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Jonathan Linkous of the American Telemedicine Association identifies the trends to watch
With so much going on in health IT today, it can be difficult to determine which trends will really influence managed care organizations in the near term. To help clear up some of the confusion, and zero in on the biggest trends that matter, Managed Healthcare Executive (MHE) recently spoke with Jonathan Linkous, CEO of the American Telemedicine Association (ATA).
The ATA advocates for the use of advanced remote medical technologies. As the chief staff executive of ATA since its inception in 1993, Mr. Linkous has lectured and written extensively on healthcare modernization, technology issues, emerging applications and market trends in the U.S. and around the world.
LinkousLinkous: There are two areas that are moving into the healthcare space that will have a significant impact. The first is actually not new: the growth of outsourced vendors for telemedicine IT.
Historically, programs implementing a telemedicine project hired a technology professional to help select, install, and maintain equipment and broadband telecommunications. Many large health systems are moving away from pilot projects using telemedicine toward a strategic approach integrating telemedicine services throughout the organization’s clinical operations. Thus, telemedicine becomes a catalyst to the transformation of the entire enterprise from, for example, from a bricks and mortar facility to a region-wide health provider.
This is a challenge to the traditional approach to IT. The challenges have caused many organizations to use an outside vendor to provide IT services. As hospitals become one component of a health system the use of an outsourced vendor for all IT services is growing.
The second significant change is the development of sets of home-based, vital sign devices. Consumers have commonly used weight scales and thermometers but new innovations have provided an array of high-quality, low-priced devices with digital outputs allowing consumers to send providers enough data and images to allow diagnoses and treatment of conditions that previously required doctor visits. Telemedicine kits including scopes, various measuring devices, and even minor lab tests are already on the market in limited areas-but may soon become so widespread that the home will become the doctors’ offices of the future.
Linkous: Automation and artificial intelligence potentially represent the greatest transformation in healthcare services. Robotics and computer-assisted decision making have actually been used in many clinical environments for over a decade in critical care, lab testing, and imaging. Computer diagnostics are already being used to read EKGs, automating Pap smear analysis, and providing decision support in the ICU. Robotics are allowing surgeons to perform minimally invasive surgery and do grand rounds from their home.
The growth of downloadable digital apps for providers and patients combined with artificial intelligence is exploding the possibilities of moving the doctor’s office to the home. Testing is already underway for handheld devices that will monitor and diagnose over a dozen healthcare conditions independent of a healthcare worker or facility. In the clinical environment, robotics and artificial intelligence have improved quality metrics, especially for complex diagnoses and procedures.
Plus, such innovations are allowing clinical staff from one facility to see and treat patients in other locations, thus opening up the possibility of shared staffing on regional or even national levels. In some instances, such technologies could reduce the need for additional specialty services.
Linkous: Home lab testing and intelligent apps are starting to revolutionize the management of chronic care. Home lab testing allow consumers convenience, privacy, and control by using technology to provide results for a wide variety of conditions from high cholesterol to STDs. The availability of low-cost, almost instant lab tests allows a consumer to not only get the results right away but also use computer analytics to interpret the results and receive recommendations for actions to take as a result of the test.
Intelligent apps for wireless devices take this a step further, allowing patients with chronic conditions to monitor their vital signs anywhere they are located. This explodes the concept of “home care” to “anywhere care,” allowing many patients who are restricted on travel to be almost anywhere and still be able to send in notifications, send in vital signs, and talk to a provider.
For example, a device could pick up elevated blood pressure or glucose and alert the provider before the patient has to be sent to a hospital. Some estimates predict 500 million patients will be using mobile health apps. There are over 150,000 health-related apps which run on one or another of the two main smartphone operating systems, Apple’s iOS and Google’s Android. PwC, a consulting firm, forecasts that by 2017 such apps will have been downloaded 1.7 billion times.
Aubrey Westgate is executive editor of Managed Healthcare Executive.