner for the patient in the remote environment," he said. "A mobile device should fulfill that goal."

Dr. Ronald Weinstein, director of the Arizona Telemedicine Program, sees it as a natural progression.

"Telemedicine is rapidly evolving into being next-generation or even a generation beyond by going to mobile health or e-health, and the concept du jour is that the smartphone is the telemedicine workstation," he said.

That's happening at Benson Hospital, where health care workers use Skype on iPads to save time.

"It's very low-cost and it's to facilitate communication between our ER docs and admissions," said John Roberts, information technology director.

The entire story is here.

Is A Competitive Health Care Model All It’s Cracked Up To Be?

By Julie Appleby and Marilyn Werber Serafini
Kaiser Health News, in conjunction with The Atlantic
Originally published on September 20, 2012

Republican vice presidential nominee Paul Ryan says his proposal to overhaul Medicare would use market competition to tame costs in the government health program relied on by almost 50 million people.

As models, he often cites the health program for federal employees – including members of Congress -- and Medicare’s prescription drug program. "It works with federal employees, it works with the prescription drug benefit, and more to the point, it saves Medicare," Ryan said on "Meet the Press" in April.

Both of those programs get high marks from beneficiaries for the choices they offer. But their track record on cost control is more complicated, raising questions about whether the competitive model is in fact the silver bullet that backers have suggested. 

The federal employee health insurance program is often touted as holding down the increase in premium prices more successfully than private workplace plans or government-run programs. But a data analysis done for Kaiser Health News (KHN) and interviews with experts shows it has not held down costs per enrollee as efficiently as Medicare during the past decade.

Average spending in the federal workers’ program grew at 7.1 percent annually per enrollee, higher than the 5.8 percent growth rate for traditional Medicare – excluding the drug program -- over the decade ending in 2010, according to data analyzed at KHN’s request.  The analysis, based on 10-year averages, was done by Walton Francis, a consultant and principal author for 30 years of the Consumers’ Checkbook Guide to Health Plans for Federal Employees.

The entire story is here.

Hospitals Reaping Financial Benefits of Telehealth

By Karen Minich Pourshadi
Health Leaders Media
Originally published July 19, 2012

Here are some excerpts:

The passing of the years has softened resistance by patients to using this approach. Patients are now willing to forego an in-person visit with the doctor in order to get the care they need swiftly, without having to travel, and in some instances at a lower cost. Moreover, the reimbursement environment is changing. Whereas at one time payers rejected the notion of reimbursing e-health, now more are willing to pay for it. Plus, legislators nationwide are creating state laws requiring payers to reimburse for these services, though in many instances payers are doing so irrespective of mandate.

"Telemedicine can lower healthcare costs by reducing avoidable hospital visits and providing regular access to care in remote parts of the state, and it's more convenient for patients," says Georgia Partnership for TeleHealth CEO Paula Guy. The nonprofit telehealth provider works with more than 350 partners and 175 specialists and other healthcare providers and has handled some 40,000 patient encounters as of 2011.

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GPT has also placed telehealth into nursing homes. In 2011, using telehealth resulted in 160 ED visits being avoided, saving approximately $480,000 in ED cost, Guy says, "In the past, these older patients may have just called for an ambulance when they had a problem. But now patients can be seen by a doctor without an expensive ambulance trip to the ED. Plus they can use it for routine access to care, and by getting that they're less likely to end up in the hospital as frequently," Guy says.

Telehealth visits saved 310 miles and nearly six hours of traveling on average, according to a study by Children's Healthcare of Atlanta, a three-hospital system for children and teens. CHA reviewed 609 appointments over a nine-month period and noted that approximately 86% of patients would have missed school and more than 80% of parents would have missed a full day of work to go to the city for an in-office visit, according to data published in the Atlanta Journal-Constitution. Additionally, Guy explains that out of the 40,009 telehealth visits GPT tracked, a random sample showed an average savings of patient travel time of 124 miles per encounter and nearly $762,027 in fuel alone.

The entire article is here.