In December 2018, it was revealed that Teladoc's chief financial officer, Mark Hirschhorn, 54, had an extra-marital affair with a lower-level employee, 30. He is also alleged to have passed tips to her about when to sell Teladoc company stock. Hirschhorn sold over $20,000,000 in company stock during and after the alleged affair. Several law firms launched investigations of potential securities law violations. Company stock fell roughly 20% in the days following the report.
The evolution and standardization of 5G has been a long process, but the technology could lead to major advancements in numerous areas like the smart home, media consumption, augmented reality, self-driving cars, telemedicine, and more. — Verge Staff, The Verge, "The road to 5G: the biggest news on next-gen mobile networks," 24 Feb. 2017 But now the clinic has expanded services to the surrounding community, offering primary care and specialty care services via telemedicine, including neurology, cardiology and diabetes education. — Maria Clark, NOLA.com, "Ochsner and NASA partner to open a health center at the Michoud Assembly Facility," 21 Mar. 2018 Such speeds are promoted as aiding the development of new technology in the fields of cloud robotics, telemedicine, connected cars and drones, augmented and virtual reality and more. — Ileana Najarro, Houston Chronicle, "Sprint to bring 5G mobile speeds to Houston this year," 27 Feb. 2018 Thus employees lack a strong financial incentive to seek out cheaper options, such as using a telemedicine service to diagnose pinkeye or having a hip replaced at an ambulatory surgery center instead of a hospital. — Joel Klein, WSJ, "The IRS Can Save American Health Care," 1 July 2018 The bill also has provisions meant to encourage telemedicine, and to add doctors to the state VA programs. — Erica Martinson, Anchorage Daily News, "What the new VA health care bill means for Alaska’s veterans," 24 May 2018 When patients report symptoms that are too complex to handle via telemedicine, Lemonaid doctors refund their money and urge them to see a doctor in person. — Rebecca Robbins, STAT, "A startup promised to make health care ‘refreshingly simple.’ Building the business has been anything but," 26 Apr. 2018 Folks can find a telemedicine service by contacting their insurance company (some have their own service) or local medical centers. — Houston Chronicle, "Hookah health news from your very own galaxy," 1 July 2018 The two topics at hand on this day: Whether to subsidize space exploration and whether to increase the use of telemedicine. — Kevin Kelleher, Fortune, "IBM's Jeopardy-Winning AI Is Now Ready to Debate You," 19 June 2018
This type of telemedicine allows providers to share patient information with a practitioner in another location. For example, a primary care physician can now share patient records and medical data with a specialist without being in the same room. Systems can transmit information across vast distances and different systems (sometimes) so one physician can know what another has already done. This leads to less duplicate testing and fewer instances of poor medication management.
We make any additions or deletions to the services defined as Medicare telehealth services effective on a January 1st basis. The annual physician fee schedule proposed rule published in the summer and the final rule (published by November 1) is used as the vehicle to make these changes. The public has the opportunity to submit requests to add or delete services on an ongoing basis.
Originally, health professionals developed this technology to reach remote patients living in the rural areas. But with time, medical staff and the U.S. government saw the big picture – the potential to reach urban populations with healthcare shortages, and to respond to medical emergencies by sharing medical consults and patient health records without delay. In the 1960s, heavy investments from the U.S. Government, including the Public Health Department, NASA, Department of Defense, and the Health and Human Sciences Department drove research and innovation in telemedicine. Sending cardiac rhythms during emergencies started at about this time. For instance, in Miami, the university medical center worked together with the fire rescue department by sending electro-cardiac rhythm signals over the voice radio channels from the rescue sites.
The growth in telemedicine solutions means that telemedicine options are now more diverse, with many more affordable solutions. However, most telemedicine programs do require the purchase, set-up and staff training of new technology and equipment – some of which may be outside the budget of providers in smaller independent practices. Many providers are already stretched thin on new technology budgets and staff training for EHR systems, imposed by the Meaningful Use program. Also, for patients who may not have access to a smartphone or a computer with internet, real-time telemedicine may be out of reach.
All the numbers point to the exponential growth of telemedicine – in other words, it’s not going anywhere. The global telemedicine market was worth $17.8 billion in 2014, and is projected to grow well beyond that by 2020. ATA President Dr. Reed Tuckson estimated that approximately 800,000 virtual consultations will take place in the U.S. in 2015. And health systems, doctors, legislators, and patients are fueling that upward trend. A recent survey found an incredible90% of healthcare executives were in the process of developing or implementing a telemedicine program, and 84% said these program were important. IHS projected the number of patients using telemedicine will rise from roughly 350,000 in 2013 to 7 million by 2018. And with this high demand for telemedicine, legislators are scrambling to pass bills that offer both support and needed regulations; in August 2015, Congress had 26 telemedicine-related bills waiting for decision.
At the Consumer Electronics Show (CES), TV celebrity Dr. Phil McGraw discussed the Doctor On Demand app, which connects any patient with a Board Certified physician or pediatrician via video chat in just two minutes. To use Doctor On Demand, patients download the app, give some background on their medical history, enter information on what’s wrong, and the app connects them to a health care provider from there. The service is currently available in 47 US states (excluding Arkansas, Louisiana, and Alaska) and can be accessed through the iPhone, iPad, Android, and on the web. Doctor on Demand’s hours of operation are 7 am to 11 pm local time (we're hoping it will one day become available 24 hours a day). A 15-minute session costs $40, which is a bit higher than the average co-pay many patients have for in-office visits, and the program currently does not accept health insurance. From the app demo at CES and from Kelly’s experience (more on that below), the Doctor On Demand app is quite sleek and the video chat is as easy to use as Facetime or Skype. Patients can find pharmacists and manage their prescriptions right from their smartphone – no more hard-to-read prescriptions or the potential to lose the prescription slip. Dr. Phil characterized the service as a “game-changer” and proposed that it could address 17 of the top 20 reasons people see a doctor (the flu, skin conditions, etc.) – these day-to-day conditions seem to be a key focus of Docotor on Demand, as opposed to more chronic conditions like full-time diabetes management. To learn more about Doctor on Demand’s policies and most frequently asked questions, please see this page.
While the industry is still a long way from a standard set of established guidelines for telemedicine, the American Telemedicine Association has put together guidelines for a range of specialties based on a survey hundreds of research study. What are the clinical, technical, and administrative guidelines a medical practice needs to put in place when they’re adopting telemedicine? Beyond the minimal legal requirements of that state, what are telemedicine best practices?
Alan Pitt, MD, is a neuroradiologist at Barrow Neurological Institute. He is the former chief medical officer of Avizia, which was acquired by American Well earlier this year. Dr. Pitt also serves as an advisor to several health IT companies and operates his own podcast. He offers a four-pronged framework to examine the current world of telemedicine: direct-to-consumer, self-service, clinician collaboration, and "spaces."
Telehealth for Education and Training: Numerous organizations provide healthcare education with the help of digital telehealth technologies including Harvard’s Safety, Quality, Informatics and Leadership (SQIL) program which takes a blended learning approach. SQIL uses on-demand content combined with in-person training to create a new medical education model that uses “information technology (IT), data, and a culture of continuous improvement to enable healthcare organizations to evolve into true learning systems.” Time-crunched physicians are increasingly using online and mobile platforms to meet their CME and MOC requirements, and to prepare for Board Exams.
On the eve of its July 1 IPO, the company was billed as the first and largest telehealth platform in the United States. The number of visits facilitated in 2014 was 299,000. By 2016, its visit count had grown to 952,000. The company had 8.1 million members in 2014 and 10.6 by the end of the first quarter of 2015. By the end of the first quarter of 2015, the company has 4000 clients including 160 of the Fortune 1000 companies. Two years later, the company had 7500 clients and 220 Fortune 1000 companies.
It is common for outlying healthcare facilities to transfer unnecessarily or forced to refer patients to complex cases that are beyond the knowledge-base of the local providers. Patients are therefore frequently transported over long distances to get direct care or for specialist’s consultation. These referrals and transfers can be quite costly for the patient since they present clinical, operational and financial challenges to all the parties that are involved. Telemedicine can curb such issues, reduce the frequency of travel and deliver considerable efficiencies and returns for all parties involved.
There are several areas where telehealth medicine could make a significant impact. It could be used as a tool to remotely monitor patients who have recently been discharged. It may also help treat individuals with behavioral health issues who might normally avoid treatment due to its high cost, or to avoid any perceived public stigma.  The largest area where technology could advance medicine is in treating the chronically ill. These patients usually require many visits with several specialists who may practice at different and distant originating sites. To move telehealth forward, organizational leaders must present evidence to peers and patients that the technology offers value. In addition, care providers must work to transition patients from using telehealth services only for minor conditions (for headaches, colds, etc.), to accepting the technology as a viable replacement for costly physician office visits. Advocates for telehealth medicine must also develop quality controls, so that this potentially transformational tool can maximize its problem solving capabilities and its service effectiveness. To harness the benefits of telehealth technology, America’s brightest medical professionals (both experienced and up-and-coming) must make a concerted effort to incorporate the tool into their practices and make it a regular service offering. Today’s medical students — as they enter a world where telehealth is becoming more pervasive — can take part in what might be a monumental change in the way health professionals think about medical treatment.
Blue Sky Telehealth is committed to making specialty healthcare services more accessible to patients nationwide. We partner with hospitals to create a customized telehealth system that integrates with the facility’s existing processes and technology. Through our service, medical facilities can contact highly experienced medical specialists 24/7 to assist with patient care, diagnosis, and treatment. This saves hospitals the cost of keeping a medical specialist on-call full time and ensures that a qualified medical professional will always be available to tend to a patient with special care needs.
Store-and-forward telemedicine involves acquiring medical data (like medical images, biosignals etc.) and then transmitting this data to a doctor or medical specialist at a convenient time for assessment offline. It does not require the presence of both parties at the same time. Dermatology (cf: teledermatology), radiology, and pathology are common specialties that are conducive to asynchronous telemedicine. A properly structured medical record preferably in electronic form should be a component of this transfer. A key difference between traditional in-person patient meetings and telemedicine encounters is the omission of an actual physical examination and history. The 'store-and-forward' process requires the clinician to rely on a history report and audio/video information in lieu of a physical examination.
“I woke up Sunday morning with a dry cough and terrible headache,” Ben said. “Realizing I didn’t feel up to going to a clinic, I logged on to Medical City and selected the virtual option. Using the interface was straightforward. I answered several easy questions about my current condition and minutes later I received an email that my info was being examined. I was instructed to set up an account. A second email contained my prescription and expected recovery time. I sent the prescription to the pharmacy next to my house and good to go. In no time, I had the medication and was on my way to feeling better.”