Telehealth Monitor

Congress moved a step closer Tuesday to filling a critical vacancy in President Obamas Cabinet when a Senate committee approved the nomination of Kansas Gov. Kathleen Sebelius to head the Department of Health and Human Services.

Senate Finance Committee Chairman Max Baucus, Montana Democrat, said he would press for a speedy confirmation for Mrs. Sebelius before the full Senate, although several Republicans are determined to block the vote.

“I congratulate Governor Sebelius and will push for immediate action by the full Senate so that she can finally roll up her sleeves and get down to helping out on this critical work of reforming the health care system,” Mr. Baucus said.

via Sebelius backed by Senate panel – Washington Times.

Baton Rouge on Thursday became the second city in the United States to implement a telemedicine program that allows doctors to treat patients en route to the emergency room, city-parish officials said.

Initially, the specially equipped ambulance will communicate only with Our Lady of the Lake Regional Medical Center, but plans call for the program to be expanded to all seven major area hospitals with federal Homeland Security funds, said Chad Guillot, assistant director of Emergency Medical Services.

Our Lady of the Lake was selected for the pilot program because it already uses a hard-wired telemedicine system to monitor intensive-care patients from a central location, he said.

The ambulance in the “BR Med-Connect” program will use the same wireless mesh network that police are using for their new high-tech surveillance system, which includes not only video cameras but shot-spotters that detect the origin of gunshots.

via 2theadvocate.com | News | BR implements telemedicine program — Baton Rouge, LA.

A former Fort Collins psychiatrist has pleaded no contest in California to practicing medicine without a California license and faces a possible year in jail.

Christian Hageseth III, M.D., who still lives in Fort Collins, will be sentenced April 17 in a San Mateo County court. Hageseth, 68, had been facing a possible three-year sentence and a $10,000 fine. He has been free on $100,000 bond.

Hageseth was charged with prescribing a generic antidepressant medication in 2005 to John McKay, a 19-year-old student at Stanford University, via an Internet pharmacy Web site. McKay, who had a history of mental illness and alcohol abuse, later committed suicide and traces of the drug were found in his system.

Carleton Briggs, Hageseth’s attorney, said his client pled to the charge mostly due to health considerations. “A major reason was his health,” Briggs said. “He just had open-heart surgery and this was literally killing him.”

Prosecutors argued that Hageseth needed to have a California license before he could prescribe medications for a person living in that state. A trial had been scheduled for April 20.

Briggs said he believed the case has been precedent-setting even though it did not go to trial. “For the first time in the English-speaking world a doctor is being jailed for prescribing medicine across state lines without a license,” he said. “I think this effectively eliminates telemedicine nationwide.” 

via Northern Colorado Business Report – Business News Focused on Northern Colorado.

Some new low-cost services have popped up on the Internet with the aim of providing basic health-care consultations more cheaply and easily.

In January, American Well Inc. went live with a Web service that allows patients to communicate with doctors via online video, text chat or phone. The doctors can view patient personal health records through Microsoft Corp.’s HealthVault and even prescribe medication over the Web. The service is currently available only in Hawaii through the Hawaii Medical Service Association, the Blue Cross Blue Shield affiliate in Hawaii. HMSA-insured patients pay $10 for a 10-minute visit; uninsured or non-member patients pay $45 for a 10-minute consultation.

A similar service, SwiftMD Inc., launched in November and is now available in New York and New Jersey. For a one-time $18 registration fee and $9 a month, users can make an appointment at any time to speak with a doctor over the phone or through online video chat. Doctors call or connect on average within a half an hour of when the appointment was made, and patients pay $59 for the consultation.

And in Dallas, TelaDoc Inc. has a similar service that allows anyone to go online or pick up the phone and schedule phone consultations with physicians.

The services are the next step in “telehealth,” or the delivery of health care through the telephone, Web or other telecommunications technologies. While some doctors communicate with their patients electronically, medical providers and insurance companies generally provide online services that allow patients only to manage personal health records, schedule appointments, refill prescriptions and request referrals.

via Cough, Cough. Is There a Doctor in the Mouse? – WSJ.com.

Personal health records, or PHRs, were all the buzz at last week’s health-tech conference in San Diego — especially recent entries by Google and Microsoft that have the rest of the industry energized, focused and at least a little bit frightened.

Bill Reid, director of Microsoft’s HealthVault program, described the effort to integrate information technology into personal health care as a “long journey. We’re just at the front end of the process.” Was this an acknowledgment of the complexity of the task ahead? Or a way to reduce expectations about the software giant’s big investment?

Based on the conference, a high-energy gathering of great minds and entrepreneurial hustlers, it may be both. In addition to Google and Microsoft, dozens of companies presented online products designed to make U.S. health care smarter, stronger and better looking. There was a plan to offer online doctor consults at $1.99 per minute, a provider search tool pitched as “the match.com of health care,” and an electronic medical record that made you want to bask in the sheer beauty of ear infection data.

via Microsoft Health vs.Google Health – washingtonpost.com.

COLUMBIA, Mo. – Many older adults want to remain active and independent for as long as possible. Seniors want to age in their own homes and avoid moving to institutions or nursing homes. University of Missouri researchers are using sensors, computers and communication systems, along with supportive health care services to monitor the health of older adults who are living at home. According to the researchers, motion sensor networks installed in seniors’ homes can detect changes in behavior and physical activity, including walking and sleeping patterns. Early identification of these changes can prompt health care interventions that can delay or prevent serious health events.

As part of the “aging in place” research at MU, integrated sensor networks were installed in apartments of residents at TigerPlace, a retirement community that helps senior residents stay healthy and active to avoid hospitalization and relocation. MU researchers collected data from motion and bed sensors that continuously logged information for more than two years. The researchers identified patterns in the sensor data that can provide clues to predict adverse health events, including falls, emergency room visits and hospitalizations.

“The ‘aging in place’ concept allows older adults to remain in the environment of their choice and receive supportive health services as needed. With this type of care, most people wouldn’t need to relocate to a nursing home,” said Marilyn Rantz, professor in the MU Sinclair School of Nursing. “Monitoring sensor patterns is an effective and discreet way to ensure the health and privacy of older adults.”

In recent evaluations, the sensor networks detected changes in residents’ conditions that were not recognized by traditional health care assessments. MU researchers are perfecting the technology infrastructure at TigerPlace as a model, so these technologies and supportive health care services can be made available to seniors throughout the country.

“Our goal is to generate automatic alerts that notify caregivers of changes in residents’ conditions that would allow them to intervene and prevent adverse health events,” Rantz said. “Additional work is underway to establish these health alerts, improve the reliability and accuracy of the sensor network, implement a video sensor network, and refine a Web-based interface to make it even more user friendly and meaningful to health care providers.”

Tiger II, a 22-unit addition to TigerPlace, opened on Jan. 1. TigerPlace community residents receive health and wellness services through TigerCare, a service of the Sinclair School of Nursing. Residents receive care and services when they need them and where they want them – in the privacy of their apartments.

Through its university affiliation, residents can participate in a number of educational, cultural and research projects both on site and on campus that are conducted by the College of Engineering, School of Nursing, Health Professions, and Medicine at MU.

The study, “Using Technology to Enhance Aging in Place,” was presented at the 2008 International Conference on Smart homes and health Telematics. It was funded by a grant from the U.S. Administration on Aging and the National Science Foundation ITR grant.

via Health-Monitoring Technology Helps Seniors Live at Home Longer, MU Researchers Find | MU News Bureau.

(pressebox) Hannover, 16.02.2009, Das Krankenhaus Barometer 2008 der Deutschen Krankenhaus Gesellschaft redet Klartext: Jede dritte deutsche Klinik schreibt rote Zahlen. Die Aussichten für 2009 sind nicht besser. Prozessoptimierung ist deswegen eines der ganz großen Themen für die Krankenhäuser. Ein wichtiger Stellhebel für die Verbesserung der Wettbewerbsfähigkeit von Kliniken sind moderne IT-Lösungen. Sie können helfen, Prozesse effizienter zu gestalten und die Behandlungs- und Versorgungsqualität von Patienten nachhaltig zu verbessern. Die im Rahmen der CeBIT 2009 ausgerichtete Kongressmesse TeleHealth widmet sich dem Thema ITK in der Medizin. Vom 3. bis 8. März erfahren Fachbesucher auf der TeleHealth zum Beispiel, warum Software bei der Entlassung von Patienten hilft und weshalb mobile Visiten mehr sind als nur technische Spielerei.

IT-gestütztes Entlassmanagement nutzt Patienten und Kliniken

90 Prozent der deutschen Kliniken mit mehr als 50 Betten sehen etwa beim so genannten Entlassmanagement großen Handlungsbedarf. Eine pünktliche Entlassung der Patienten nach erfolgreicher Behandlung bedeutet für Krankenhäuser in Zeiten der Finanzierung durch Fallpauschalen bares Geld. Was die IT dazu beitragen kann, zeigt auf der TeleHealth 2009 beispielsweise InterComponentWare (ICW). Das Unternehmen stellt seine an Kliniken gerichtete Lösung eDischarge vor. Dabei stattet eine Klinik ihre Patienten zur Entlassung mit einer internetbasierten Gesundheitsakte aus. Zum Einsatz kommt das Produkt LifeSensor. “Je nach Erkrankung erhalten die Patienten außerdem Messgeräte, mit denen sie für die Genesung relevante Daten direkt in ihre Gesundheitsakte übertragen können”, betont ICW-Sprecher Dirk Schuhmann. In der Akte können die Klinikärzte die Daten kontrollieren und haben so in den Tagen nach der Entlassung die Gewähr, dass der Patient gut überwacht ist. Der Übergang zwischen stationärem Aufenthalt und ambulanter Betreuung wird fließender und sicherer. Auch medizinische Befunde und Arztbriefe können auf diesem Weg von der Klinik zum nachbehandelnden Arzt übertragen werden.

via Pressemitteilung: TeleHealth 2009: Informationstechnik wird zum Wettbewerbsfaktor.

Remote monitoring slashes hospital stays: Another area ripe for innovation is chronic disease. “We know that chronic illnesses require close monitoring because patients have a tendency to get worse in a relatively short amount of time if they fail to comply with treatment,” Waxman explains. “We think technology i.e., remote monitoring, personalized messages can be used to improve compliance. He points to Health Hero Network, a Palo Alto, Calif.-based firm acquired by The Bosch Group in 2007. Psilos was once the principal shareholder in the firm. The company developed a user-friendly monitoring device to serve as an interface between patients at home and care providers. Through increased communication with caregivers, behavior modification and prevention, Health Hero says it can dramatically reduce hospitalizations. CMS last month extended and expanded a three-year project with the firm designed to illustrate how telehealth technology can improve care and reduce hospitalizations associated with conditions such as heart and lung disease and diabetes. The project, launched in 2006 with medical groups in Wenatchee, Wash., and Bend, Ore., was extended to January 31, 2012, and could be expanded to include an additional location.

via Innovations That Are Needed to Reform Health System Could Disappear Due to Limited Venture Capital.

Proponents of home monitoring devices long have believed that widespread use of those systems can help solve some of the problems plaguing health care today. Now, some technology companies, medical centers, insurers and patients will be testing that theory.

Intel and the Cleveland Clinic announced in recent weeks that they are focusing less on the technology itself than on the ease of its use by the elderly, its role in the continuum of care, and the potential cost savings.

Technology developer Intel announced four separate pilot programs, in partnership with Aetna, SCAN Health Plans in Arizona, Erickson Retirement Communities and Advanced Warning Systems. The Cleveland Clinic is conducting a pilot with Microsoft HealthVault.

Home monitoring provides a way for patients to use electronic devices to collect their own health data, such as vitals or glucose levels. The devices can then be linked with a computer, allowing data to be transmitted to the health care team or to an accessible data repository.

via AMNews: Dec. 22, 2008. Usefulness of home monitoring devices studied … American Medical News.

New concepts on the horizon can assist in delivering wellness to healthy adults and children, the elderly and others infirmed. One of these concepts is the new care delivery system called Patient-Centered Medical Home, which is being considered as a ”better value care model” in our community. It provides a personal primary care physician for all patients with a team that includes health educators, nurse coaches, social workers and others to optimize prevention and wellness, and to better manage or reduce chronic illness. Primary care physicians are at the team’s core. Electronic health records, disease registries and electronic prescribing are integral parts that link all team members.

via Future of health care depends on innovation, new ideas — themorningcall.com.

WASHINGTON – Congress is expected to approve $19 billion toward health information technology, with $17 billion allotted to incentives and $2 billion to jump-start healthcare IT adoption, according to a Wednesday night draft of the stimulus package.

The original House version of the bill designated $20 billion for healthcare IT, with the Senate setting aside $22 billion.

The $789 billion conference agreement between the House and Senate versions of the American Recovery and Reinvestment Act (H.R. 1) still faces potential amendments before a final vote, and some healthcare provisions of the bill were not scored as of Wednesday night.

via Industry News | Healthcare IT News.

Telemedicine has caught on over the past several years as an effective way to bring patients and specialists together via the magic of video conferencing. Unfortunately, most telemedicine setups require the patient to be in a room equipped with a computer, camera, microphone and monitor, so that specialists can remotely assess his or her condition. Could robots be the answer, providing both patient care and a view for specialists checking in from afar?

via Who Needs a Doctor When There’s a Robot in the House, er, Hospital? [Slide Show]: Scientific American.

Daily phone calls help U.S. Army veteran Leroy Miles stay out of the emergency room.

Usually, the calls are between a machine in his home and a computer server in Houston operated by Viterion TeleHealthcare, which provides his twice-daily blood pressure and sugar readings to a registered nurse at the Department of Veterans Affairs’ Pittsburgh Healthcare System.

Occasionally, that prompts another phone call from the nurse to Miles, 74, of Wilkinsburg.

via VA doctors monitor veterans over the phone – Pittsburgh Tribune-Review .

Technology provided by the Department of Veterans Affairs used to remotely monitor the health of patients with chronic conditions is successful at reducing hospitals stays, according to a VA-sponsored study.

The study examined the VA’s teleheath technology that lets health providers collect data about patients from their homes. Telehealth tools help montior things like blood pressure and blood glucose levels.

Members of the VA national telehealth staff conducted the study. The study is available in the current issue of the journal Telemedicine and e-Health, a peer-reviewed publication. VA officials announced the findings today. The study looked at health outcomes from 17,025 VA home telehealth patients.

via VA: Technology helps monitor patients’ health remotely — Federal Computer Week.

Congress has targeted more than $6 billion to wire rural America with Internet service as part of the nearly $790 billion stimulus plan. But the bill would place much of those funds in an Agriculture Department program that has been criticized for its past management of grants, raising concerns among some public interest groups.

Under a deal House and Senate leaders negotiated yesterday, about $1.5 billion would fall under the oversight of the USDAs Rural Utilities Service, a program launched in 2002 to connect farming towns to high-speed, or broadband Internet, according to a Senate Commerce Committee aide.

Some public advocacy groups are critical, citing a September 2005 report on an investigation by the USDAs inspector general that found that $236 million, or more than one-quarter, of the programs loans under review “was either not used as intended, not used at all, or did not provide the expected return of service.”

via Broadband Program Oversight Questioned – washingtonpost.com.

The centerpiece of President Obama’s domestic agenda is an $819 billion economic stimulus plan. The Senate will consider the measure this week, with an eye toward the amount of tax cuts and spending. Republicans and Democrats spar over what to consider a tax cut. An analysis by the nonpartisan Congressional Budget Office tallies the tax-cut portion to be significantly less than the one-third Democrats claim it to be.

via Taking Apart the $819 billion Stimulus Package – washingtonpost.com.

Short-circuiting a gradual move toward e-health records

Many physicians are moving toward electronic health records for reasons of their own, including market pressure, convenience, and efficiency. This happens as old systems are being replaced or upgraded, questions about security find better answers, and doctors and their staff become more familiar with the technology.

The Centers for Disease Control and Prevention found, in response to a mail survey last year that 38.4 percent of physicians reported using full or partial e-records system, not counting billing. This is up from 25 percent in 2005.

In the absence of the so-called stimulus bill, doctors and companies have been gradually moving in that direction, individually weighing the costs against the benefits and choosing the technology that best suits their needs.

This is the gradual process that the Democrats who wrote the legislation, and sent it the floor without the benefit of a single hearing, hope to short-circuit. The bill punishes physicians who are not “meaningful users” of a government-certified e-record database, and specifies certain procedures and information exchanges that will “satisfy” the requirement.

Starting in 2015, government reimbursements to physicians who are not participating in the federal e-record effort will begin to decline.

via U.S. stimulus bill pushes e-health records for all | Politics and Law – CNET News.

Recent testing with telehealth by the Centers for Medicare and Medicaid Services (CMS) and the Department of Veterans Affairs (VA) have proven successful, representing a significant breakthrough for the technology.

CMS’s 2005 Care Management for High Cost Beneficiaries Demonstration (CMHCB) program, incorporated telehealth services, such as the remote monitoring of chronic conditions and patient education, into the treatment plans for its highest-cost beneficiaries.  One program participant was the Health Buddy system.  This system was created by the Health Hero Network as a way of remotely connecting patients, providers, and health care facilities through the use of monitoring technologies, clinical information databases, and online decision support tools.

CMS officials noted that the Health Buddy system and others had been extremely effective both in reducing expenditures and providing continuously high-quality care to high cost Medicare beneficiaries.  “The programs in the demonstration have had a positive impact…and have met and/or exceeded the savings target required in the demonstration agreement,” CMS officials said in a statement.  Additionally, they announced that they will be granting the Health Hero Network demonstration a three-year extension.  In doing so, the Health Buddy system and other programs “would have the opportunity to continue to impact their populations, maximize savings and assist CMS in determining the replicability of the programs.”

Another recent triumph for the technology was the VA’s Care Coordination Home Telehealth (CCHT) Program.  Researchers who monitored a test group of patients daily through telehealth reported that there were 20 percent fewer hospitalizations, as well as an overall improvement in health conditions.  The program, which cost a comparatively low $1,600 per patient per year, was so successful that VA officials plan on expanding it significantly, estimating that by 2011, more than 50,000 patients will be monitored via telehealth.

The demonstrated success of the VA and CMS programs represent a significant step forward for telehealth, as well as hope for thousands of chronically ill patients.  As VA researchers noted, “If 50 percent of patients requiring (non-institutional care) can ultimately be managed in a way that means they get improved access to care at lower cost and higher quality, then this represents an important advance.  It means that a low cost and flexible solution will be available to deal with the large numbers of patients with chronic care conditions that health care systems know they need to serve.”

via For the CMS and the VA, Telehealth Programs are a Clear Success.

For chronic respiratory disease patients in the rural Champlain region of Ontario, Canada, a new telehealth program provides the opportunity to receive necessary care without traveling to hospitals in Ottawa. The new program, headquartered at the 22-bed Carleton Place District and Memorial Hospital (CPDMH) and operated by the Ontario Telemedicine Network (OTN) in conjunction with St. Francis Hospital, connects patients with respirologist Dr. Stephen Bencze of Ottawa Hospital’s Clinical Telehealth Program. Through videoconferencing, patients are brought together with physicians for consultation, evaluation, and education.

The new program for respiratory disease patients is a significant part of the telehealth program at CPDMH, which serves several rural communities of about 23,000 people total, that was established in 2002 with the OTN. Since then, the hospital has seen an increase in telehealth-related visits, with about 400 annual visits. The program is part of a larger effort to enhance access to treatment for rural patients and to help chronic disease patients in better managing their conditions.

Malcolm Robinson, CEO of CPDMH, said that the telehealth program was a necessary and important one. “Our hospital is located in a rural community, and for many of our patients, traveling to Ottawa or elsewhere to see a specialist may be quite difficult or in some cases not possible,” he explained. “Telemedicine provides an alternative way for patients to access needed health care within their own community, and we are very happy to see how the program has grown to include additional specialties.”

via In Canada, Telemedicine Helps Rural Patients Manage Their Conditions.