Telehealth Education at the State Fair: A History

The State Fair countdown continues! Today, we take a look back at the history of telemedicine education at the Minnesota State Fair.

The video below illustrates the development of telemedicine educational program at the Minnesota State Fair over the past ten years. The program started in 2002 under the direction of the Minnesota Telehealth Network and since 2009 has been directed by gpTRAC. Every year gpTRAC hosts a “patient awareness booth” at the fair, educating fairgoers about telemedicine services.

The goals of this event are:

1) To increase the general awareness among fairgoers about the capabilities and availability of telemedicine services, and

2) To increase the awareness of skin cancers and the importance of regular communications with healthcare providers about this dangerous disease.

The telemedicine services are provided free of charge in the University of Minnesota building on the State Fair grounds, which connects to the University of Minnesota Department of Dermatology via the University’s gigabit network.

gpTRAC will be in the University of Minnesota tent again during the 2013 State Fair, continuing the tradition. Come stop by and visit us August 22-30!

Teledermatology at the 2013 Minnesota State Fair

It’s almost time again for the Minnesota State Fair!  Again this year gpTRAC will be partnering with Minnesota physicians to provide fairgoers with free teledermatology screenings.

At the 2012 Minnesota State Fair gpTRAC connected 182 patients to dermatologists using a videoconferencing system and a hand held exam camera.  Thousands more were able to watch the sessions in action.  Many of the fairgoers said they hadn’t made it a priority to get screened until they came upon our booth, and many passerbys said it was their first experience seeing telemedicine in action.  To date, gpTRAC has showcased teledermatology, pulmonology, and stroke screenings.

Stay tuned for a schedule soon!  And be sure to stop by and visit us in the University of Minnesota tent for your free teledermatology screening!

The Futures of Telehealth: What you need to know now

For June’s National Telehealth Resource Center Webinar last week Dr. Stuart Speedie of gpTRAC presented on the topic of Telehealth Futures.

According to Dr. Speedie, the guiding principle that will shape the future of telehealth is that healthcare and the healthcare delivery system are largely concerned with the exchange of information.  So how can telehealth services improve information exchange?  Dr. Speedie sees five distinct possibilities:

1. Through Specialty Care Delivery– including elaborate videoconferencing based telehealth.

2. By investing in mHealth– including healthcare mobile apps, devices, and solutions.

3. By exploring options for In Place Care– including home monitoring, nursing home settings, and schools.

4. Through Care in the Work Place.

5. By focusing on Consumer Wellness– including physical, mental, social, and spiritual health promotion.

The futures of telehealth depend largely on staying relevant as new modes of information exchange are developed and the focus of healthcare delivery continues to shift and evolve.  At the core of each of these futures however is the uniting fact that a career in telehealth will always be a career in information exchange and healthcare delivery.  To access Dr. Speedie’s full presentation and other previous webinars, visit the gpTRAC webinar archive, or you can download Dr. Speedie’s presentation directly here.

Minnesota DHS: Telemedicine and Chemical Health

The Minnesota Department of Human Services is exploring how telemedicine can improve the efficiency and effectiveness of interventions, treatment, and recovery related to Alcohol and Drug Abuse.  Why?  According to DHS research, of all the people who seek treatment for chemical health issues in the US, only 10% actually receive it.  Additionally, rural populations experience the most barriers to substance abuse treatment programs and recovery options.  Telemedicine technology could help ameliorate these problems by extending the reach of chemical health counselors employed in areas like the Twin Cities, to underserved and geographically isolated populations in rural Minnesota, where counselors are harder to find.  However, currently insurers do not resimburse for chemical health services delivered at a distance.  DHS has a task force (the Sustance Use Disorder Model of Care Workgroup on Telemedicine) compiling information on the subject.  The group recently released their first collective report:  Telemedicine/Telehealth Workgroup Issue Analysis.  For more information, visit the DHS website.

Minnesota company Clear.md: Startup of the Year Finalist

Clear.md is a web and mobile application that connects patients to healthcare providers through short, one topic, tailored videos called “vidscriptions.”  Almost a year ago, gpTRAC was writing about clear.md in this blog as an example of how innovative technology healthcare companies could help alleviate future physician shortages.  Today, Clear.md is being recognized at the Doctors 2.0 conference in Paris as a finalist for “Startup of the Year.”

From clear.md’s press release:  “A global perspective has defined our strategy since day­one. We are honored to be recognized by Doctors 2.0 in Europe as a US ­company with an international identity, and we look forward to representing the Twin Cities digital health community at the conference in Paris this June,”said John Brownlee, CEO and co­founder of clear.md.”

Congratulations to John Brownlee and the clear.md team!  For more information on clear.md, visit the website at www.clear.md.

Mill City ICC: New Healthcare Innovation Center

Information technology, mobile connectivity, social networking, and healthcare delivery are at a historical point of convergence.  Now is the time to invest in new strategies to direct the future of healthcare.  As of May 8th, 2013, Minneapolis has a new healthcare innovation center to do just that, and it is right in gpTRAC’s back yard!

Announcing the Mill City Innovation and Collaboration Center
Mill City ICC Full Press Release

The goal of the Mill City Innovation and Collaboration Center (Mill City ICC) is to reduce unnecessary clincal visits while improving the quality of chronic disease and ambulatory patient care.   The ICC plans to do this by researching and testing new care models based on collaboration and intelligent utilization of technology.  Telehealth will play a critical role in the ICC design process.

Press release excerpt:  “The ICC has already become a magnet, attracting hardware, software, telecommunications, life science and academic institutions that want to play a vital role in reimaging the patient experience. The ICC’s programs will educate healthcare systems and serve as a site where participants can collaborate in developing the necessary New Models of patient engagement, monitoring and motivation.”

We are looking forward to tracking the ICC progress as they delve into the “super convergence”, and you should to!  For more information and to follow the ICC visit millcityicc.org

Telehealth News Flash

The telehealth news articles we have been talking about around our office this week:

New York Times Well:  My Stroke of Luck
How one man learned about telestroke technology through a stroke of his own.  His response to reimbursement resistance:  “Well, there was no living, breathing stroke specialist at my bedside to bill in those first vital hours. Give me a virtual doctor any day.”

Washington Post:  Telemedicine makes new advances, all the way to Antarctica
Videoconferencing enables a partnership between the University of Texas Medical Branch and National Science Foundation workers living at a scientific research station in Antarctica.

Healthcare IT News:  Why not MU for telemedicine?
Noteworthy reflection on Ryan Spaulding’s presentation at this year’s American Telemedicine Association meeting.  The topic:  Meaningful use of telemedicine and how Telehealth Resource Centers can help create a national strategic plan.

Argument: It is not necessary to include mid-level providers in telemedicine policy

Advocates for telemedicine policy that includes mid-level providers will likely face opposition.  Three likely arguments will be: (1) patients aren’t interested in telemedicine, (2) telemedicine should not replace in-person visits and (3) if telemedicine policy does change, there is no need to include mid-level providers.  Below is a sample evidence-based response to the third argument.

Argument:  It is not necessary to include mid-level providers in telemedicine policy.

Response: Unless mid-level providers are reimbursed for services provided via telemedicine, they will remain underutilized.  In the proposed policy we include nurse practitioners (NP), physician assistants (PA), nurse midwifes, and clinical nurse specialists (CNS). There are three main reasons they should be included as reimbursable for telemedicine services.

1.  According to the Association of American College work force projections “nationwide physician shortages are expected to balloon to 62,900 doctors [by 2015] and 91,500 by 2020 (Krupa, 2010).”  Mid-level providers can help fill this gap.

2.  It has been suggested that “in telemediated heath care nurses or physicians’ assistants are the key actors who have to perform many tasks in the absence of physicians (Oudshoorn, 2009).”  Mid-level providers are an ideal workforce to train as technology experts for delivering telemedicine services.

3.  Under the Interstate Nurse Liscensure Compact, a nurse that is liscenced to practice in one state of the compact, may practice in any state of the compact (Bailey, 2011).  This means that nurses are not subject to the same laws governing licensing of physicians which prohibit them from practicing medicine (or telemedicine) outside of their state.  There are currently 24 states that have adopted the compact (Bailey, 2011).  Nurses, therefore, are able to offer telemedicine to a wider range of patients nationwide than primary care physicians.

The utilization of mid-level providers is integral to maximizing the potential benefits of telemedicine.

Bailey, R.A. (2011). The Legal, Financial, and Ethical Implications of Online Consultations, HEINONLINE, 16, J. Tech. L. & Policy, 53

Krupa, C. (2010) Physician Shortage Projected to Soar to More than 91000 in a Decade, American Medical Association. Retrieved from http://www.ama-assn.org/amednews/2010/10/11/prsb1011.htm

Oudshoorn, N.(2011) Telecare Technologies and the Transformation of Healthcare. United Kingdom, Palgrave MacMillan.

Argument: Telemedicine should not replace in-person doctor visits

This is part 2 in our 3 part series on responding to arguments against telemedicine. 

Background:  Advocates for telemedicine policy that includes mid-level providers will likely face opposition.  Three likely arguments will be: (1) patients aren’t interested in telemedicine (covered here), (2) telemedicine should not be allowed replace in-person visits and (3) if telemedicine policy does change, there is no need to include mid-level providers.  Below is a sample evidence-based response to the second argument.

Argument:  We should not let telemedicine replace in-person doctor visits

Response:  It is true that a patient-doctor interaction is different through telemedicine.  Without the physical ability to touch the patient, the doctor is limited in the care they can provide.  However, telemedicine is a tool meant to complement existing healthcare methods, not replace them.  As specified in the American Medical Association guidelines about online medical consultations, “E-visits are not intended for new patients or for established patients with an urgent medical issue, a condition with a significant visual component, such as a rash, or one requiring a physical exam.  Those patients would be asked to visit the patient’s practice for an on-site evaluation (Bailey, 2011).”  Telemedicine will not replace traditional in-person visits; only expand the range of care providers are able to offer.

Bailey, R.A. (2011). The Legal, Financial, and Ethical Implications of Online Consultations, HEINONLINE, 16, J. Tech. L. & Policy, 53

Argument: Patients don’t want to use telemedicine services

Advocates for telemedicine policy that includes mid-level providers will likely face opposition.  Three likely arguments will be: (1) patients aren’t interested in telemedicine, (2) telemedicine should not be allowed replace in-person visits and (3) if telemedicine policy does change, there is no need to include mid-level providers.  Below is a sample evidence-based response to the first argument.

Argument:  Patients don’t want to use telemedicine services

Response: Telemedicine patients have reported good acceptance rates and satisfaction with the technologies and treatment via telemedicine has been proven to be efficacious (Whitten, 2007).  Additionally, a recent Price Waterhouse Cooper Study found that 50% of people surveyed stated that they “would seek healthcare through online consultations” and that “email consultations were the most preferred method”, followed by “Webcam/video consultations (Thompson et al, 2011).”

Thompson, M., Isgur, B., & Foong, S. (2011) Focusing on Healthcare Value, Price WaterHouse Cooper, Retrieved from http://www.pwc.com/us/en/view/issue-12/focusing-on-healthcare-value.jhtml

Whitten, P. & Buis, L. (2007) Private Payer Reimbursement for Telemedicine Services in the United States, Telemedicine and e-Health, Vol. 13, DOI: 10.1089/tmj.2006.0028