Readers Write: Everybody’s Talkin’ Telemedicine

Everybody’s Talkin’ Telemedicine
By Janet Munro, CEO, Mehealth

From the corridors of power, where talk is of the Telehealth Parity Act, to the drugstore on the corner, with CVS Health reporting patient satisfaction rates topping 90 percent in its huge telemedicine pilot, everybody’s talking about telemedicine.

But does it work? Yes. Over 40 years of publications demonstrate that telemedicine saves money for patients, providers and payers; improves care; and yields high levels of patient satisfaction.

Here’s an example. There is a problem in pediatric ADHD care. The percentage of US children diagnosed with ADHD is climbing alarmingly; 11 percent of US children have diagnosed with ADHD. Specialists are warning that although environmental factors and social pressures may partly account for the rise in cases, poor diagnostic practices are also (probably substantially) to blame. The recommendations for the evaluation and diagnosis of ADHD are clear, but they are not systematically being followed. Misdiagnosis is a big problem. Of the 6.4 million kids diagnosed with ADHD, 4.2 million have been prescribed psychostimulants.

The American Academy of Pediatrics recommends the use of the Diagnostic and Statistical Manual of Mental Disorders. The relevant symptom groups should begin before 12 years of age, be present in at least two settings (for example home and school), and cause meaningful impairment. The symptoms and impairment should not be better explained by some other diagnosis, psychiatric or otherwise.

Digital health technologies are great for automatically coordinating this type of complex clinical task:

• Communication.
• Remote monitoring.
• Data analysis and application of algorithms.
• Mapping individual results against guidelines.
• Providing alerts.

Does this example resonate with you? Are you ready to begin utilizing telemedicine? Let’s take a look at best telemedicine practices that will start physicians off on the right foot:

• Use telemedicine to solve a problem. it’s best to start by using technology to tackle a clinical or admin problem that really bugs you. So, list your everyday challenges, determine what telemedicine tools could help you solve them (talk to colleagues, associations, professional organizations, etc.), then pick just one problem and implement a solution to help you tackle it. Don’t try to boil the ocean!
• Check out the laws in your state. We’re moving towards central regulation of telemedicine, but we’re not there yet.
• Check your equipment. For a remote consultation, you need a reliable Internet connection. For IT solutions such as on-line clinical decision support tools, make sure your Internet browser is compatible with the software.
• Don’t share your passwords and user credentials. It’s bad practice and will likely violate the terms and conditions of your service providers. If someone else in your practice needs access, then they need their own log-in.
• Privacy and confidentiality are critical. For a remote consultation, make sure you have a private and professional location, just as you would do in your clinic.
• Select the right patients for telemedicine interventions. It’s great for some patients, but not right for others.
• Obtain the patient’s consent. Whether it’s for use of a remote monitoring tool, a clinical decision support tool in the clinic, or a remote consultation. Explain what the technology is, why you are using it, and if there are any risks. Make sure patients understand what’s required of them, too.
• Think “patient-centered care” – not technology centered care!

Ready to begin? Check out the American Telemedicine Association or your own specialty organization and get connected.

Janet Munro is CEO of Mehealth in Marlborough, MA.

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Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

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