These are all examples of telemedicine or telehealth, catch-all terms for the use of telecommunications to diagnose, monitor and treat patients from afar.
Although telemedicine has been around for decades, its prevalence and popularity has suddenly exploded, fueled by a powerful combination of market forces and technological advances. The shift is expected to revolutionize the health care industry.
"It's a whole new world," said
More than half of U.S. hospitals now use some form of telemedicine, according to the
He said he was inspired by the memory of his deceased father, who suffered from irritable bowel syndrome. Had affordable telemedicine been around a decade ago, his father might have been able to get his painful condition properly diagnosed and treated earlier, Cohen said.
"It seems to me it would be a useful option," he said. "And it's generally an inexpensive option."
The savings wouldn't come to individual patients as much as to the system, which would cut costs by providing more primary care, which would then reduce hospital stays.
Though Cohen's measure has stalled, telemedicine advocates are hopeful a bill of some sort will be passed before the legislative session ends in 2016.
"There's an all-out effort to move legislation," said
Those advancements are clear on multiple fronts.
Using teleconferencing equipment, a patient can talk to a remote doctor on a computer monitor. A nurse at the patient's side assists the doctor by using an exam cam to focus on a particular part of the patient's body, or perhaps a scope to peer into the patient's nose or ears. The doctor can see the patient's face and high resolution images captured by the exam cam or scope.
It's a lot like
Then, about five years ago, she saw her first telemedicine demo.
"I was like, 'Oh my gosh, this is so cool. This is what we have to do,' " she recalled.
Today, LVHN's infectious disease doctors use that technology to examine about 30 to 40 patients a month, dramatically reducing the amount of time they have to spend on the road shuttling between hospitals.
"Think about the cost savings in transportation alone," Tracy said.
For LVHN's behavioral health doctors, telemedicine has resulted in a 75 percent reduction in travel and a corresponding 75 percent increase in psychological evaluations, according to Tracy.
Another beneficiary is LVHN's burn center. Because it is one of the few top-accredited facilities of its kind north of Philadelphia, hospitals in
One of the first challenges for these hospitals is to figure out if patients should stay put or be transported -- often at great expense. Telemedicine allows the LVHN specialists to weigh in on the tough call. If they don't have immediate access to a computer, they can view images on their cellphones.
Since 2008, the burn center has responded to more then 5,000 cases virtually, about a third of which resulted in admission to the center, according to Tracy.
Another facet of telemedicine is remote monitoring.
Every night at LVHN's Advanced Intensive Care Unit on
Since the unit was established a decade ago, the mortality rate of intensive care unit patients has dropped 31 percent, Tracy said: "If a patient is heading in a bad direction, we're going to catch that real fast."
During the day, the unit turns its attention to chronically ill patients -- those with congestive heart failure or diabetes, for example -- who live at home. Staff can check their vital signs, which are relayed by electronic devices.
St. Luke's has a similar program administered by its
"It makes the world a little smaller for our providers, and takes some of the travel and anxiety away from our patients," said Dr.
"We've done a number of patient satisfaction surveys," he added. "They love [telemedicine], and they feel like it has made a difference in their health."
Even so, the technology isn't without drawbacks, the most notable being that it keeps a doctor from actually touching a patient and from observing certain cues that sometimes aid in diagnosing a condition. It also puts distance between a doctor and patient, making the experience more clinical and impersonal.
For hospitals, cost is a drawback. Because insurance coverage for telemedicine is so spotty, St. Luke's and LVHN -- the region's biggest health care providers -- end up providing some services without reimbursement.
"If we waited for legislation to pass, we'd never make progress in health care," Portner said.
Some insurance companies, apparently, have reached the same conclusion. Capital BlueCross, which has a major presence in the Lehigh Valley, plans to cover virtual doctor visits for its PPO (preferred provider organization) plans in 2016, though not for its HMO (health maintenance organization) plans.
"This is great for the mom with the sick child in the night, and you know it's not emergency-room serious," said
An early leader in this growing market is Doctor on Demand, which Wegmans began testing this spring at several locations, including the one on
Doctor on Demand, whose founders include TV psychologist Phillip "Dr.
It won't be long -- perhaps a year -- before St. Luke's offers a similar service, Portner predicted.
"What we're trying to do," he said, "is keep our patients at home, where they want to be, and healthy."
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