As the tech landscape continues to evolve and change, healthcare is following suit with new applications that aim to make urgent care more accessible to all. Telehealth involves the use of telecommunications and other technologies to support all aspects of health, including patient care, public health, clinical health care, and health administration.1 What are examples of telehealth? Practically, telehealth can take the form of video conferences between doctor and patient, the sharing of data between providers, and patient education within communities.
As telehealth is still an emerging part of healthcare, some providers are using it better than others. Read on to see some examples of organizations using telehealth effectively.
1. Partners HealthCare and Remote Monitoring for Heart Failure Patients
Remote monitoring is one of the best forms of telemedicine, essentially allowing for the real-time transfer of data from the patient to a doctor or clinician. Using this data, the doctor can then adjust treatment options and provide better care.
Partners HealthCare, a Boston-based non-profit network for digital healthcare providers, offers a variety of programs through its Center for Connected Health. In particular, the Connected Cardiac Program was introduced in 2006 and has since enrolled over 1,200 heart failure patients. The telehealth program combines remote monitoring with care coordination, nurse intervention, coaching, and education. Patients send data about weight, heart rate, pulse, and blood pressure to providers every day, allowing for a more effective assessment of patient status and prompt education and care. This has contributed to a nearly 50 percent reduction in hospital readmissions related to heart failure.2
2. Tele-ICU Services at the University of Massachusetts
Over the past 20 years, telemedicine in psychiatry has expanded to incorporate upwards of 13 percent of patients in intensive care units throughout the country. Integrating tele-ICU care programs has allowed for improved outcomes thanks to population oversight, proactive management, and a standardization of care processes.3
The University of Massachusetts’ Memorial Medical Center has found increasing success with remote tele-ICU (or eICU), which provided early concrete evidence in the potential for telemedicine in improving care. Tele-ICU essentially allows intensive care specialists to remotely monitor patients and act as a second pair of eyes for on-site nurses and doctors. The remote healthcare professionals could enforce patient treatment plans, ensure best practices, and alert on-site staff when patients were in trouble. Studies found that the implementation of eICU at UMass Memorial Medical Center contributed to fewer patient complications and lower mortality, but even outside of the medical center, tele-ICU saw great success, reducing mortality rates from 10.7 percent to 8.6 percent.4
3. Telehealth in Alaska
While The Land of the Midnight Sun offers an expanse of icy forests, Alaska is most often characterized by large areas with low population density. This results in small health care networks with some smaller villages surviving without doctors or nurse practitioners. In the event of a network outage, patient records have to be sent by dog sled to Anchorage (a 30-day trip).
Thankfully, locals in Alaskan villages realized the need for telehealth services. Alaska’s telehealth program launched in 1999, allowing for better access to patient care. Community health aides, similar to EMTs, input patient information into the telehealth program and take care of minor health issues in small village communities.
The next big step is better integration of these telehealth services into electronic health record systems. This could eliminate the amount of labor involved with inputting patient information and could help to support population health, particularly in more developing communities that don’t have access to healthcare.5
4. Kaiser Permanente’s Adoption of Teledermatology
Skin cancer is the most common form of cancer in the United States and the world at large. Estimates suggest that one in five people in the country will develop some form of skin cancer at some point in their lives.
Kaiser Permanente developed its teledermatology program in Northern California over a decade ago. The program allows primary care physicians to transmit pictures of potentially cancerous lesions to on-call dermatologists before making any referrals to the dermatology department. The workflow of teledermatology with dermoscopy and a face-to-face followup increased skin cancer diagnoses by 9 percent while reducing potential biopsies by 4 percent. The teledermatology workflow also reduced the need for face-to-face visits by 39 percent. These new strategies in teledermatology may offer more effective and more affordable medical care to the U.S. healthcare system overall.6
5. Telehealth in Vanuatu
Located in the South Pacific, Vanuatu normally requires a boat ride lasting up to six hours to reach the nearest health facility. Others in need of emergency health services had to be carried by stretcher across the island and up a 500-meter incline to reach the nearest hospital.
In 2016, the country established its first high-speed internet connection, along with its first telemedicine system. This system connects local nurses to remote physicians and specialists, mainly providing education and telemedical consultations.7
6. Wireless Medication Adherence Systems
While telemedicine consultations are important to patient health, making sure that patients adhere to medication and treatment plans outside of consultations is also vital. The previously mentioned Center for Connected Health from Partners Healthcare studied the potential for medication adherence using an electronic pill bottle. The pill bottle essentially alerted patients to take their medication for high blood pressure using lights and sounds. The wireless functionality allowed for the pill bottle to send notifications to a patient’s phone, along with medication refill reminders and progress reports that could also be sent to family and primary care providers. An intervention-plus group also received a financial incentive for adhering to the study.
A three-month analysis showed that those in the intervention had adherence rates of 98 percent, while those in the intervention-plus group had adherence rates of 99 percent. This was significant considering the control group, which did not have the electronic pill bottle, had an adherence rate of just 71 percent.
Poor adherence reduces the effectiveness of medications, increases overall healthcare costs, and puts patients at risk.8
7. Remote Patient Monitoring for Veterans
Remote patient monitoring is becoming increasingly important in the ongoing medical care of those with chronic diseases. In the Veterans Health Administration, remote patient monitoring has been used to help those with depression and post-traumatic stress disorder, patients undergoing chemotherapy, and those in need of palliative care. Studies show that remote monitoring and chronic care management supports patient self-management and reduces pressure on emergency departments and hospital services.
An assessment from 2002 found that use of remote patient monitoring among veterans led to a 60 percent decrease in hospital admissions, a 66 percent decrease in emergency department visits, and an 81 percent decrease in nursing home admissions. Remote monitoring for end-of-life palliative care also led to reduced hospital and emergency department costs.9
From video conferences to remote monitoring, telehealth applications continue to develop with the growth of technology and interconnectivity provided by the internet. The future is bright for telehealth, and it may just be a matter of time before it is more broadly and effectively applied among all healthcare providers.