Telemedicine inroads from California to Canada

California is one of many states enacting laws for telemedicine and tele-health.

 

The American Telemedicine Association meets with respect to health care reform:

 

Based on current projections, ATA 2010, May 16-18 in San Antonio, Texas will, once again, be the largest meeting on telemedicine and telehealth ever held. The gathering is the 15th annual meeting of the American Telemedicine Association and serves as an international focal point for health care professionals, administrators and representatives of technology, telecommunication and healthcare service entities.

The growth in registration and participation on the exhibit floor is a strong indicator that the market for telemedicine is continuing its expansion, despite downturns in the economy. The meeting will feature over 300 educational presentations and 200,000 square feet of exhibits, double the size from the previous year.

The surge of interest in the meeting also reflects strong upward trends in the use of telemedicine in all phases of healthcare from intensive care to chronic care monitoring to health and wellness applications for mobile devices. No longer confined to remote areas, telemedicine services are expanding rapidly in urban and suburban areas with the creation of metropolitan-wide networks of health services and direct to consumer applications using the Internet and mobile devices.

The American Telemedicine Association is the leading resource and advocate promoting access to health care for consumers and health professionals via telecommunications technology. ATA’s members include representatives from traditional medicine, academic medical centers, technology companies, medical societies, government and others to overcome barriers to the
advancement of telemedicine. Established in 1993, ATA is headquartered in Washington, DC. For more information about ATA or the ATA 2010 meeting, go to www.americantelemed.org.

Contact:
Ben Forstag
Director of Communications
American Telemedicine Association

Canada is also stepping up its telemedicine efforts in the absence of compelling law and regulation to the contrary:

 

Saying "what's up, doc?" to a physician on the phone instead of sitting around for hours in a hospital waiting room could save the beleaguered health-care system a bundle, a Montreal economic think-tank says.

In a report released Thursday, the Montreal Economic Institute says several studies in the last few years have shown telemedicine can significantly reduce costs, increase health-care service efficiency and boost patients' well-being because they spend less time travelling to and from clinics and hospitals and waiting around to see a nurse or a doctor.

This isn't shockingly new information — a similar study in Ontario in 2007 showed much the same result — but the institute says booming health-care costs make getting a tech upgrade an urgent necessity.

"With a smart phone I can take a picture of a wound on my leg and send it to a doctor," said Germain Belzile, the institute's director of research. "The doctor might say, 'It looks like diabetes; go get a blood test.' Already, we've saved 12 hours of waiting in a hospital emergency waiting room."

One Quebec study, at Maisonneuve-Rosemont Hospital in Montreal in 2003 and 2004, involved 2,400 chronic lung disease outpatients. Some had a device in their homes that gauged their lung capacity, cardiac rhythm and blood pressure and sent the results automatically to the hospital over the Internet. These patients were also consulting more frequently by phone with nurses. Other patients had no such devices in their homes and received regular medical care, including short phone calls and frequent visits by nurses to patients' homes.

Meanwhile, thanks to California's Telemedicine law, a huge initiative is underway:

What Is the Specialty Care Safety Net Initiative?


The Specialty Care Safety Net Initiative (SCSNI) is a telehealth demonstration project that connects safety net clinics across California with medical specialists at University of California (UC) Schools of Medicine at Davis, Irvine, Los Angeles, San Francisco, and San Diego. The SCSNI is a collaborative effort that seeks to discover the policy, statutory and practice pattern barriers preventing wide-spread adoption and sustainability of telehealth programs. Identifying and removing these barriers is essential to the long-term sustainability of telehealth services for the safety net.
SCSNI


Why This Initiative?

Access to specialty care is a major concern in both rural and urban underserved communities. While private and public community-based health centers provide a safety net for primary care, there is no designated safety net for specialty care. Primary care providers whose patients need specialty consults are left to navigate an uncoordinated network of private and university-based providers, many of whom are reluctant or refuse to see Medi-Cal or uninsured patients. Many of the areas in which safety net clinics indicate the highest unmet need for specialty consultations are dermatology, psychiatry, orthopedics, endocrinology, neurology and hepatology. Telehealth technologies can facilitate access to timely, cost-effective care, and these specialties are ideal for delivery via telehealth. While some telemedicine programs are financially self-sustaining, the majority of projects depend on grant support to maintain operations. Work needs to be done on alignment of incentives, reimbursement, and business planning to develop sustainable models of care. This initiative offers that opportunity.

How Is the Initiative Funded?

The California HealthCare Foundation awarded the Center for Connected Health Policy (CCHP) with $2 million to facilitate UC system and safety net community clinic participation in the initiative. The CCHP will:

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Purchase specialty clinic time from the UC medical schools. Specialty telemedicine clinics will be reserved exclusively for the patients of SCSNI partner clinics, allowing access to care for patients regardless of insurance eligibility.
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Contract with Telemedicine.com, Inc. to provide support for each participating site to include: technology assessment; telemedicine technology training; patient presentation training; and high level ongoing technical support and user training throughout the duration of the project.
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Provide limited financial support for participating safety net clinics.

 

What Is the Initiative's Approach?

Through a CCHP-supported laboratory approach, the four UC Schools of Medicine will provide consultation services to primary care providers in SCSNI partner clinics. The laboratory environment will:



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Provide access to specialty services for safety net patients via telemedicine and telehealth technologies. Specialties to be offered in this project comprise those services identified by safety net clinics as high need and include:

Dermatology (Pediatric and Adult)
Neurology (Pediatric and Adult)
Hepatology (Adult)
Endocrinology (Pediatric and Adult)
Orthopedics (Pediatric and Adult, Non-Operative)
Psychiatry (Pediatric and Adult)

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Provide education services (through physician assisted patient consults and continuing medical education presentation) to the safety net providers.

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Determine new and innovative ways to utilize telehealth and health information technologies to improve the quality, safety and efficiency of specialty care.

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Determine what, if any, policies or regulations prohibit wide spread adoption of telemedicine in the UC and safety net clinic environments.


What Are the Goals Of the Initiative?

The goals are to provide an action/advocacy agenda of policy, regulatory, statutory and/or care delivery model changes that will increase the financial sustainability of telehealth services in the safety net; and to identify a sustainable mechanism for UC and other medical specialists to serve safety net patients.

Center for Connected Health Policy

The Center for Connected Health Policy (CCHP) is a strategy and planning organization that seeks to increase the use of telehealth services in California. CCHP promotes a policy environment that encourages the adoption of telehealth services, which will improve health outcomes and access to medical care, particularly among Californians who are uninsured or low-income. CCHP conducts policy analysis and research, communicates findings and policy recommendations, and operates telehealth demonstration projects.

 

If you've watched the tele-conferences on 24, you'll recognize Cisco's presence in telemedicine..... And check out use of telemedicine in the airways of UAE:

September 21, 2010 Code Blue: ESA emergency telemedicine system soars to commercial success

Cabin personnel taking a paseenger's temperature using the Tempus IC telemedicine system. The data will be transmitted back to an expert medical team on the ground. Credits: RDT

‘Is there a doctor on the plane?’ Piping this request over aircraft speakers is the traditional response to a potential onboard medical emergency. But now the availability of expert medical advice can be guaranteed every time.

Etihad Airways, national carrier of the United Arab Emirates, is the latest airline to install the ESA-derived Tempus IC telemedicine system on its long-haul flights.
ESA developed the technology in collaboration with the UK manufacturer RDT. Already in service with numerous airlines, the briefcase-sized Tempus IC puts non-medical cabin crew in contact with ground-based experts during in-flight .

Key information about the passenger’s health can be quickly transmitted via satellite to a dedicated response centre.

The same vital signs which are measured routinely in a , including blood pressure and sugar levels, temperature and , are captured to a clinical level of quality.
At the same time, the crew can also talk with the medical specialists and send them still and moving pictures of the situation.

Imagine a long-haul flight passenger complaining of acute shoulder pain

 

. He may just have strained his muscles lifting too much luggage - or he could be experiencing a heart attack.

The Tempus IC system can transmit the passenger’s electrocardiographic readings to the medical team, allowing them to rule out and preventing an emergency diversion costing many thousands of euros.

 

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If you have legal questions concerning telemedicine and telehealth practices, HIPAA legal issues, health care reform questions, or other health law matters in New York, California, Massachusetts, Washington DC, and other states, contact a lawyer who knows the rules.

Consult an experienced health care law attorney who knows complementary medicine and integrative medicine for legal advice pertaining to any project involving allied health or CAM professionals.

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If you  have legal questions concerning telemedicine and telehealth practices, HIPAA legal issues, health care reform questions, or        other health law matters in New York, California, Massachusetts, Washington DC, and other states, contact a lawyer who     knows the rules.

Consult an experienced  health care law attorney who                  knows     complementary medicine and  integrative    medicine     for       legal     advice     pertaining to any project     involving     allied    health    or CAM     professionals.

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