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Health April 2012

Financial Fortitude

Telemedicine: The Robot Will See You Now

By Karen Telleen-Lawton

Health care organizations have experimented for over a dozen years with providing health care at a distance. For example, a stroke specialist in an urban hospital can connect with a robot in a rural outpost using an Internet connection, prescribing life-saving medication to an emergency patient.

“The robot will see you now: how non-medical technologists are revolutionizing health care.” The provocative lecture title intrigued me enough to attend and learn about what is being called telemedicine. Like television and telephones, there are pluses and minuses with this new technology.

At first I wondered whether it really is new. We all are already steeped in medical technology from the moment we arrive at the doctor’s office. Physicians enter the examination room with laptops or iPads for note taking. They examine us with electronics and send our specimens to be analyzed by more computers. Our records are slowly being transformed from thick, yellowed files to streamlined electronic bits. But telemedicine goes beyond electronic health record keeping to diagnosis and treatment.

Wikipedia describes telemedicine as helping eliminate distance barriers and improving access to medical services in distant rural communities. It makes possible immediate access to specialists that can save lives in emergencies.

An interesting aspect is the cross-disciplinary approach that is driving innovation. Electrical engineers and computer scientists are adding new viewpoints, helping to resolve health care challenges. For example, cloud computing (data storage outside your own computer) helps companies lower their health insurance costs by inexpensively collecting anonymous health data. Cloud computing is obtaining computing power as a service, typically delivered over the Internet, rather than buying computers.

Doctors are incorporating technology invented by a physicist for a device they hope will help diagnose osteoporosis – another example of the dovetailing of various disciplines that drives telemedicine. U.S. companies like BioIQ and Active Live Scientific, in the examples above, are spearheading these new technologies -- furthering not only patients’ health but the national economy as well.

Dr. Cathleen Carr is the executive director of CertifiedCare.org, which educates and certifies caregivers. She appreciates the telemedicine trend. “Videoconferencing and telemedicine can help improve the quality of care for homebound patients and cut costs,” she believes.

Robots are one of the biggest areas. Health care organizations have experimented for over a dozen years with providing health care at a distance. For example, a stroke specialist in an urban hospital can connect with a robot in a rural outpost using an Internet connection, prescribing life-saving medication to an emergency patient.

The robotic technology – basically a rolling machine topped by a video monitor – has been used since 2010 at Thomas Jefferson University Hospital in Philadelphia. A robot from a California company called InTouch enables specialists to perform remote consultations. Stroke patients in particular benefit, because a rapid assessment and treatment can prevent death or serious complications.

“A physician sitting in a remote location can direct the robot to go to a patient's bedside,” according to Pamela Kolb, vice president of clinical and support services at Jefferson, in an interview with InformationWeek Healthcare. “Then the offsite physician examines and communicates with the patient, their family, and their onsite providers.” Success, of course, depends on acceptance by the medical community and patients. A recent study conducted at three critical care units at university hospitals sought to investigate the attitudes toward the use of remote consultants in the nursing staff’s perceptions about the uses of telemedicine. The results were mixed.

Overall, most respondents thought telemedicine “improved survival in the ICU,” but the contact between local and telemedical staff was low. Seventy percent reported two or fewer telemedicine-to-nurse contacts in the prior six months. An important factor seemed to be personally knowing the physician on call for telemedical consultations. Most nurses didn’t feel the telemedicine staff was intrusive or interrupted work flow, but over a quarter thought it decreased privacy for the patient.

Eighty-seven percent of the nurses agreed that it was important for the telemedicine staff to let the bedside nurses know when they were "entering" the patient's room. Over half (57%) said that telemedicine could be improved if the current one-way system was modified so that the floor nurses could also talk to the telemedicine staff.

Improving rural care with remote diagnosis and treatment appears to be a promising area. Combined with on-the-ground trained medical personnel, telemedicine could go a long way towards improving health care in remote areas. But knowing the importance of “bedside manner” to health outcomes, I hope we move forward slowly and methodically, taking the time to observe the non-quantifiable costs as well as benefits. Next time the nurse tells me “the doctor will see you now,” I still hope it’s my flesh-and-blood one.

 

Karen Telleen-Lawton, CFP®, is the principal of Decisive Path Fee-Only Financial Advisory
(www.DecisivePath.com) as well as an environmental and economics author and writer (www.CanyonVoices.com). She can be reached at: This email address is being protected from spambots. You need JavaScript enabled to view it. .

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