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Paramedics prepping patient for transport and EMS telemedicine

Are Paramedics Ready for EMS Telemedicine?

As video communications infrastructures and telemedicine technology constantly improve, the opportunities to expand telemedicine into new fields are multiplying rapidly. One such area, mobile health (mHealth), refers to the application of telemedicine technologies in areas beyond the four walls of a hospital or clinic—in other words, medicine on-the-go. For instance, EMS telemedicine (Emergency Medical Services) integrates telemedicine into ambulances so that paramedics can contact a specialist at the hospital for an initial assessment, diagnosis, and treatment plan—even before arriving at the emergency department (ED). This capability offers the potential to save crucial minutes for patients like stroke victims, for whom the drug of choice—tissue plasminogen activator (tPA)—must be administered within a certain time frame to be effective and life-saving. Indeed, a recent meta-analysis of over 6,600 patients treated with tPA found a strong correlation between EMS telemedicine availability in the ambulance and decreased times from symptom onset to treatment. However, the technology can only be useful if the operator can wield it effectively; how do paramedics value and use mHealth? Read more

5 Things I Learned on ATA’s This Month in Telemedicine Webinar

As with last month, this is largely geared to updates about legislation along with reminders about the upcoming Fall Forum conference in Palm Springs, CA, which I’ll have to consider as I live out Orange County.

This month’s takeaways are a little more subdued than last month which had some pretty big news (see here).  The ATA had just done a survey on online consultations and had over 500 respondents.

1)  45% of respondents are using telemedicine TODAY.  This is fantastic news and, in my mind, is possibly underreported because, as Mr. Linkous and Mr. Capistrant pointed out on the last call (and pointed out in our 3 Things from last month), nearly every institution is already using some form of telemedicine and the boards don’t realize it.

2)  Specialty Care and Behavioral Health were the leading segments.  Not terribly surprising, as specialty care often needs to use leading edge tools to leverage resources for special care, and behavioral health lends itself well to an old-school videoconferencing set up (patient and doctor meet via video), leading to less push-back on its use while providing maximum benefit to both patients and providers.  The industry will have to really work, I think, to make sure providers and CDOs are aware of the more specialized applications and the benefits to be had.  Telemedice will not yield a large harvest if we only pick the low-hanging fruit.  As if to prove that point:

3)  77% use video, 57% use audio and 28% use medical peripherals.  Just over a quarter are using peripherals, while three times that are using video.  Being at a video-primary solution provider: Yay!  Being a proponent of telemedicine as a whole: We can do better.  Even the video-primary medical solutions offer a lot of specialized or integrated offerings that provide more than just adding a visual element to distance care.  Again, the question is, how do we get this to the doctors and CDOs?

4) Of the 55% of respondents that replied they are not using telemedicine today, 75% plan to implement it very soon.  I present that as Exhibit A to the tipping point naysayers…although I concede that if you responded to a survey about telemedicine from the American Telemedicine Association, you’re probably already predisposed to an interest in telemedicine.  Having said that, interest in telemedicine has been on the rise, and 75% of that growing crowd being interested in giving it a shot can only be a good thing.

4)  Mr. Linkous pointed out something toward the end that I assumed would be a primary driver (or at least remove an obstacle) but assumed would take several more years:  Private insurance is increasingly taking the lead in pushing telemedicine.  I’ve been noting that the reduced cost/better outcome/reduced readmissions scenario HAS to eventually turn private insurance into champions of telemedicine.  Amongst the names he mentioned were Kaiser Permanente, Aetna, WellPoint, and others.

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