Telemedicine: Just What the Doctor Prescribed

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“You don’t have 10 minutes to wait for a surgeon,” Dr. James Marcin told the other physician. “You need to place a femoral line now.” The patient, Ian, was in a diabetic coma in Willits, California, and needed immediate intravenous fluids and medications. Dr. Marcin proceeded to explain the necessary procedures to his colleague in a calm, steady voice, and then observed placement of the special catheter into the patient. One would assume this was just another commonplace occurrence in an emergency department, except that Dr. Marcin, the director of the Pediatric Telemedicine Program at the Center for Health and Technology at the UC Davis Children’s Hospital in Sacramento, California, was in another hospital over 100 miles away. Because the ER in Willits was already bustling with two other critically ill patients and a lack of available physicians, Dr. Marcin’s virtual presence and guided instructions were crucial to Ian’s survival [1]. Ian’s case is just one example of the global impact of telemedicine, the use of electronic communication to evaluate, diagnose, and treat patients at remote distances.

According to the U.S. Department of Health, 20% of the United States population – nearly 60 million Americans – lacks direct access to vital health care [2]. Telemedicine can significantly improve access to medical attention for these people. Although such communication has been around for over 40 years, remote monitoring has expanded rapidly over the last several years due to recent innovations in networking speed and wireless devices. These devices can monitor heart rhythms, access digital images, and conduct remote robotic surgery, producing data that can be transmitted and analyzed anywhere, at any time [3].

Most Americans take accessible health care for granted. But for 1 million American children, the nearest primary care provider could be stationed 50 miles away [4]. Only 10% of the nation’s physicians practice in these rural or isolated areas. Without available medical care, it is difficult for both children and adults to maintain healthy lifestyles.

Telehealth can fill these gaps within our medical system. Expert caregivers can attend to the needs of millions of underserved patients across the globe with a simple click of a mouse. Distance and time will no longer dictate access to premier medical institutions, and the geographic reach of hospitals will increase tremendously. Regardless of the severity of a situation, telemedicine has the potential to save lives through remote consultations with patients suffering from strokes, trauma, or other critical illnesses.

The telemedicine revolution has already been set into motion, offering its benefits to participants around the globe. InTouch Heath, a leading telemedicine company, is just one example. Founded in 2002, InTouch Health delivers high-quality medical care through remote networks in approximately 1000 hospitals spanning 19 countries.

The company especially targets stroke patients. According to Andre Grujovski, the marketing manager of InTouch Health, “only 35% of the United States population is within 30 minutes of a hospital that is certified to treat stroke,” meaning many individuals live out of reach of neurologists in case of emergencies. InTouch Health works to implement “high-acuity” remote consults between certified stroke specialists and patients, achieving one consultation every 10 minutes and increasing t-PA (a time sensitive, “clot-busting” drug) administration rates from 3% to 18.9% [5]. For this company, telemedicine has given rise to a continuity of care that magnifies clinical precision, progression, and productivity.

Telemedicine does not solely benefit underprivileged patients – the average person’s healthcare costs can be cut by over 27% [6]. Telemedicine provides for consistent medical attention in less expensive and more relaxed settings, eliminating the burden of transportation and facility charges. It also guarantees near immediate care without time spent in waiting rooms. “It is more convenient for patients to travel to their local provider and connect to the specialist using telemedicine,” Dr. Marcin of UC Davis, said. “It can save time and gas, and it can prevent missing work or school.”

Telemedicine also opens the door to international medical collaboration. Remote access allows physicians to globally interact and communicate ideas at a more intimate level. Furthermore, it permits distant professors to more easily supervise the usage of specialized instruments or technologies.

Nevertheless, the greatest benefit of telemedicine may still be in the works as cutting-edge academic medical centers move from episodic care to continuously monitoring long-term disease in a cost-effective manner. Provision of chronic disease management and preventive medical carecould potentially save countless lives and billions of dollars for governmental and insurance agencies.

There are, however, a few drawbacks to telemedicine, despite the numerous advantages it brings. Perhaps most clearly, the introduction of novel technologies into a traditional, clinical environment can foreshadow inevitable mechanical difficulty. The supplemental training and instruction required to properly manipulate telemedical instruments can add additional stress to medical specialists. With virtual medical appointments, a deterioration of the traditional patient-doctor relationship could occur. Without direct face-to-face consultation, patients may lose the sense of intimacy or familiarity with their doctors.

As telemedicine becomes more ubiquitous, confidential health records will become increasingly susceptible to “curiosity seekers,” hackers, and computer criminals [7]. Videoed healthcare conversations and corresponding digital archives are subject to electronic eavesdroppers, and people can gain unauthorized access to medical charts, leading to potential losses of privacy.

With increased financial pressures and a volatile economy, the need to promote the use of telemedicine is greater than ever. Telemedicine is an affordable and novel solution that promises to improve access to and efficiency of medical care. Widespread adoption will likely revolutionize the delivery of global health care, drive down overall cost of care, and create a greater sense of provider connectivity.

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References

1. “Telemedicine Helps Save a Youngster’s Life.” Video file. Accessed December 1, 2013.

2. Diehl D, Isaac SL, Knickman JR: “The Southern Rural Access Program”, To Improve Health and HealthCare, RWJF, 2010.

3. Hjelm NM: “Benefits and Drawbacks of Telemedicine”, US National Library of Medicine: PubMed. 2 November 2012

4. Bonnie Rochman: “In Rural Areas”, TIME Health and Family, 21 December 2010

5. Grujovski, Andre. Interview by the author

6. Michelle McNickle, “5 Ways Telemedicine Can Boost Care in Rural Communities”, Health IT Care News, 31 October 2011.

7. Christina M. Rackett, “Telemedicine Today and Tomorrow: Why “Virtual” Privacy Is Not Enough”, Fordham Urban Law Journal, Article 6, Volume 25 Issue 1.

Image Credit:

[1] Retrieved February 28, 2014 from: USA.gov

[2] Retrieved February 28, 2014 from: Flickr “Telemedicine Consult.”

(Both images public domain)

Anokhi Saklecha is a junior at the Harker School. Follow The Triple Helix Online on Twitter and join us on Facebook.

 

 

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  • Adam Luzkin

    This is absolutely the future! Medical care has to be distributed, but in a manner that maintains or elevates quality without increasing cost. Nice article!