What would render the word “complete” meaningful in terms of a telemedicine technology solution? According to Dr. Arlen Meyers, the president and CEO of the Society of Physician Entrepreneurs, or SoPE, and a professor at the University of Colorado, it would be an integrated system that had the ability to do telemedicine, billing, scheduling, analytics, EMRs, patient portals and other functionalities. That’s a pretty tall order, but I get your point, doctor. If the workflow is complicated, only a very few will attempt to learn how to use it. Others will try once or twice, then decide that they work better without it.
Right now, the ehealth world is fragmented. Electronic medical records could be the repository for data on patients that could be accessed in off-hours or during an emergency. Without a direct benefit to physicians, however, the government has found that “meaningful use” has been a tough sell, even with what look to be generous subsidies to cover the costs of computer hardware and software. What the incentive doesn’t cover, and what physicians must swallow, are the costs associated with digitizing all their paper records. And then, figuring out a way to make the information available 24/7/365 to other medical entities and perhaps, the patients themselves, via patient portals.
The push is on to adopt smart phone apps that monitor a patient’s health or in some way are used for medical purposes, and yet the FDA has still not published a formal decision on the smartphone, the iPad or other tablets. Are they medical devices or not? Can physicians use them to make diagnoses? Doctors will readily admit friends and family members already email photos of wounds and ask their medical opinion.
Telemedicine is more than videoconferencing – a lot more. Some behavioral health specialists think all they need is Skype to see and talk to their patients remotely. (The confidentiality issues with Skype are fairly well documented, but if you are unaware, click here. ) Now there is talk that psychiatrists and psychologists could be useful in delivering a basic level of primary care as well. When you move into the world of primary care telemedicine, you can’t do much without some medical devices like a good examination video camera, a video otoscope, a digital stethoscope, an ultrasound probe, and a way to capturing and preserving both visible and invisible light images in a patient’s electronic medical record on a PACS system, or better yet, a cloud PACS system for accessibility around the clock.
The good thing about Dr. Arlen’s proposal for a complete telemedicine technology solution is that it would do just about everything. The bad thing is that it would do just about everything. I say “bad” because systems that try to do everything almost always fail to do something right. So, what Dr. Arlen seems to be advocating is one, overall telemedicine technology solution. For the sake of argument, let’s say two or three companies develop competing systems, what would we have? Something like we have today in electronic health records – proprietary software and systems that don’t communicate. On the other hand, giving one company the monopoly position for a complete telemedicine technology solution would ensure interoperability. Without competition though, monopolies become complacent about making advancements. If only one automobile company made and sold cars, there would be no R&D department. Disregarding political involvement and safety measures, what would be the advantage to spending money on developing improvements for a customer base that had no other option but to buy your car?
And yet, I am not ready to concede defeat. I believe there are companies like GlobalMed that are looking for ways to broaden the use of their present products and are developing new ones that bring us closer to a complete telemedicine technology solution.
Roger Downey is the Communications Manager for GlobalMed, a telemedicine company dedicated to offering life science solutions to help the world realize a shared vision of health care without boundaries. He is a broadcast news veteran with 25 years of experience. In 2004, became the Media Relations Officer for the Arizona Medical Board, the regulatory agency for MDs in the state.