MedCity Influencers

The evolving influence of telemedicine

Today telemedicine is still mostly used in the hospital, but as it continues its expansion outwards into underserved populations, outpatient care and chronic care, one can predict that in the not-so-distant future many routine and specialized care needs will be delivered in the patients’ home.

Healthcare in America, despite the tremendous cost to the individual, corporation and government alike, ranks toward the bottom of most current global lists.  So, how do we get more from our medical system for less?

One of the prevailing answers is telemedicine.

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Within the realm of emergency or acute care, telemedicine is traditionally viewed as a support system. For example, a patient might have symptoms of a stroke, so they go to the emergency room where they can be quickly evaluated by an ER doctor who confers with a stroke specialist via telemedicine.

While the support system role of acute care is indeed a common one, the on-call telemedicine specialist as a stop-gap is giving way to the telemedicine specialist as a primary line of defense. We are already seeing it in consumer and health insurance apps for low-touch, low-risk telemedicine care.  But the role of telemedicine and its potential reach in the continuum of care is still widely untapped.

Rural care
When you visit the hospital with an emergency, there is a baseline expectation that it will have the specialists you need on staff. However, we are in an era where attracting and retaining skilled clinicians is a challenge for U.S. hospitals, and the reality is that many hospitals lack access to providers for every medical specialty. This is especially true in rural areas, where hospitals may have little to no access to specialized providers.

As such, telemedicine – especially in fields of high demand like neurology and psychiatry – is increasingly the first line of support. Telemedicine makes it possible to connect a highly qualified, board-certified expert with a patient in minutes. In rural areas, these doctors are the first and last solution for hospitals in need of specialist care. A suitable telemedicine program can rapidly fix coverage shortages and load imbalances.

Correctional Care
Correctional facilities in the U.S. are considered to be the nation’s largest provider of mental health services; yet many prison systems struggle to provide adequate treatment, even after lawsuits and courts demand access to mental health care. The fact is, our treatment of mentally ill correctional populations is at national crisis levels as evidenced by the Bureau of Justice Statistics’ 2017 special update on the mental health of incarcerated populations.

U.S. prisons and jails have reached their full capacity and cannot properly support those experiencing mental health problems because they lack the financial resources and the necessary mental health staff to provide treatment to everyone who needs it. However, telemedicine and especially telepsychiatry can help improve access to mental health services for inmates.

Correctional systems are beginning to see how telemedicine can offer them a comprehensive approach for cost savings, timely access to mental health care, and overall better health for both inmates and staff. In fact, well-managed telemedicine programs in prisons are shown to improve mental health, reduce recidivism, eliminate most prisoner transport requirements, promote staff and public safety and reduce costs for inmate care.

Outpatient Post-Acute Care
Most everyone knows and understands the value of emergency services in telemedicine, connecting experts to hospitals (and even prisons) in a time of need. The extent to which telemedicine can grow its impact on our day-to-day lives depends on the degree to which outpatient telemedicine can become the norm.

Widespread access to high-speed internet, devices with high definition cameras, and demand for convenience are dramatically changing the way patients interact with health services. Our technological infrastructure, teleconferencing capabilities and comfort with interfacing through these avenues have grown significantly. These same tools can be used to serve medicine in dramatically different ways.

Outpatient adoption of telemedicine is happening today in the offices of private practice doctors and primary care doctors. The model in primary care has made considerable inroads with insurers; that growth will continue in years to come.

Remote follow-up visits are another excellent example of telemedicine benefitting patients and practices. By connecting via telemedicine, we can effectively eliminate the inconvenience of follow-up appointments in medical offices wherever possible.

If you look at outpatient services in terms of acute care, there is tremendous potential for a care roadmap to develop in the coming years that connects subspecialists via telemedicine to patients as they move through rehabilitation and ongoing care.

Perhaps the most significant outpatient telemedicine impact is the promise shown in chronic care management. With an aging population, the number of people suffering from chronic conditions like arthritis, diabetes and heart disease grows every year. Access to quality care is often a function of where patients live, their degree of mobility and their financial means. Telemedicine allows an easier connection between patient and provider for coordinated care anywhere, any time.

The growing influence of telemedicine throughout society
Our society is benefitting from greater connectivity. Better technology. A faster and more robust flow of data. Healthcare and telemedicine are finding their sweet spot together in this new digital landscape, and as the influence of remote experts grows, so do the benefits to patients and caregivers throughout the continuum of care. Today telemedicine is still mostly in the hospital, but as it continues its expansion outwards into underserved populations, outpatient care and chronic care, it becomes more common every day. Which leads one to predict that the day is not so far off where many routine and specialized care needs will be served to the patient from the comfort of their own home.

Photo: nicescene, Getty Images

Mauricio Sirvent is the General Manager, Neurology at SOC Telmed

Mr. Sirvent is an experienced C-suite executive with more than 25 years of expertise leading and advising health care organizations with an emphasis on operational efficiencies. In his current role, Mauricio is focused on the strategic growth and alignment of the neurology service line of SOC Telemed. This involves working with SOC Telemed partner hospitals to improve quality of care for patients in an effective and stream-lined manner, while working internally to improve the planning and execution of key care-delivery processes, resource utilization, staff schedules, and quality outcome measurement. As a key executive for the neurology service line, Mauricio works with the service line growth executives and client success executives in new and ongoing hospital partnerships. Mauricio joined SOC with a varied healthcare background as an ex-hospital CEO and CFO with HCA Healthcare, as well as the CFO/COO with the Florida International University College of Medicine Faculty Practice and executive roles in other healthcare organizations. In his role as an ex-hospital administrator, Mauricio was involved in the delivery and utilization of teleNeurology as part of the first Joint Commission certified Primary Stroke Centers in Miami, FL. Mauricio, married with two daughters, holds a BS in Accounting from St. John’s University, the Peter J. Tobin College of Business.

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