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Telemedicine catches on, offers glimpse into health care’s future

telemedicine_mainMinnesota’s Mayo Clinic is using video cameras to connect babies born in distress at small hospitals to neo-natal specialists at their Rochester hospital.

In Maryland, intensive care unit patients in 11 hospitals — 10 of them in sparsely pop­ulated rural areas — now have instant access to top specialists across the state through vid­eo cameras installed in their rooms.

In Oregon, stroke victims at some two doz­en medical sites can be evaluated instantly and around the clock by neurologists.

In hospitals and medical centers across the country, telemedicine — the diagnosis and treatment of patients using telecommunica­tions technology — is transforming the deliv­ery of a growing portion of health care ser­vices. Just one example: Kaiser Permanente CEO Bernard Tyson recently announced that his health system is now seeing more patients online than in person.

Experts agree that the use of telemedicine is only going to grow.

“It’s starting to really catch on,” said Dr. Marc T. Zubrow, vice president of telemedi­cine for the University of Maryland Medical System. “I think this is the future. … In 10 years, there’s going to be a huge paradigm shift in a lot of the things we do in medicine — dramatic changes.”

Dr. Archit Bhatt, medical director for te­lestroke at Providence Health and Services in Oregon, said his system’s telestroke pro­gram is booming and now provides about 1,000 consultations a year. In the process, he said, it has given thousands of patients access to expert diagnoses and effective treatments they probably wouldn’t have gotten before — a key selling point of telemedicine.

The success has prompted Providence to explore other uses for telemedicine, such as telepsychiatry.

Bhatt conceded, however, that telemedi­cine has its limits.

“We have a long way to go for other non-stroke and non-neurological issues,” he said. “There are several barriers.”

That barriers remain for telemedicine is undisputed.

A study published in January 2015 by the American Hospital Association concluded that while telemedicine (sometimes called telehealth) is “increasingly is vital to our health care delivery system,” there are also “significant legal and regulatory challenges posed by telehealth technologies.”

Among those challenges, according to the AHA, are licensure (generally, physicians have to be licensed in the state where the patient lives, so treating patients across state lines is tricky), liability, privacy, security, and a “patchwork of reimbursement rules and rates.”

Zubrow mentioned one more impediment: Resistance from some physicians, most fre­quently, older physicians.

“We rarely run into patient or family resis­tance, but there’s a lot of physician resistance, for whatever reason,” he said. “It’s not tradi­tional, not the Marcus Welby way of doing things.”

Even the most enthusiastic advocates say telemedicine does not work for some types of medicine.

“Obviously, there are some things you can’t do very well — some things where someone has to touch the patient, to see what’s going on has to be in the same room,” said Dr. Steve Ommen, medical director at Mayo Clinic’s Center for Connected Care.

Ommen said he expects the medical com­munity to “re-examine” what needs to be done to advance telemedicine — and not just with video cameras.

He noted, for example, that devices al­ready exist that allow someone to listen to a patient’s heart and lungs remotely, not to mention monitor blood pressure, weight, and other health factors. Those devices will be used more and more in the future, he said.

“Even just exchanging text messages, in a secure environment, can be helpful,” Ommen said.

To avoid “depersonalizing” medical care, Ommen said, physicians will have to figure out the proper balance between the conve­nience and advantages of telemedicine and the need for in-person visits and touch. “We don’t know all of that yet, but I think we’ll learn it organically,” he said.

As for telemedicine’s advantages, advo­cates say they are legion. The American Tele­medicine Association lists a handful, includ­ing: improved access to expert health care, especially in less-populated areas; reduced or controlled costs due to increased efficien­cy, better management of chronic diseases, shared staffing, reduced travel times and shorter hospital stays; and equal or even bet­ter quality of care, especially in services such as mental health and intensive care.

Jonathan Linkous, CEO of the American Telemedicine Association, said telemedicine is growing faster than expected. In the past 24 months, he said in an email response to questions, the number of patients served has increased by about 30 percent.