Fundamentally, we tend to think of telemedicine as a way to overcome a serious distance barrier between a patient and a healthcare provider. This point-to-point connection supports a critical function. There are cases when a patient requires the care of a particular doctor at a particular time, and technology is the best way to facilitate that interaction.
Patients and their families often want continuous monitoring and care. Traditional health insurance providers are partnering with telehealth companies, to address those concerns. Anthem is working with American Well, Cigna is working with MDLive, Bupa is working with Babylon Health and Aflac is working with MeMD to deliver benefits of telehealth to it’s existing customers. Health insurance providers such as Oscar Health is redefining health-insurance by building the whole customer experience around its own telehealth services.
Like most telemedicine tools, remote patient monitoring solutions make it easier for patients and physicians to maintain close communication. Many RPM solutions record and transmit a patient’s medical data automatically, generating a regular report for the physician. In some cases, this medical data is transmitted to a team of health monitoring professionals who are responsible for flagging any warning signs and sending them on to the physician, if needed.
Teladoc Health enjoys a killer advantage with its head start in telehealth. Around 40% of the largest companies in the world contract with Teladoc to provide virtual healthcare services to their employees. Over 35 of the biggest health plans in the U.S. have partnered with Teladoc. More than 290 hospitals and health systems have teamed up with the telehealth leader.
In the United States, the major companies offering primary care for non-acute illnesses include Teladoc, American Well, and PlushCare. Companies such as Grand Rounds offer remote access to specialty care. Additionally, telemedicine companies are collaborating with health insurers and other telemedicine providers to expand marketshare and patient access to telemedicine consultations. For example, In 2015, UnitedHealthcare announced that it would cover a range of video visits from Doctor On Demand, American Well's AmWell, and its own Optum's NowClinic, which is a white-labeled American Well offering. On November 30, 2017, PlushCare launched in some U.S. states, the Pre-Exposure Prophylaxis (PrEP) therapy for prevention of HIV. In this PrEP initiative, PlushCare does not require an initial check-up and provides consistent online doctor visits, regular local laboratory testing and prescriptions filled at partner pharmacies.
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.
As the virtual health provider highlights, the global health insurance market is worth in the trillions and expected to double in the next decade. This market growth will play out over time, but the really easy addressable market is in the US multinational employment outside the US. The new company can now provide a more complete virtual health solution for corporations with over 14 million employees outside the US on top of the 28 million in the US.
Only some states have actually regulations requiring healthcare providers to get patients’ informed consent to use telemedicine. However, this is always good practice, whether or not your state requires it. Before the first telemedicine visit, providers should explain to patients how telemedicine works (when service is available, scheduling, privacy etc), any limits on confidentiality, possibility for technical failure, protocols for contact between virtual visits, prescribing policies, and coordinating care with other health professionals. Everything should be explained in simple, clear language.
In an increasingly crowded field, the start-up is undercutting the competition with its $40 fee. American Well, which provides its technology to WellPoint , charges $49 for online visits, so does MDLive. Better offers access to a personal health assistant for $49 a month, and HealthTap recently announced it will facilitate medical consultations for $99 a month. Jackson also says that his company charges corporations $40 when the service is used, as opposed to the industry practice of charging per employee per month.
Glenda Clemens has worked in primary care since 2001 and provided virtual care since 2012. She has practiced medicine as a nurse's aide, licensed practical nurse and registered nurse before receiving her Master of Nursing from the University of Oklahoma. From running her own practice to caring for veterans, she demonstrates a commitment to providing care to underserved populations. When she is not working, she enjoys knitting, crocheting and writing poetry.
The future of telemedicine is wide open, with room for drastic improvement and more technology based medical care. As the world of tech continues to evolve, so too can the world of telehealth. Already, patients can sit down for a one on one appointment anywhere and anytime with the use of nothing more than a mobile phone. Imagine what new technology will bring in terms of holographic imaging, long distance x-ray, and more work in the field of ultrasounds.
Like all technology in the healthcare space, telemedicine solutions need to be HIPAA compliant to protect patient privacy. While an app like Skype might offer a doctor an easy way to consult a patient remotely, using it in that way is not in compliance with HIPAA. Technology used for telemedicine services needs to ensure high-level security and prevent any breaches of patient personal health data.
When a patient is in the hospital and he is placed under general observation after a surgery or other medical procedure, the hospital is usually losing a valuable bed and the patient would rather not be there as well. Home health allows the remote observation and care of a patient. Home health equipment consists of vital signs capture, video conferencing capabilities, and patient stats can be reviewed and alarms can be set from the hospital nurse’s station, depending on the specific home health device.
Although this is more difficult to prove, big payers like Blue Cross Blue Shield and Aetna are benefiting from telemedicine too. Patients with substance abuse disorders who are treated using various telemedicine strategies provide cost-savings for payers. The cost per treatment is cheaper overall and offers cost savings across the board. As technology continues to improve, the cost savings will become more visible.
Lab work and scheduling will be handled virtually on Doctor On Demand’s mobile app. Between Quest and LabCorp, patients should be able to visit a lab in-person and continue care via the app with their assigned doctor. It’s a move that will allow the tele-provider to move beyond urgent care into preventative care and encourage more regular virtual visits.
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Interoperability: This refers to two systems ((software, networks, communication devices, computers and other types of information technology components))or more being able to interact with each other and exchange information so that predictable results can be achieved. There are three different kinds of interoperability: technical; clinical and human/operational.
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