Telemedicine At Sea

In International Shipping News

ClipperTelemed+ offers advanced telemedicine services 24/7 from emergency physicians to crew members of merchant ships, super yachts, and individual yachtsmen.  Recently ClipperTelemed+ assisted 2 crewmembers aboard yachts racing around the world.  The first patient was a 68 year old made suffering from symptoms that were suggestive of a possible heart attack, however, after consultation with the telemedicine service, he was treated for heat exhaustion and was able to continue the race.  The second patient suffered a large arm wound. The telemedicine physician was able to guide other members of the crew on stitching and setting the injury.

In both instances, a diversion and medical evacuation was avoided. The physicians can help diagnose and treat anything from broken bones to infections, collapsed lungs, dislocated shoulders and abdominal injuries while giving advice on using/administering medicine from the on board kit they also provide.

Cleveland Clinic Offers New Telemedicine App

Ron Hurtibise

The Cleveland Clinic recently announced a service called MyCare Online which gives patients the ability to see medical professionals any time of the day. The visits can take place on any device including computer, tablet or smartphone. The cost of a 10 minute visit is $49.

The most common conditions that can be diagnosed and treated include bronchitis, asthma, cough and cold, earaches, allergies, sinus infections, rashes, urinary infections and yeast infections. “The way we deliver services is rapidly evolving and technology allows us to make access to healthcare more convenient,” said J. Gregory Rosencrance MD, chairman of internal medicine at Cleveland Clinic Florida, in the news release. If an emergency happens at night or on a weekend, “patients can be seen and treated instantly or advised to go to the hospital for further treatment.”

The Cleveland Clinic is partnering with American Well. American Well is a large national provider of telemedicine services with alliances with many large insurers and medical providers.

Sport Telemedicine in Washington

Teresa Yuan

“Several high schools in the Pugent Sound, Washington area will introduce the capability for parents to reach a sports medicine doctor virtually using a cellphone or computer for their children injured while a playing a sport. Physicians will consult and diagnose minor injuries like sprains and bruises, but more serious injuries like concussions would still need to go to the emergency room.

The state of Washington made changes this year to telemedicine law to allow coaches, trainers, students, and parents to log on to private portals to obtain consultations. The benefits of telemedicine include cost and convenience. The cost for an emergency visit is approximately $1400 while a telemedicine consultation costs $50. “We can talk to the athlete. We can ask how it happened. We can actually take the cellphone’s camera and look at the injured part of their body and see if it’s swollen, see if it’s bruised. Then we can come up with a preliminary diagnosis,” said Ryan Dirks, a sports medicine physician assistant.”

Colorado Expands Telehealth Guidelines

Ed Sealover, Denver Business Journal

Colorado’s Medical Board recently adopted guidelines to enact a new telehealth law expanding services to urban residents in addition to rural residents. Additionally, the new rules do not require an initial in person visit, a particular technology, or for patients to be in a certain facility.

Colorado previously has required insurance coverage of telehealth visits for several years in counties of fewer than 150,000 residents, but now residents in larger cities are able to take advantage of the services.   Studies show that Colorado faces a shortage of primary care physicians so telehealth allows these physicians to see more patients more efficiently.

The bill does not require insurers to provide for the telehealth benefits until the beginning of 2017. House Bill 1029 was sponsored by Reps. Perry Buck, R-Windsor, and Joann Ginal, D-Fort Collins.

Telemedicine in Schools

Eric Wicklund – Editor, mHealthNews

Texas and Georgia appear to be leading the way in implementing telemedicine to public schools. The Children’s Health System of Dallas is expanding a pilot project in 2 preschools to 57 schools in four counties. The program allows for a virtual consultation between the school nurse and a doctor or nurse practitioner at Children’s Health. The cost of a telemedicine cart is $22,000 and is being funded by a Medicaid waiver. “You want to talk about access? You want to talk about affordability? This is their access,” says State Rep. Jodie Laubenberg. “We can treat the child, have him ready to go, and we can leave him here. … You don’t have to take off work. He doesn’t have to leave school. It’s less disruptive.”

Georgia through the Georgia Partnership for Telehealth (GPT) is also looking to expand its school telemedicine program. The GPT has received a grant from the Georgia Office of Rural Health’s 2015 Rural School-Based Telehealth Center Initiative to expand its pilot program to eight schools. “For a variety of reasons, whether it be distance or financial factors, not all children have access to the medical care that they need to grow in a healthy and happy manner,” Sherrie Williams, the GPT’s executive director, said in a press release. “This grant program will help get more children the care that they need and ultimately helps foster better lives for students in rural Georgia communities. That is a huge victory and we are glad to be a part of it.”

Telemedicine Market May Reach $34B by 2020

Bernie Monegain, Editor at Large,

According to a market research report by Modor Intelligence titled “Global Telemedicine Market – Growth, Trends and Forecasts (2015-2020)”, the market for telemedicine is expected to reach $34 billion.

Factors contributing the growth include an aging population, increasing incidence of chronic diseases, rapid rise in the software market, and a desire to monitor patients in their own homes to decrease healthcare costs. North America is the largest market, accounting for more than 40% of market size, however the scope of telemedicine is increasing in developing countries.

“Telemedicine has revolutionized medicine as it has not only made healthcare more accessible to the rural population but also taken the burden off the overburdened healthcare setup. The hospitals and clinics can cater to the critically ill, while everybody else can get a consult through a simple phone call or by videoconferencing. There are a number of telemedicine startups that are investing in the telemedicine market. The advancing technology has ensured that telemedicine is as good as going to the hospital and physically meeting the doctor. It also ensures that everyone has access to a specialist consult,” the report stated.

Telemedicine Facility at Central Jail

The Times of India

Telemedicine is not just a hot medical topic in the United States. The Times of India is reporting that the central jail in Nashik Road has installed a telemedicine system to allow doctors at the local hospital to provide advice on conditions affecting the inmates.

The jail has a 72 bed hospital facility. For serious illnesses, the inmates are transported to the civil hospital. Civil surgeon GM Holey of the civil hospital said, “Over the past one month or so quite a few medical cases of jail inmates have been taken up for discussion through the telemedicine system.”

The prison has had 2 cases of attempted escape by prisoners during trips to the civil hospital for evaluation. Officials hope that the use of telemedicine may help prevent such incidents in the future.

Psychotherapy for Depression via Telemedicine

Egede LE, et al. Lancet Psychiatry. 2015; doi:10.1016/S2215-0366(15)00122-4.

Many patients with major depression do not have access to evidence based psychotherapy. This group in the Lancet Psychiatry hoped to demonstrate non-inferiority of therapy delivered via telemedicine as compared to in person therapy.

The study randomly assigned patients from the Ralph H. Johnson Veterans Affairs Medical Center and four surrounding clinics being treated for depression. to eight sessions of either therapy via telemedicine or delivered in the same room. The primary outcome measured was treatment response according to the Geriatric Depression Scale, Beck Depression Inventory, and Structured Clinical Interview.

The study found that the response on all three measures was the same and non-inferior in the telemedicine group compared to the in-person group. “Telemedicine-delivered psychotherapy for older adults with major depression is not inferior to same-room treatment,” the researchers wrote. “This finding shows that evidence-based psychotherapy can be delivered, without modification, via home-based telemedicine, and that this method can be used to overcome barriers to care associated with distance from and difficulty with attendance at in-person sessions in older adults.”

HealthSpot Kiosks Begin Retail Rollout

Carrie Ghose – Columbus Business First

HealthSpot telemedicine kiosks and Rite-Aid have announced the opening of 25 booths in stores in Akron, Canton, Cleveland, Dayton and Springfield.   Based on feedback from this initial rollout, a decision will be made on whether more stores will install booths.

HealthSpot’s booths use high-definition teleconferencing to connect patients with on-call physicians. The booths have an attendant who helps operate and sanitize the system. Incorporated within the booth are digitally connected instruments such as stethoscopes, blood pressure cuffs, and cameras.  The on-call physicians are from Cleveland Clinic, Kettering Health Network, and University Hospitals of Cleveland.

HealthSpot is a “natural extension” of the company’s offerings and provides an “alternative solution to accessing quality health care in a familiar, professional and convenient setting,” said a statement from Robert Thompson, Rite Aid executive vice president of pharmacy.

Americans Wary of Telemedicine

– Eric Wicklund, mHealthNews

A new internet survey was recently performed by TechnologyAdvice. The study included 504 respondents and asked several telemedicine questions. Of those surveyed, approximately 75% would not trust a diagnosis made by telemedicine or give it less weight than an in-person meeting. Additionally, 56% said they would not be comfortable meeting a doctor for the first time by telemedicine. Only 7.5% said they would be comfortable using a healthcare kiosk in a retail setting.

“This is perhaps the largest issue that telemedicine vendors and healthcare providers will need to overcome,” say the lead author, Cameron Graham. The study goes on to comment that “”In order for telemedicine to make a meaningful impact on American healthcare, patients will need to not only become familiar with the concept, but also recognize the benefits it can offer over traditional appointments.”

Study was not all negative. 65% of respondents said they would use telemedicine after first meeting the doctor in person. Less than 30% had a strong opposition to the technology. The survey concluded, “If patients can be convinced that telemedicine provides an experience comparable to an actual visit – at least for preventative questions – there appears to only be a small amount of intrinsic opposition to virtual systems. Overcoming these concerns will be crucial for the long-term success of the industry.”