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Telehealth
Telemedicine is becoming mainstream,
observers say
Spurred by healthcare trends and
technological advances, telemedicine is growing into a mainstream
industry, according to a recent analysis in the New York Times.
About 20 percent of Americans live in places where primary care doctors
are scarce, and telehealth technology is, in theory, a solution for
providing care at a distance. Thanks to recent improvements in
videconferencing equipment and lower prices for satellite links, the
theory has become a reality.
“The technology has improved to the point where the experience of both
the doctor and patient are close to the same as in-person visits, and in
some cases better,” says Dr. Kaveh Safavi, head of global healthcare for
Cisco Systems, which is supporting trials of its own high-definition
video version of telemedicine in California, Colorado and New Mexico.
The interactive telemedicine business has been growing by almost 10
percent annually, to more than US$500 million in revenue in North
America this year, according to Datamonitor, the market research firm.
It is part of the US$3.9 billion telemedicine category that includes
monitoring devices in homes and hundreds of healthcare applications for
smartphones.
Christine Chang, a healthcare technology analyst at Datamonitor’s Ovum
unit, says telemedicine will allow doctors to take better care of larger
numbers of patients. “Some patients will be seen by teleconferencing,
some will send questions by e-mail, others will be monitored” using
digitized data on symptoms or indicators like glucose levels, she says.
Eventually, she predicts, “one patient a day might come into a doctor’s
office, in person.”
Although telemedicine has been around for years, it is gaining traction
as never before. Medicare, Medicaid and other government health programs
have been reimbursing doctors and hospitals that provide care remotely
to rural and underserved areas. Now a growing number of big insurance
companies, like the UnitedHealth Group and several Blue Cross plans, are
starting to market interactive video to large employers. The new federal
healthcare law provides $1 billion a year to study telemedicine and
other innovations.
With the expansion of reimbursement, Americans are on the brink of “a
gold rush of new investment in telemedicine,” says Dr. Bernard A. Harris
Jr., managing partner at Vesalius Ventures, a venture capital firm based
in Houston. He has worked on telemedicine projects since he helped build
medical systems for NASA during his days as an astronaut in the 1990s.
Face-to-face telemedicine technology can be as elaborate as a
high-definition video system, like Cisco’s, that can cost up to hundreds
of thousands of dollars. Or it can be as simple as the Webcams available
on many laptops.
Dr. Oscar Boultinghouse and two colleagues – Michael J. Davis and Glenn
G. Hammack – run NuPhysicia, a start-up company they spun out from the
University of Texas in 2007 that specializes in face-to-face
telemedicine, connecting doctors and patients by two-way video.
NuPhysicia uses equipment in the middle of that range – standard
videoconferencing hookups made by Polycom, a video conferencing company
based in Pleasanton, Calif. Analysts say the setup may cost $30,000 to
$45,000 at the patient’s end – with a suitcase or cart containing scopes
and other special equipment – plus a setup for the doctor that costs far
less.
Telemedicine has its skeptics. State regulators at the Texas Medical
Board have raised concerns that doctors might miss an opportunity to
pick up subtle medical indicators when they cannot touch a patient. And
while it does not oppose telemedicine, the American Academy of Family
Physicians says patients should keep in contact with a primary physician
who can keep tabs on their health needs, whether in the virtual or the
real world.
“Telemedicine can improve access to care in remote sites and rural
areas,” says Dr. Lori J. Heim, the academy’s president. “But not all
visits will take place between a patient and their primary-care doctor.”
Dr. Boultinghouse dismisses such concerns. “In today’s world, the
physical exam plays less and less of a role,” he says. “We live in the
age of imaging.”
Some oil rigs, for example, have saved $500,000 or more a year,
according to NuPhysicia, which has contracts with 19 oil rigs around the
world, including one off Iraq. Dr. Boultinghouse says the Deepwater
Horizon drilling disaster in the Gulf of Mexico may slow or block new
drilling in United States waters, driving the rigs to more remote
locations and adding to demand for telemedicine.
NuPhysicia also offers video medical services to land-based employers
with 500 or more workers at a site. The camera connection is an
alternative to an employer’s on-site clinics, typically staffed by a
nurse or a physician assistant.
NuPhysicia’s business grew out of work that its founders did for the
state of Texas. Mr. Hammack, NuPhysicia’s president, is a former
assistant vice president of the University of Texas Medical Branch at
Galveston, where he led development of the state’s pioneering
telemedicine program in state prisons from the mid-1990s to 2007. Dr.
Davis is a cardiologist.
Working with Dr. Boultinghouse, Dr. Davis and other university doctors
conducted more than 600,000 video visits with inmates. Significant
improvement was seen in inmates’ health, including measures of blood
pressure and cholesterol, according to a 2004 report on the system in
the Journal of the American Medical Association.
Posted June 3, 2010
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