"A cue that we can take from the corporate world would be to further implement the innovation of telemedicine"

In my most recent segment I expressed the desire for actual innovations in healthcare delivery, and not simply health insurance reform. I have since come to the conclusion that innovations will not occur at the federal level, and that we need to consider innovations at the regional, state and/or local level.

What, then, are examples and or opportunities for innovation? 3M, one of the most successful corporate innovators of our time, defines innovation as, “New ideas – plus action or implementation – which results in an improvement, a gain or a profit.” (3M)

A cue that we can take from the corporate world would be to further implement the innovation of telemedicine, “ the transfer of medical information via telephone, the Internet, or other networks for remote consultations, examinations, or even procedures.” (Ref. 1)

A popular use of telemedicine is for rural health care, and emergency medicine is also using this innovation. Some of the outcomes are the prevention of unnecessary transfers (which could save thousands of dollars), the use of telemedicine suites in the Emergency Department (ED) for “specialty and subspecialty consultation” and the use of virtual tools. (Ref. 2) An example is the use of telemedicine in the management of asthma in which a spirometer-oximeter is equipped with a speaker enabling the device to transfer the data via acoustic coupling over a normal phone line.

As to the prevention of unnecessary transfers, “About 60 percent of transports to UMC possibly could be avoided if specialists were available for consultations, saving hundreds of thousands of dollars and many lives”, (says) Dr. Latifi (Ref. 3).

For those concerned with the safety of telemedicine, an article in JAMA recently “detected no association between implementation of telemedicine technology and adjusted hospital or ICU mortality, LOS, or complications.” (Ref. 4).

Telemedicine is not without its concerns of software compatibility, privacy (concern with two-way transmissions) and differences of site credentialing between CMS and JCAHO.

My personal experience with telemedicine is having witnessed my (now deceased) father at home, post-discharge from a bout of CHF, having an apparatus delivered to his home that would awaken him at 10 AM every day, direct him to step onto a platform that would register his weight, measure a pulse-ox, blood pressure and pulse, administer a series of audio and written questions to which he could respond either verbally or written, and have the information and responses sent to a central monitoring location. This apparatus and process allowed him to return home at least three days earlier from the hospital.

Access is paramount, and so is the control of cost due to chronic disease. Though our time with patients is already (mandatorily) shortened, maybe it’s time for us to consider medicine and telemedicine from the corporate perspective of an innovation that will avoid unnecessary encounters, provide distanced service and bring about “gain, profit and improvement”.

References

1. Joint Commission Perspectives, May 2009, volume 29, issue 5.

2. Telemedicine in Emergency Medicine. Information Paper. www.acep.org/WorkArea/DownloadAsset.aspx?id=8988

3. Trauma Surgery Goes Virtual to Aid Rural Arizona. Tue Dec 14 08:55:56 2004 Pacific Time. AHSC Office of Public Affairs: News Release Archives. www.opa.medicine.arizona .edu/newsroom/newsArchive.cfm?…1

4. Association of Telemedicine for Remote Monitoring of Intensive Care Patients With Mortality, complications, and Length of Stay. JAMA. December 23/20, 2009. Vol 302, No. 24.

About the Author

Dr. Ardena Flippin

Ardena L. Flippin, MD/MBA is a professional speaker who focuses on the healthcare crisis facing corporations today.

Dr. Flippin, a Chicago native, is a retired board certified emergency medicine physician.