More On Ebola and Telemedicine

One of the main reasons why Ebola has been halted in the U.S. is that we’ve got the technology to help prevent its spread. For example, the New York physician who came down with Ebola checked his temperature daily and reported it (via cell phone) to other doctors. When his temperature hit 100, he knew it was time for quarantine.

So here’s the question: does West Africa have the cell network and 4G Internet reliability to effectively use technology to combat Ebola? The answer is a resounding yes.

Cell signals in West Africa are so reliable that Microsoft co-founder Paul Allen recently donated 10,000 cell phones to West African authorities and physicians combating Ebola.

In 2011, French Telecom and other providers began installing the Africa Coast to Europe (ACE) cable system. More than 10,000 miles of high-speed fiber-optic cable now connects West Africa with Europe.


West Africa fiber-optics

So there’s already an infrastture to support sophisticated telemedicine networks throughout West Africa. Everything needed to use an RP-Express robot is already in place.

In our view, there’s nothing to prevent telemedicine from playing a much larger role in the effort to stop the spread of Ebola.

Redefining “Access”

Polls consistently show that “access” to healthcare is a high priority for most patients. But a patient’s definition of access is a far cry from how providers see it.

For most hospitals and health systems, the Patient Access department is a large and complex operation. In many cases, it includes the call center employees who schedule appointments and all the folks who handle patient registration, insurance verification and payments.

In short, this team preps the patient to see the doctor, but do their efforts really ensure that you’re getting access to the right care at the right time at the right place? What happens if the specialist you’re scheduled to see is sick or stuck in traffic?

Most providers approach “patient access” either as a workflow issue or an opportunity to get upfront payment for services. They may have a check-in kiosk to expedite the process, but that’s about as far as their technology goes.

So here’s a novel idea: why not take greater advantage of telemedicine technology?

Let’s say that you visit your ophthalmologist, who’s baffled by a retinal condition she’s never seen before. It would clearly be advantageous to have “access” to a retina specialist who is familiar with it so you could get the right treatment without delay.

That’s the sort of improved access that health reform is aiming for – not just a faster way to get an appointment.

As technology-enabled consultations become more commonplace, we may not need an on-site army of registration and billing people anymore. Telemedicine is redefining “access” to mean something very simple: putting the patient in touch with the best provider, whenever and wherever needed.



An eBola Solution

In sci-fi movies, people infected with intergalactic viruses are usually treated by contagion-free robots. In similar fashion, technology is playing a role in the battle to prevent the spread of Ebola…but it needs to be deployed in a more robust way.

Currently, some of the CDC’s special biocontainment units across the country are using technology to connect Ebola patients and caregivers inside with consulting physicians and family members at remote locations. The most recent example is that of Dr. Richard Sacra, a U.S. doctor who contracted Ebola in Liberia and was taken to a biocontainment unit in Nebraska.

That’s a smart – but fairly limited – use of technology. Telemedicine would be immensely more effective if used in the danger zone. Imagine, if you will, that the government of Liberia has just built a special Ebola clinic equipped with telemedicine robots and supporting technologies. The robots could allow a remote clinician to watch the attending physician put on and take off protective apparel, reducing the risk of accidental exposure.

Robots can glide right into harm’s way, and obviously don’t require any of the fancy air filtration and ultraviolet light environments that are standard in U.S. biocontainment units.

Using robotic helpers would be an incredible “force multiplier” for the courageous doctors and nurses helping to contain the outbreak. It’s likely that fewer of them would be needed on the front lines, which would mean fewer quarantines for returning caregivers.

The prefix “e” (for electronic) is used everywhere these days: e-commerce, eBay, and so on. Maybe it’s time to thwart a deadly disease with an eBola strategy using telemedicine.



Is Your ED a Hub?

Telemedicine can help unclog crowded Emergency Departments.

There are basically two ways to run an Emergency Department. Most are designed like the Department of Motor Vehicles where you sign in and wait for service. The emerging way is to use the Grand Central Station model, where the ED is the service hub. People don’t hang out at Grand Central; they get quickly routed to the places they need to go.

Today’s most innovative EDs are using this hub approach to better serve patients – and remote presence plays a vital role in that process. For too long, Emergency Departments have seen themselves as the hospital’s front door, not the center of the entire enterprise. But a hub-style ED offers a host of benefits: more efficient workflow, better resource utilization, greater throughput, and higher quality care.

In a hub-style ED, the idea is to quickly triage and route each patient to the most appropriate care setting. How does telemedicine help? For starters, it provides better service for the ED’s most frequent users: behavioral health and pain management patients, plus those who rely on the ED for routine primary care. Because those patients aren’t in critical condition, they often sit for hours waiting to be seen. But with remote presence, they can get high-quality care without clogging up the ED. A remote physician can quickly make an assessment through devices like the RP-7i robot. That means that ED physicians have more time for patients with life-threatening emergencies.

It’s obvious that the most expensive resource in today’s ED is the provider. Highly trained ED physicians and nurses have more pressing things to do than treat sinus infections or try to determine whether a patient is depressed (especially when a behavioral health professional can be reached quickly with remote presence).

So the choice is clear: your ED can either be a plodding DMV or a fast-paced hub capable of delivering higher throughput and better care while improving the hospital’s bottom line.

This Trend Is Easy To Interpret

About 10% of U.S. patients have limited English proficiency. By law, all hospitals that receive federal funds must offer some kind of interpreting service to those patients. Big medical centers usually have an on-staff interpreter proficient in the most needed languages like Spanish. Small hospitals often have to rely on a clumsy “he said/she said” solution, where the patient and provider pass a cell phone back and forth while a translator in a distant city tries to sort things out.

Sometimes an interpreter can’t be found at all – and that can have a negative impact on outcomes. In a recent study at two pediatric ERs, when a nonprofessional interpreter (such as a family member) was involved, there was a lot of miscommunication. And nearly 25% of those translation errors posed potential health risks for the children being treated.

That’s why many healthcare organizations are turning to telemedicine for solutions. With remote presence, hospitals don’t need to hire full-time interpreters because the language experts are available 24/7. Instead of a crackly phone call, patients get face-to-face communication (resulting in fewer errors). And you can find interpreters for a variety of languages, not just Spanish.

Here’s one scenario: Suppose a business traveler from Rio de Janeiro comes to the ER at a large medical center in Los Angeles. They’ve got an excellent Spanish interpreter on staff, but the man speaks Portuguese, not Spanish. The interpreter might get close to a decent translation, but close isn’t good enough in the ER. With remote presence, you can quickly connect the patient with a Portuguese interpreter in Boston.

Because of health reform, patient satisfaction now plays a key role in reimbursement. And a recent study in Annals of Emergency Medicine revealed that patients who had professional interpreters had satisfaction scores that were four times higher than patients relying on family members.

It’s all very simple. Remote presence boosts patient satisfaction, which in turn boosts reimbursement. That’s a language everyone can understand.