Brave New World

The rising tide of telemedicine is forever changing how we experience healthcare



These days, the e-visit is not only an accepted norm for some people but also a lifesaving reality that contains costs and increases access.

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It's almost hard to imagine life before smartphones.

Was there really a time when we weren’t jabbing at small, light-emitting devices to find out where we stood in the world?

The truth is, advanced technology informs our every day. From the vastness of the smartphone universe to the cars we drive, technology’s reach defines our present.

But one tech application in particular is still coming of age — telemedicine.

Rooted in the Greek word tele, meaning far off or operating at a distance, this tech-fueled field is making a serious mark and changing the landscape of healthcare as we know it. Broadly defined by the American Telemedicine Association as “the delivery of any healthcare service or transmission of wellness information using telecommunications technology,” telemedicine is well on its way to placing our best health in the palm of our hand.

The Virtual Visit
In the not-so-long-ago time before video chat, it might have seemed pretty odd to meet with your doctor through a video monitor. But these days, the e-visit is not only an accepted norm for some people but also a lifesaving reality that contains costs and increases access.

Available at a growing number of hospitals and healthcare facilities nationwide (including Indio’s JFK Memorial Hospital — see Home Advantage below for details), the virtual visit serves a number of purposes, but it is most widely used to bring specialized consultations to remote locations.

The Skype-like sessions take place in a private consult room as with any appointment, with the patient and a healthcare provider meeting remotely with a specialist using secure, specialized, closed-circuit video transmission. Equipped with real-time tools such as a wireless stethoscope and speakerphone, the physician can examine and talk to the long-distance patient and deliver a more complete diagnosis and course of action than would have normally been possible. Not limited to initial diagnoses, even second opinions are available in this virtual space as part of the MyConsult Online Second Medical Opinion at the renowned Cleveland Clinic.

Complicated medical needs aside, the feared shortage of doctors needed to serve an increasingly insured population has the medical community embracing tele-techniques that optimize their time and deliver the best patient care. By most estimates, up to 70 percent of primary care visits can just as effectively be conducted remotely as in person, and companies like MDLive, Doctor on Demand, and PlushCare are streaming into the virtual arena to both serve and advocate this shift in consumer/physician behavior.

These membership-based models connect patients with board-certified physicians who assess symptoms, provide solutions from self-care to prescriptions, or fast-track patients in to see a physician should a condition appear to warrant the extra oversight. And all of this usually happens within 24 hours via video, email, or phone.

If a real-time appointment is what you want and need, platforms such as ZocDoc help make that happen. Not unlike beauty apps that let you know where to find the next available manicure appointment in your part of town, ZocDoc’s free online service takes advantage of similar gaps in physician schedules.

So instead of the 20-day average U.S. wait time, ZocDoc’s network gets you in to see a provider within 72 hours.

Mindful Monitoring
With increasing numbers of people living with chronic disease and a graying population aging in place, the need for advances in home healthcare and monitoring has never been greater.

According to the research firm InMedica, telehealth systems will be applied to 1.8 million patients worldwide by 2017, compared with the 308,000 in place today. While the specific needs of each patient vary on many levels, compassionate and careful monitoring of daily habits and vital statistics can play an essential role in maintaining a healthy quality of life.

New home monitoring devices can accurately measure and record vital stats like blood pressure, heart rate, and blood sugar levels and then transmit that data directly to a healthcare provider. Variations in a patient’s baseline readings can be immediately detected and intervention initiated before a condition escalates.

Similarly, sensors placed around the homes of elderly patients living on their own — or even in assisted living — record normal behaviors that become the framework for detecting trouble. Lights being turned on in the middle of the night or not opening the refrigerator at mealtimes can signal trouble and caregivers can be alerted.

With medication adherence being among the most common vulnerabilities in ongoing healthcare, particularly among the elderly, an ingestible sensor made by Proteus Digital Health aims to change all that. Once swallowed, the pill’s trackable coating interacts with a specialized patch on the patient. The patch in turn emits a signal notifying a related computer program being monitored remotely by a health practitioner or family member. No signal, no medication. A simple phone call can save the day.

Refining and improving tele data accuracy is another area of interest, with promising strides in the ongoing treatment of congestive heart failure and related conditions. The iRhythm ZIO XT is unlike traditional cardio monitoring devices tethered by wires, which can cause patient discomfort and offer noncontinuous data collection. Instead, the sensor-based patch can be worn continuously for seven to 14 days, providing a bigger and better window on heart patterns.

Care management is then determined with greater diagnostic accuracy. And this bodes well for the health economy: According to a Brookings Institution analysis, remote monitoring technologies stand to save our healthcare system close to $200 billion over the next 20 years.
And as those heart patients improve enough to spend more time out in the world, Ford Motor Co. has their backs: A car seat that measures heart rate is in the works.

The Empowered Individual
With game-changing technology as near as a smartphone, the rising interest in tracking, quantifying, and changing health-related behaviors is a no-brainer. And it’s a telehealth trend that hasn’t nearly reached its potential. Juniper Research predicts that the current $1.5 billion U.S. market for smart wearable devices will grow to $19 billion by 2018.

Wristbands, armbands, and smartphones fitted with sensor technology can record and monitor individual fitness, food, and sleep habits to help devise optimal health regimens. Whether this means losing weight, improving cardio health, or walking 10,000 steps in a day, individual objectives are programmed into devices and/or phones using a variety of apps and websites to rally virtual support.

Most users agree that without set goals, recording data alone isn’t that interesting. But it can, and likely will, make you more aware of your input and output behaviors — that is, how much you’re eating and exercising every day.

While many of these first-generation sensors leave room for improvement in terms of accuracy, several are already standouts, especially for weight loss.

Getting enough sleep is essential in any weight loss program, and the Basis B1 Band watch is widely considered the best sleep tracker on the market, monitoring resting heart rate, perspiration, and skin temperature. Bodymedia’s armband sensors measure perspiration and muscle heat to accurately compute activity levels and calories burned — a boon for weight loss.

For overall and long-term health strategies, curated programs like MD Revolution’s RevUp sync a range of mobile health devices and apps along with your personal health history to generate a physician-directed, personalized health plan. Following an in-depth health intake that employs a blood panel and saliva-based genomic test results, a team of practitioners helps you measure — and meet — your goals, using an advanced technology it calls predictive intelligence that can detect when you’re beginning to stray from your desired course.

As technology advances in leaps and bounds and our curiosity along with it, telemedicine is expanding our healthcare universe on unprecedented levels, virtually rewriting how we seek and assimilate medical expertise. Empowered with data, digital tools, and the intelligence (artificial or otherwise) to use them, we’re poised to partner with physicians as never before.

Despite or because of technology, this brave new world of telemedicine and remote care may well serve to bring us closer to our healthiest, most natural selves.

Home Advantage

In Greater Palm Springs, hospitals and healthcare facilities are wired into the telemedicine trend to better serve their patients throughout the valley.

At JFK Memorial in Indio, TeleMed appointments connect local specialists with remote patients through a network of affiliated healthcare providers. Serving urology, orthopedic, pulmonary, surgical podiatry, general surgery, and some oncological needs, the program expands the geophysical reach of its expertise to a 100-mile radius. And for the past four years, the hospital has also been using a SENSOR robot for remote neurological evaluation, especially important for the time-critical assessment of stroke.

Desert Regional Medical Center saves patients time and money with its InQuicker teleservice. For noncritical emergency room care, the free program not only lets you book appointments and check in remotely but, best of all, also lets you know estimated treatment times so you can come in when they’re actually ready to see you, saving you time, money, and waiting room aggravation.

At Eisenhower Medical Center, the Eisenhower 365 telehealth program leverages RelayHealth’s secure online system to provide an open line of 
communication between patient and physician. Between direct access to 
test results and a variety of messaging options, patients can connect 
with their healthcare providers 24/7.

 

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