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Summary:

In many ways, the U.S. is still behind the curve when it comes to using technology in medical care, not because the technology industry isn’t interested in providing software and hardware, but because of connectivity troubles and the way doctors are reimbursed for care.

Dr. Mohit Kaushaul

Intel, GE and the Mayo Clinic today said they would conduct a year-long study to find out if remotely monitoring patients via gear made by the two companies and hooked up to a home broadband connection can keep them out of emergency rooms. The move ties in nicely with a chat I had yesterday with Dr. Mohit Kaushal, director of health care for the FCC’s Broadband Strategy Initiative, about encouraging broadband use in medical care.

In many ways, the U.S. is still behind the curve when it comes to using technology in medical care, not because the technology industry isn’t interested in providing software and hardware, but because of a failure on the part of doctors to use the technology and on the part of Medicare and other government-sponsored health programs to pay for health outcomes rather than procedures, said Dr. Kaushal.

Plus, in many areas, especially rural ones where physicians are scarce, the broadband network just isn’t up to speed. The Mayo Clinic/Intel study will involve video conferencing between patients and doctors to ascertain patient fitness — something that could benefit from better broadband and even HD quality. In a presentation before the FCC last week, Dr. Kaushal said that using e-care could save $700 billion over the next 15-20 years.

In the meantime, the U.S. is starting down the path to e-care with electronic health records. Currently a patient’s medical records are text-based, but Dr. Kaushal says he sees a future where in addition to large image files, a patient’s medical record would include video and audio notes as well. He declined to speculate on the size of such a file nor would he disclose the quality of the bandwidth he thought would be needed to deliver such information over networks.

However, in addition to the quality of the broadband network, Dr. Kaushal said that there are regulatory issues at play when considering broadband’s role in monitoring patient health. For example, using smartphones to help diagnose illnesses or even to monitor vital signs is a new area of innovation. Dr. Kaushal said that currently a lack of regulatory oversight on such apps may make investors afraid to put money behind such innovations.

To counter that problem, he said the FCC is working with the Food and Drug Administration knowing that at some point in the future devices for home health monitoring will need both an FCC stamp of approval and one from the FDA. The meetings and work so far haven’t created a framework to write such regulations, but have merely acknowledged that such rules will soon be needed. Unfortunately, much of the health portion of the National Broadband Plan so far is like that.

It’s all about recommendations and setting “frameworks,” with very little ability to actually enforce policy. For example, Dr. Kaushal said that part of the plan will include a taxonomy of terms such as e-health, telemedicine, telehealth and e-care. That’s wonderful — and certainly doctors and insurance companies will have to use those definitions in their care and for reimbursements — but at the same time it makes clear just how far off we are from driving health care into the 21st century. Indeed, we’re still defining our terms.

However, Dr. Kaushal can certainly articulate the value of broadband connectivity when it comes to improving health care. “Through the mechanism of broadband, time and geography barriers are reduced,” Dr. Kaushal said. “Within the health care world we monitor people in hospitals and at primary care physician offices, and what is exciting is that we could continuously monitor people via broadband, gathering info all of the time.”

That could mean fewer hospital visits, but also a better quality of life for many people who live with chronic disease. Much like broadband has reduced the distance between people, enabling parents to communicate with their children at college or people to telecommute, broadband will help deliver health care as soon as the FCC and related agencies figure out how to drive fatter pipes and doctor adoption. But connectivity is merely a first step.

“Building connectivity doesn’t improve outcomes,” Dr. Kaushal said. “Networks, the applications on those networks, and the data capture and the analytics can improve outcomes.” That’s a job for the technology companies. I know they’re eager to get started.

  1. As Mark Twain said, “The reports of my death are premature.” The US military makes extensive use of telemedicine and in the US civilian sector it is being used for stroke assessment, remote language interpretation, dermatology, etc. You are correct that home health monitoring has lagged due to infrastructure requirements, but home broadband is gradually improving at the same time that newer, more resource-efficient video products are becoming available such as Skype and VSee.

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    1. I noticed in my American Way magazine yesterday that doctors in Beverly Hills were using the web to consult on plastic surgeries before patients would travel to California to get a procedure done. So yes, it’s done, but I’m all for telemedicine being used far more often.

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  2. Telemedicine is used successfully in prisons and jails throughout the country. It works especially well in the field of Mental Health, since most of our mentally ill are now housed in jails and prisons. An inmate in a remote prison is able to get an immediate Psychiatric evaluation through the use of telemedicine.

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  3. Nice article. I think it is important to note here that sophisticated telemedicine has been happening all over the world for years. To quote an example, we have been using Telemedicine applications in rural areas to not only securely share patient clinical data and large image files but also Ultrasounds – and all this as far back as 5 to 6 years (i.e. much before broadband). The technology is there – what is required is the will, the money and good business plans to sustain a telemedicine center after the first flush of funding.

    rgds,
    Dr Lavanian
    MBBS, MD

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