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Health Care Without Leaving the Home The Emergence of Telehealthcare

Introduction
ComputerIn today’s high tech world, the concept of receiving quality health care from an experienced, licensed physician without leaving the home is not such a difficult one to conceive. In fact, an increasing number of physicians are opening up the paths of communication with their patients in a whole new way – providing consultations, drug prescriptions, and other health services via email or telephone. Often depicted as the “wave of the future,” telemedicine involves qualified medical professionals or “online doctors” offering patients clinical care services over telecommunications devices such as the telephone, email, video, and even Internet chat rooms.

An expansion of telemedicine, telehealth is an umbrella term used to describe the several variations of healthcare services using telecommunications. Telemedicine focuses more on the curative aspect of medicine, while telehealth covers the preventive, supportive and curative aspects. Indeed a broad term, telehealth can refer to two healthcare professionals simply discussing a patient’s case over the telephone; or can be as refined as several healthcare professionals from various countries using videoconferencing to discuss the latest breakthrough medical technology.

According to the American Medical Association, as many as 70% of all doctor visits are for information only and/or are matters that can easily be handled over the phone. In addition, as much as $300 billion of health care costs are deemed unnecessary, inappropriate, and/or wasteful, and are contributing to higher insurance costs for groups and individuals.

The success of online doctor consultations and prescriptions services for both patients and physicians are leading many hospitals, clinics, and private medical practices to implement their own telemedicine systems. To date, over 36 million Americans have been treated through online doctor  consultations, and this number is only getting bigger.


Clinical and Non-Clinical Uses
Black NurseThere are both clinical and non-clinical uses of telehealth technologies. Examples of clinical uses of telehealth technologies include the transmission of medical images for diagnosis; groups or individuals exchanging health services or education live via videoconference; transmission of medical data for diagnosis or disease management; advice on disease prevention and promotion of good health; and health advice by telephone for emergency cases.

Non-clinical uses of telehealth technologies include education from a distance, such as medical education and patient education; administrative uses such as meetings among telehealth networks, supervision and presentations; research; online information and health data management; healthcare system integration; general healthcare system management; asset identification, listing and patient to asset matching and movement; and patient movement and remote admission.


Benefits of Telehealth
 There are a range of benefits of using online doctor consultations and prescription services, which directly apply to individual patients, family members, and healthcare providers, as well as to community organizations, healthcare facilities, and governments.

Direct and indirect benefits of online doctor consultation and prescription services include improving the way patients and their families access information; improving health outcomes for patients; empowering consumers and communities by providing accessible health education and decision-making options; improving the way healthcare providers deliver care and access information; enhancing recruitment and retention of healthcare providers in rural/remote areas; lowering healthcare costs, reducing travel, minimizing time off of work, and decreasing patient wait time; decreasing patient anxiety, eliminating unnecessary repeat diagnostic procedures or tests; improving early diagnostic capabilities; improving administrative and communication capabilities; and improving emergency triage.

The economic benefits of online consultations and prescriptions are job creation, increased research and development investment; new business for existing and new healthcare providers, companies and solo medical practices; and increased national competitiveness at various levels including local, regional, national and international.

Additionally, utilizing online doctors benefits patients in areas in which traditional delivery of healthcare services are negatively affected by distance and/or lack of specialist clinicians to deliver services.


Home Telehealth and Survey Findings
 Steadily rising in the healthcare industry is home telehealthcare – health and education services delivered to patients in their homes utilizing telecommunications devices such as the telephone and email, as well as telecommunication-ready healthcare monitors, such as blood pressure cuffs. Home telehealth allows healthcare professionals increased opportunities for contact with their patients, which subsequently provide more comfort and reassurance to the patients and improve patient health outcomes.

According to a recent 2008 survey conducted by Fazzi Associates of nearly 1,000 home care agencies in the United States, one-third of them utilize telehealth systems; and the use of home telehealth is expected to double over the next two years. The Philips National Study on the Future of Technology and Telehealth in Home Care also reports that over 88 percent of agencies testify that telehealth services led to an increase in quality outcomes, confirmed by a reduction in unplanned hospitalizations and ER visits; and 71 percent report an improvement in patient satisfaction. The study represented all pertinent segments of home care, which include large and small, rural and urban, free-standing and hospital-based; and for profit and not-for-profit.

Senior Director of Philips Telehealth Solutions, Mike Lemnitzer believes that home health agencies will be a critical part of the solution to the present U.S. healthcare crisis, as well as ensure a continuum of care from the hospital to the home.

The study was originally designed in order to address questions and concerns of agency leaders regarding the role of four major home care technologies – human resources and billing systems, point of care systems, electronic medical records, and telehealth systems.

doctorsA great portion of the study concentrated on the various types of telehealth systems being used, the system components, what agency leaders liked and disliked about the systems, and what the leaders felt were the most significant impact of these systems on the aspects of quality and financial outcomes. The findings indicated that 17.1 percent of the agencies surveyed use some type of telehealth system, while 32 percent provide telehealth services. Over 88 percent reported that telehealth led to an increase in quality outcomes. Reductions were reported for unplanned hospitalizations (76.6 percent); and emergency room visits (77.2 percent).


In terms of value of telehealth in the home, nurses are more alert to their patients’ current needs in an increasingly timely manner; and patients who receive telehealth interventions are apt to receive more comprehensive management, which leads to more rapid stabilization. In addition, patients learn to become more competent in self management skills, which is proving to be the most cost effective home health service interaction of all.


The next step in home telehealth is to assess if the latest home telehealth technology will work in today’s ordinary home. After all, much of the new “tele-ready” equipment such as radiofrequency identification devices (RFIDs) that can be embedded in various devices remain in the lab and not so much in the average Joe’s home. This is an area that needs to improve considering that people, especially the elderly, need regular health services and personal health monitoring.


However, the good news is, these needs are being addressed. In the last ten years alone, telecare-ready devices have become more suitably designed to meet today’s health needs and have become quite affordable, thus enabling the use by a broad spectrum of patients who require health services at home. Such devices include telecommunications-ready blood pressure cuffs, glucose meters, and other peripherals that total a few hundred dollars or less. There are also full-scale online doctor work stations available, which can accommodate most monitoring devices in healthcare such as pulse oxymeters, weight scales, glucose meters, and more. These are available for as little as several thousand dollars, as compared to $20,000 per station less than 20 years ago.
On a daily basis, home telehealth products and systems are becoming increasingly simplified and better designed. Much of the equipment is conveniently color-coded and includes easy-to-follow verbal or printed directions for helping patients to obtain and transmit information to healthcare professionals.


Telemedicine is Ideal for Patients
 Several studies have shown that over 70% of patients indicated a willingness to use email and/or telephone communication with a physician.

With online doctor consultation and prescription services, patients are offered increased access to health care services with added convenience and affordability. Telemedicine helps patients avoid the hassle of having to go into the doctor’s office for acute simple medical conditions such as bronchitis, colds, coughs, flu, ear infections, sinus infections, laryngitis, sore throats, upper respiratory infections, urinary tract infections, smoking cessation, shingles, athlete’s foot, acne, rashes, insomnia, weight loss, herpes, and more.

As is the case for many physicians offering telemedicine services, after the initial consultation, patients are granted the opportunity to have physicians refill medications and receive follow-up treatment for nominal fees.

Additionally, online doctor consultation services are considerably less expensive than the average medical insurance deductible. For those who are uninsured, telemedicine services are typically considerably more affordable than the average doctor or emergency room visit in a clinic or hospital. Not to mention, a growing number of clinics and healthcare advocates secure increased funding for telemedicine centers.


Summary
Telehealth was built with the premise in mind that telecommunications technology is a tool that can drastically improve the distribution of medical care services. The utilization of online doctor systems in the United States will undoubtedly continue to rise. According to the aforementioned survey on telehealth, 84% of agencies stated that fewer than one in ten of their patients refused such systems, and fewer than 1 in 20 people refused telehealth services. Based on surveys such as this, as well as the overall consensus of telehealth in the healthcare industry, it is clear that consumers are clearly ready for telehealth in the home. Not only do telehealth services increase patient satisfaction, but they also produce far greater quality outcomes and a reduction in on-site visits, unplanned hospitalizations, and emergency room visits.

In terms of telehealth’s benefits to physicians, telehealth technology contributes to healthier, more satisfied patients, which thereby equates to cost savings and maximized operational efficiencies. In addition, telehealth allows healthcare providers well-organized access to a larger pool of patients because of their increased range of services – a big plus in today’s competitive market.

Market analyst Datamonitor predicts that the overall global telehealth market is expected to exceed $8 billion by 2012.

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