Telemedicine: Business Opportunities for Rural Broadband Providers
Posted by Jesse Ward on Monday, September 19, 2011 · 
(1)
- Telemedicine: Business Opportunities for Rural Broadband Providers
- Telemedicine: Health Information Technology Services
- Telemedicine: Remote Patient Monitoring
The health care industry is under increasing pressure. Costs are rising and straining available resources. Currently, the U.S. spends more on health care than any other developed nation.[1] It accounts for 17% of U.S. GDP;[2] by 2017 it will top 19%.[3]
The population also is aging. By 2040 there will be twice as many Americans over age 65 than there are today.[4] Chronic conditions, which account for 75% of nation’s health care costs, are increasing across all ages.[5] Further, the current health care system is not without fault. For instance, on an annual basis, 1.5 million Americans are injured because of prescription drug errors.[6]
In rural areas, health care providers face additional challenges. Rural Americans experience more chronic conditions such as diabetes and heart disease than their urban and suburban counterparts.[7] People living in rural locations also face greater difficulty accessing quality health care. Although nearly 25% of the U.S. population lives in rural areas, less than 9% of physicians practice there.[8] As a whole, the country is expected to have a shortage of tens of thousands of physicians by 2020.[9]
Faced with these challenges, the health care industry is undergoing dramatic, evolutionary change. Regulatory, legislative and industry drivers are altering established pricing and reimbursement structures, enabling new treatment applications, and creating new standards of care, while simultaneously promising to reduce costs.
This transformation in the health care value chain will be facilitated and enabled through the use of technology. Broadband-enabled solutions, usually grouped under the name health information technology (HIT), will assist health care practitioners as they strive to more effectively and efficiently serve the patient.
Over the next few weeks, the New Edge will publish a series of articles exploring how the health care industry is adopting and utilizing information technology, and how broadband providers can support health care facilities, practitioners and patients with their technology needs.
What is Telemedicine?
In March 2010, President Obama signed into law two pieces of legislation that together comprise a large-scale reform of the U.S. health care system: the Patient Protection and Affordable Care Act (PPACA, H.R. 3590) and the Health Care and Education Reconciliation Act of 2010 (H.R. 4872), which amended the PPACA.
This landmark legislation has three overarching goals: it endeavors to reduce costs, both for the individual user and for the overall population; it strives to increase overall standards of care; and third, it aspires to shift the U.S. medical system from a reactionary to a preventive and proactive organization, which monitors and treats patients before they are in need of expensive, urgent care. In order to bolster these goals, the legislation advanced the use of HIT, and its underlying telehealth and telemedicine fields.[10]
HIT is an overarching term, which refers to new information-driven health practices and the technologies that enable them. It includes electronic billing and scheduling systems, the use of electronic health records (EHRs) and automated processes for clinical care.[11]
The American Telemedicine Association (ATA) defines telemedicine as “the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status.”[12] Telemedicine encompasses a wide variety of applications and services. For example, remote patient monitors, which electronically collect and send biometric patient information to health care providers; store and forward technologies which electronically transmit pre-recorded videos and digital files such as X-rays and photos between specialists or primary care providers; and interactive applications, which enable patients and practitioners to communicate in real-time via voice and video sessions.
Other telemedicine services extend the reach of specialists to small, remote facilities. For instance, rural clinics may not be able to provide a full-scale pharmacy. Through the use of broadband applications, telepharmacies can remotely dispense medications. The electronic connection allows patients to receive medication counseling. Through remote, intensive care unit (ICU) monitoring, devices track patient health information in small hospital ICUs. The information is sent to tele-ICU centers (or tele-hubs), which are managed by specialists. The remote ICU specialists can support on-site practitioners who may have less critical care expertise.
The terms telemedicine and telehealth often are used interchangeably. However, telehealth is a broader use of technology, which expands beyond clinical evaluations to non-clinical practices such as research, education and administration.[13] This is especially important for rural care providers as broadband facilitates continuing education and an expanded professional community.
Telemedicine intersects with HIT in many areas, such as interoperability, infrastructure, privacy and security. For instance, a radiologist reviewing X-rays must be properly authenticated and connected to a secure network. Likewise, data collected from a remote patient monitor must be securely transmitted to a health care practitioner for review. Telemedicine requires a robust HIT infrastructure.
Communications Links
Telemedicine was first introduced more than 40 years ago, as hospitals extended care to patients in remote areas. Today, telemedicine applications are offered in a variety of settings: hospitals, clinics, home health agencies, private physician offices, and in patient’s homes and workplaces.
Applications are delivered using two-way video, voice and data transmissions, and oftentimes wireless or mobile connectivity. There are a variety of network options: the use of the pubic Internet with an encrypted connection; dedicated and private point-to-point connections, which are often much more expensive; and private telehealth networks.
The ATA estimates the number of existing telemedicine networks in the United States at roughly 200, connecting nearly 2,000 medical institutions throughout the country. These regional or state networks developed as needs arose, and based upon the availability of funds via grants, loans and subsidies. Oftentimes, these private networks are used by a variety of other public resources such as higher education institutions, public libraries and government agencies.
High-speed, future-proof broadband is a vital component to telemedicine applications. Connectivity will take on new importance over the next few years as the federal government imposes HIT standards on all health care providers and facilities (to be discussed in the next section).
Rural local exchange carriers (RLECs) have a demonstrated tradition of serving anchor institutions. Many RLECs already provide large data circuits to local hospitals and health facilities. Another opportunity is for RLECs to work with the existing state or regional telemedicine network to expand the number of connected sites and locations.
Further, these existing telemedicine networks will require increased bandwidth as they adopt additional telemedicine applications and services. Current, participating facilities primarily use their connectivity for education or to perform administrative functions.[14] In the future, rural health care practitioners increasingly will turn to telemedicine to bridge the gap between health care availability and patient need.
Stay tuned next week for part two in the series, which will explore the evolving role of health information technology (HIT).
Related posts:
Thanks for providing such awesome information indeed!