Telemedicine is no longer considered a separate, medical specialty – it’s pervasive throughout the healthcare industry. Yet, as with any technology offering, telemedicine comes with it’s challenges. Although services are readily available to patients through hospitals, specialty departments, home health agencies, and private physicians, there are a great deal of pressures factors falling on IT teams restraining success.

  1. Matching the right telecommunication technology to end-users
  2. Managing QoS and video call quality
  3. Providing the data needed for legal and reimbursement issues

Now, this isn’t even an exhaustive list, but it gives you an idea of the scope of the issues IT must manage related to telehealth. Let’s start by defining come commonly confused industry terms.

Defining “Telemedicine” and “Telehealth”

First and foremost, let’s define the difference between the terms “telemedicine” and “telehealth.” They are often used interchangeably; however, the differences in offerings between the two can impact the way that IT teams select and manage telecommunication technologies.

Telehealth: This term includes a broad range of technologies and services aiming to provide patient care and improve the healthcare delivery system as a whole. Telehealth to a broader scope of remote healthcare services, and can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services. The World Health Organization but it well when they stated that telehealth includes, “surveillance, health promotion, and public health functions.”

Telemedicine: This term refers specifically to remote clinical services and it involves the use of electronic communications and software to provide clinical services to patients without an in-person visit. Telemedicine technology is frequently used for follow-up visits, management of chronic conditions, medication management, specialist consultation, and a host of other clinical services that can be provided remotely via secure video and audio connections.

Benefits of Telemedicine Influence a $67M Forecast for 2021

According to Mordor Intelligence’s Telemedicine Market Report, the telemedicine market is expected to reach $66,606M (USD) by 2021 which indicates growth at a CAGR of 18.8 %. This growth was mainly attributed to the potential of telemedicine to continue to revolutionize healthcare as a service. The American Telemedicine Association (ATA), states that telemedicine can be conducted by leveraging a variety of applications and services using two-way video, email, smart phones, wireless tools, and other forms of telecommunications technology making healthcare readily available to anyone – anywhere.

Patients Enjoy:

  • Less time away from work
  • No travel expenses or time
  • Less interference with child or elder care responsibilities
  • Privacy
  • No exposure to other potentially contagious patients

Providers Enjoy:

  • Increased revenue
  • Improved office efficiency
  • An answer to the competitive threat of retail health clinics and online-only providers
  • Better patient follow through and improved health outcomes
  • Fewer missed appointments and cancellations
  • Private payer reimbursement

There are very few limitations to how telemedicine can be applied. Here are a few examples of how telemedicine is being used and the results a successful offering can yield.

  • Follow-Up Visits: Using health software for routine follow-up visits is not only more efficient for providers and patients, but it also increases the likelihood of follow-up, reducing missed appointments and improving patient outcomes.
  • Remote Chronic Disease Management: The increasing rate of chronic disease is a major challenge for our health system. It is a prime candidate for the use of telemedicine software because it makes it easier and less expensive for patients to maintain control over their health.
  • Remote Post-Hospitalization Care: One telehealth program for patients with congestive heart failure reduced 30-day hospital readmissions by 73% and six-month readmissions by 50%.
  • Preventative Care Support: Weight loss and smoking cessation are the keys to reducing heart disease and a host of other conditions. Telemedicine can be a valuable tool in connecting providers with patients to make sure they get the support they need to be successful.
  • School-Based Telehealth: When children become ill at school, they might visit a school nurse or be picked up by their parents and taken to an urgent care center. Some innovative districts have teamed up with doctors to conduct remote visits from the school. The provider can assess the urgency of the case and provide instructions or reassurance to parents.
  • Assisted Living Center Support: Telemedicine software has already proven to be useful in keeping residence of assisted living facilities out of the hospital. Problems often occur at night or on weekends, making hospitalization the only option even for less urgent problems. With telemedicine, on-call doctors can conduct a remote visit to determine if hospitalization is necessary.

How to Address Limited Success in Telemedicine

Although cost and lack of infrastructure can be attributed to the lack of success for some telemedicine programs, ultimately things boil down to the management of telecommunications technology. Let’s take a look at the primary issues IT teams are faced with when it comes to supporting telemedicine for their organizations.

1) Matching the Right Collaboration Technology to End-Users

Frost & Sullivan recent white paper, The Growing Use of Videoconferencing in the Healthcare Market, does a lovely job highlighting key trends for the use of telecommunications within the telemedicine market. Along with the influence of geographical location and country-based restrictions, this report dives into recent age trends and makes some interesting predictions. Due to millions of baby boomers now retiring, technology innovators can be found designing and building a new market for them that will allow those non-tech savvy, senior citizens to communicate with healthcare providers and from their homes or assisted living facilities.

However, more interestingly, Grand View Research’s recent report indicates web-based telecommunication’s “delivery mode” market held 78% of the share in 2014 and is expected to grow at a CAGR of 17.3% by 2022. Meanwhile, cloud-based delivery mode is anticipated to be the fastest growing segment over the forecast period with a CAGR of 19.5% owing to the advantages such as easier usability, limited memory requirement, and possibility of using the system on any device. Rising investment by IT firms in cloud computing is expected to raise their demand over the forecast period.

There are very few solutions on the market right now that provide cloud-based video communications that are also secure and enable HIPAA compliance – must-haves for any healthcare organization. Requirements for an effective cloud telehealth communications platform include:

  • Video, audio, and content sharing
  • Support for desktop, mobile, and conference room systems   
  • Works well in low-bandwidth environments
  • Ease of deployment and ease of use
  • Integration with EHR (electronic health record systems like Epic) and point-of-care peripherals, such as stethoscopes and medical carts
  • End-to-end AES-256 bit encryption to enable HIPAA compliance
  • Signed Business Associates Agreement (BAA)
  • Virtual waiting room for patient privacy
  • Platform API/SDK for integration with healthcare applications
  • Remote camera control

Vyopta recently completed an integration with Zoom who provides enterprise video communications software which meets all of these requirements and more. You can learn more about Zoom at https://zoom.us/plan/healthcare.

2) Ensuring Telemedicine QoS and Video Call Quality  

Managing telemedicine technology does come with some added pressures since the term means you’re dealing with doctor-patient communication, emergency diagnosis, patient file transmissions, and so much more.

Real Time: Fixing Call Quality Issues for In-The-Moment Improvement   

The best way to stay on top of quality performance issues is to closely monitor video endpoint status. By having your finger on the pulse in these areas, you’ll be able to quickly identify, troubleshoot, and resolve video call issues before they make an impact your telemedicine network performance.

Vyopta Recommendation: One of our many joint customers with Zoom, Specialists on Call (SOC), is a major provider of telemedicine services. Before Vyopta, they didn’t have the tools needed to react quickly in real time. However, after SOC invested in a real time monitoring tool, they were able to monitor the right metrics and quickly react when any endpoint or network within their 300 hospitals experienced a performance issue.

“We can be even more proactive with our video network, allowing us to deliver the highest quality telemedicine services in the industry.”

Geoff Bricker

Former Director of Information Technology, Specialist on Call

Long-Term: Improving QoS and Video Call Quality Performance For Good

It’s an unfortunate reality, but telecommunication technical errors and malfunctions do occur within the telemedicine industry. Although physicians who have agreed to offer patient care via telecommunications should understand that technical issues are rare, this is not always the case. Ultimately, physicians still have a business to run.

However, common issues can be avoided with comprehensive telemedicine network monitoring.

Vyopta Recommendation: We encourage IT professionals to focus heavily on the following metrics in order to take preventative measures.

  • Packet loss
  • Jitter
  • Latency
  • Bandwidth (per call and total)
  • Call disconnect rate
  • Call disconnect codes

Additionally, spend time analyzing peak usage trends in order to accurately plan and allocate capacity for a most consistently positive end-user experience.

Unified communications video conferencing assessment

3) Limited Metrics and Reporting to Support Legal and Reimbursement Issues

Healthcare facilities and physicians are required to provide the same caliber as in-person care. However, to prove telemedicine services meet state and insurance standards, physicians must produce specific (and accurate) call data and reporting.

“The emergence of telehealth in recent decades and the increased adoption by private practices, hospitals, and larger health systems has triggered an explosion in telemedicine-related legislation. In January 2015 alone, over 100 telehealth-related bills were introduced.” 

Chiron Health

However, the lack of interoperability between telemedicine solutions, endpoints, and infrastructure can prove challenging for both IT professionals and healthcare administrators to locate and send in a preferred format.

Vyopta Recommendation: Learn what data and reporting is needed for your state and insurance reimbursement. To help you get started, we’ve published a Mini Guide: Telemedicine Reimbursement. You’ll find a list of required industry resources, state regulations, required data points, and more.

From there we recommend you research and document any interdependability issues within your network may be preventing you from getting the data you need. If you find you’re lacking required data points, it may be time to switch solutions or find a third party tool that can provide the additional insights you need and unify your entire network for a successful telemedicine program.

Thanks for reading! If you have comments, please feel free to leave them below.

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