Posted on Mon, Jul. 31, 2006
A potentially major development in modern health care for many Hoosiers occurred May 1 when state Medicaid coverage expanded to include reimbursement for telemedicine costs.
Telemedicine involves the electronic transmission of medical data from patients at remote sites to physicians and other health care providers, eliminating the need for travel and reducing the costs for many consultations and examinations. In the United States, home health care visits by nurses number about 500 million annually. And for many of the nearly 2 million Hoosiers who live in rural areas, the need for telemedicine can be quite compelling.
Telemedicine can be found in an ever-growing set of new technologies. Videoconferencing is the most obvious because it allows the patient and the health care provider to confer directly and in real time via the Internet.
However, other forms of remote technologies now include otoscopes that collect medical data through the ear canal, digital thermometers that scan the temporal artery on the forehead and non-invasive finger sensors to measure the heart rate and oxygen saturation level in the patient’s blood.
Additional digital equipment is used to monitor a patient’s weight, blood pressure, glucose level, blood clotting time, and breathing capabilities. Remote examination cameras, electronic stethoscopes and videophones designed for independent operation by a patient at a remote site. Data then can be transmitted to a physician for immediate analysis, or they can be stored in video, audio and text files for later evaluation.
In telesurgery, an operation is transmitted via videoconferencing to other sites for consultation with other surgeons and for educational purposes. In telepharmacy, a prescription may be transmitted by a pharmacist to a remote location where it is filled by a pharmacy technician.
Because extensive amounts of public health data about large numbers of patients can be collected and correlated via such technologies, telemedicine also provides opportunities for new avenues of research as patterns of patient behavior and treatment are investigated using these data. Moreover, the educational potential of telemedicine is enormous as it can link health care professionals, patients and students separated by large distances.
Although reimbursement by Medicaid to those eligible for such assistance is a major step forward for Hoosiers, there are other obstacles that must be overcome if telemedicine is to fulfill its promise. One technical obstacle is bandwidth capacity, for without sufficient bandwidth it becomes impossible to transmit large amounts of data efficiently. Fortunately, bandwidth capabilities are expanding rapidly across the state while the costs for such services are being steadily reduced.
Other unresolved issues include malpractice liability coverage for health care providers in telemedicine, licensing these professionals and ensuring confidentiality of electronic records.
Finally, the most difficult obstacle may be the reluctance of many physicians, nurses and especially patients to embrace this new technology because it differs from traditional health care.
Telemedicine may never be as satisfying as a personal visit to the doctor’s office or a home visit by a nurse, but it does provide part of the answer to how a limited number of future health care professionals will be able to attend properly to the needs of our ever growing elderly population.
And as the technology that supports telemedicine further develops and obstacles are overcome, the entire world of medical care will become much more accessible to everyone, including those living in remote locations.
Gerard Voland is the dean of the School of Engineering, Technology and Computer Science at Indiana University-Purdue University Fort Wayne. Send questions and comments to him at volandg@ipfw.edu or 481-6839.
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