Cadmore media player playing video Rheuban: Telemedicine Foreword: The Future of Telemedicine
Video Player
Accessibility
Using forms mode, you can utilize keyboard shortcuts to make usability more efficient.
Space bar will play and pause the video. Pressing escape will close all displays and pressing it again will jump to the end of the player.
You can press A to open the Keyboard Shortcut Dialog which also provides an audio description of the player and all of its features.
Language
1x
Play Speed
Adjust Volume
Transcript
Search
Result Count
of
Click to jump to result
Search
Re-center
Segments
Result Count
of
Click to jump to result
Search
Name:
Rheuban: Telemedicine Foreword: The Future of Telemedicine
Description:
Rheuban: Telemedicine Foreword: The Future of Telemedicine
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/0f9ec72f-9a63-4502-947e-038ee0323366/thumbnails/0f9ec72f-9a63-4502-947e-038ee0323366.jpg?sv=2019-02-02&sr=c&sig=VKj0Y6QfCvVgYZc2lRF4JJrSl9RpLyRGPCN0ojNHKLk%3D&st=2024-12-08T22%3A42%3A01Z&se=2024-12-09T02%3A47%3A01Z&sp=r
Duration:
T00H10M15S
Embed URL:
https://stream.cadmore.media/player/0f9ec72f-9a63-4502-947e-038ee0323366
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/0f9ec72f-9a63-4502-947e-038ee0323366/Rheuban-20Telemedicine20Foreword-20The20Future20of20Telemedi.mp4?sv=2019-02-02&sr=c&sig=94g9H8EQjiJ2mW%2Bjy9FY0gfjmZUmv5H4pyMNvtAmTMA%3D&st=2024-12-08T22%3A42%3A02Z&se=2024-12-09T00%3A47%3A02Z&sp=r
Upload Date:
2022-02-27T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
DR. ALI: Where do you think the future-- I think it's one of the questions I wanted to pick your mind. I have some ideas, but where do you think the future of this-- It's such a Wild West, in a way, right? This whole digital therapeutics, telemedicine, all the verticals we talked about. But where do you see the future play with telemedicine and digital therapeutics?
DR. RHEUBAN: Well, you know what? I like to think that it's not going to be telemedicine, it's just going to be healthcare. This is how we deliver healthcare, this is how we bank. This is how--
DR. ALI: Right.
DR. RHEUBAN: Assuming we can work out the regulatory challenges and appropriate regulations you know, addressing licensure, credentialing and privileging, patient privacy, evaluating outcomes, this will be everyday healthcare. We do have a long way to go in terms of making that happen because there are so many different silos right now that impact telemedicine providers. But this will be everyday healthcare.
DR. RHEUBAN: Health information exchange-- that's another thing. We have great electronic medical records, we're an Epic system--
DR. ALI: Interoperability with that--
DR. RHEUBAN: Interoperability is absolutely key. I don't need to be getting faxed requests for telemedicine services coming from a facility with faxed medical records. We don't need that anymore in the digital era. So, we just have to work out of all these elements to make it seamless and integrated. We have a distributed network in telemedicine within our health system, so every provider has a secure video conferencing portal available to them. And Epic is our electronic medical record, and we have incorporated telemedicine into Epic.
DR. RHEUBAN: But we still have a long way to go in terms of that health information exchange. And then it's the digital health tools.
DR. ALI: Yes.
DR. RHEUBAN: There are peripheral devices that can be used in the home setting that will allow us to comport with the standards of in-person care. That's important. So, then when a provider is seeing a patient, they're not just talking to somebody without using some of the very tools that we might use in our office. So, I see the digital transformation as here and now, and it behooves us to gather the evidence and show that it is effective, and that we align with the triple aim of improved access that you referred to-- improve access, improve quality, and lower costs of care.
DR. ALI: From a standpoint of the future of telemedicine, I look forward to the day that you pick up your phone, and you hit an app, and you get to see a physician when and where you want to, that the barriers of access are removed and it is as simple as banking, booking a flight, booking a hotel, or seeing a clinician for your medical care. I see the day that when a patient comes to see me, physically, in the office, that I'm really auditing their numbers.
DR. ALI: I'm actually no longer having a discussion for the short period of time that I'm allowed to, but really looking at the data analytics of compliance and behavioral changes, and really working on that. So, I look at the hardware that we've prescribed them that integrates and is interoperable with my EMR, that I have a dashboard that I get to see, "What you have been doing over the last three months?" And my conversation with you is an audit of that information.
DR. ALI: And then the subsequent treatment is actually tweaking the digital therapeutics on you and saying, "In the next quarter that I see you, these are the items that we're going to work on." And, by the way, my opinion on the matter is that healthcare is not practiced at the time that I'm seeing the patient, healthcare is practiced between the office visit. Telemedicine and wearables is that bridge.
DR. ALI: It helps us bridge the behavioral changes as well as the adoption of this information. I think those barriers are being reduced as industry and academics work hand in hand together, and I think the vision is really the prescription of digital therapeutics in the future. I think that-- go ahead.
DR. RHEUBAN: I wanted to comment on one point you made-- when healthcare is as easy as hitting an app and connecting to a physician wherever possible within the context of the medical home-- whether it's the primary care medical home or the specialty medical home. So, we don't have fractionated care.
DR. ALI: That's right. I mean, how frustrating is it that-- I don't know how many hours you spend a day just trying to get the physicians to talk to each other. And I think that the driver, again, is going to be the consumer, that the consumer is going to have the access point and allow us, as individual physicians, to look at their data, and as easy as sending me a HIPAA-compliant form that I can tap and then access their information and share that information within the home health nurse, the physicians, the MPs, the PAs, the mid-levels, that we're all on the same board.
DR. ALI: I mean, how many medical mistakes are being done right now, just through the number of pharmaceuticals that different physicians may be prescribing, because no one knows what each other's talking about?
DR. RHEUBAN: Exactly.
DR. ALI: I think the consumer's going to be the biggest driver. The consumer needs to-- especially now that we have cloud systems, we have the ability to really push out data across the spectrum. Physicians and the mid-levels and all of the healthcare communities that are affecting that patient will be able to access that data. I also think that the future of telemedicine needs to be where the patient doesn't even know that their data's being collected, gives access to be able to collect that data.
DR. ALI: I'll give you just an example of some ideas that have been floated out there. Your commute. I don't know if you're on the subway or you drive a car. But as simple as this: if you're driving a car, for example, you sit down in the car, there's your weight. You put your seat belt on, it's going right over your chest.
DR. RHEUBAN: Yup, your EKG.
DR. ALI: So, we can have your EKG.
DR. ALI: We can put monitors on the steering wheel to measure your pulse ox. Now there are glucometers, that just need sweat or skin access, so I can actually measure your glucose after you had your breakfast this morning. All this data can be collected, aggregated. There's AI apps, there's data analytics where the patient or the consumer doesn't even know that data is being collected, but wants that data collected, right? And wants to be able to give that access to the people that need to see that access.
DR. ALI: And so, I think there is even talks about when you use the restroom, right?
DR. RHEUBAN: Oh sure. That we can access your urine analysis, we can check for occult bloods in your stool that could be a predictor for colon cancer. That could be simple sensors that are put into-- as simple as a toilet system. And we can talk about sleep, sleep apnea, which is a big, chronic condition, that is a different chronic condition that affects the heart, not only the lungs, when you sleep. And I think that's a big area of interest right now in digital therapeutics is sleep apnea.
DR. RHEUBAN: So, the point is that, as things move forward, we look at the house, then going back to the apps that we talked about-- banking and booking flights and hotels. You have apps that let you in your door at home. You have Nest, that lets you access your air-conditioning before you get home. I see that there is a whole healthcare industry that can be integrated in our day-to-day routines that we don't even have to think about it. That that data is being collected as you manage your life and that your physician gets access, so when you're doing that quarterly review, it's more of an audit of that information, rather than having you have to actively collect that information.
DR. RHEUBAN: And I think you made a really good point about this is not just about physicians. This is about an entire workforce in healthcare that are engaged because there's going to be so much demand. It's advanced practice nurses, physicians' assistants, training nurses, training LPNs and CNAs and community health workers, to be part of this evolution in healthcare. There's going to be a lot of data to be analyzed and mined, and we just have to make sure we do it right and train everyone to work collaboratively and, certainly, at the top of their license.
DR. RHEUBAN: So, this is very exciting.
DR. ALI: It's very exciting.
DR. ALI: 2018, I think, is going to be a big year for all of us, and I look forward to actually collaborating and working with you, actually.
DR. RHEUBAN LAUGHING: I feel the same way. This is great!
DR. ALI: Because I think you kind of represent a lot of the academia, and kind of represent a lot of where industry is going.
DR. RHEUBAN: The innovators, yeah. And I want to also give a plug to the American Medical Association. So, the AMA has really transformed in terms of its engagement in telehealth. They have convened the AMA's Digital Medicine Payment Advisory Group. Because as we speak to what is going to incentivize systems and providers, we still have to work out the solutions and how it's integrated. So, the AMA has been extremely positive, and I'm grateful for that.
DR. ALI: Absolutely. I've attended a number of lectures at the AMA, and they do seem like they're really pushing to be a driver. They do recognize that this paradigm shift between fee-for-service and value-based systems, and I think they look at everything that we've talked about, from acute care to chronic care conditions. Especially in the cardiometabolic world, we can make a big impact, and I think telemedicine and wearables and digital therapeutics are going to be a big driving force.
DR. RHEUBAN: And "augmented" intelligence, "artificial" intelligence, however we want to--
DR. ALI: AI, data analytics.
DR. RHEUBAN: Machine learning, right.
DR. ALI: All of these things putting together and accessing. I think it's an exciting time in the telemedicine space.
Segment:0 .
DR. ALI: Where do you think the future-- I think it's one of the questions I wanted to pick your mind. I have some ideas, but where do you think the future of this-- It's such a Wild West, in a way, right? This whole digital therapeutics, telemedicine, all the verticals we talked about. But where do you see the future play with telemedicine and digital therapeutics?
DR. RHEUBAN: Well, you know what? I like to think that it's not going to be telemedicine, it's just going to be healthcare. This is how we deliver healthcare, this is how we bank. This is how--
DR. ALI: Right.
DR. RHEUBAN: Assuming we can work out the regulatory challenges and appropriate regulations you know, addressing licensure, credentialing and privileging, patient privacy, evaluating outcomes, this will be everyday healthcare. We do have a long way to go in terms of making that happen because there are so many different silos right now that impact telemedicine providers. But this will be everyday healthcare.
DR. RHEUBAN: Health information exchange-- that's another thing. We have great electronic medical records, we're an Epic system--
DR. ALI: Interoperability with that--
DR. RHEUBAN: Interoperability is absolutely key. I don't need to be getting faxed requests for telemedicine services coming from a facility with faxed medical records. We don't need that anymore in the digital era. So, we just have to work out of all these elements to make it seamless and integrated. We have a distributed network in telemedicine within our health system, so every provider has a secure video conferencing portal available to them. And Epic is our electronic medical record, and we have incorporated telemedicine into Epic.
DR. RHEUBAN: But we still have a long way to go in terms of that health information exchange. And then it's the digital health tools.
DR. ALI: Yes.
DR. RHEUBAN: There are peripheral devices that can be used in the home setting that will allow us to comport with the standards of in-person care. That's important. So, then when a provider is seeing a patient, they're not just talking to somebody without using some of the very tools that we might use in our office. So, I see the digital transformation as here and now, and it behooves us to gather the evidence and show that it is effective, and that we align with the triple aim of improved access that you referred to-- improve access, improve quality, and lower costs of care.
DR. ALI: From a standpoint of the future of telemedicine, I look forward to the day that you pick up your phone, and you hit an app, and you get to see a physician when and where you want to, that the barriers of access are removed and it is as simple as banking, booking a flight, booking a hotel, or seeing a clinician for your medical care. I see the day that when a patient comes to see me, physically, in the office, that I'm really auditing their numbers.
DR. ALI: I'm actually no longer having a discussion for the short period of time that I'm allowed to, but really looking at the data analytics of compliance and behavioral changes, and really working on that. So, I look at the hardware that we've prescribed them that integrates and is interoperable with my EMR, that I have a dashboard that I get to see, "What you have been doing over the last three months?" And my conversation with you is an audit of that information.
DR. ALI: And then the subsequent treatment is actually tweaking the digital therapeutics on you and saying, "In the next quarter that I see you, these are the items that we're going to work on." And, by the way, my opinion on the matter is that healthcare is not practiced at the time that I'm seeing the patient, healthcare is practiced between the office visit. Telemedicine and wearables is that bridge.
DR. ALI: It helps us bridge the behavioral changes as well as the adoption of this information. I think those barriers are being reduced as industry and academics work hand in hand together, and I think the vision is really the prescription of digital therapeutics in the future. I think that-- go ahead.
DR. RHEUBAN: I wanted to comment on one point you made-- when healthcare is as easy as hitting an app and connecting to a physician wherever possible within the context of the medical home-- whether it's the primary care medical home or the specialty medical home. So, we don't have fractionated care.
DR. ALI: That's right. I mean, how frustrating is it that-- I don't know how many hours you spend a day just trying to get the physicians to talk to each other. And I think that the driver, again, is going to be the consumer, that the consumer is going to have the access point and allow us, as individual physicians, to look at their data, and as easy as sending me a HIPAA-compliant form that I can tap and then access their information and share that information within the home health nurse, the physicians, the MPs, the PAs, the mid-levels, that we're all on the same board.
DR. ALI: I mean, how many medical mistakes are being done right now, just through the number of pharmaceuticals that different physicians may be prescribing, because no one knows what each other's talking about?
DR. RHEUBAN: Exactly.
DR. ALI: I think the consumer's going to be the biggest driver. The consumer needs to-- especially now that we have cloud systems, we have the ability to really push out data across the spectrum. Physicians and the mid-levels and all of the healthcare communities that are affecting that patient will be able to access that data. I also think that the future of telemedicine needs to be where the patient doesn't even know that their data's being collected, gives access to be able to collect that data.
DR. ALI: I'll give you just an example of some ideas that have been floated out there. Your commute. I don't know if you're on the subway or you drive a car. But as simple as this: if you're driving a car, for example, you sit down in the car, there's your weight. You put your seat belt on, it's going right over your chest.
DR. RHEUBAN: Yup, your EKG.
DR. ALI: So, we can have your EKG.
DR. ALI: We can put monitors on the steering wheel to measure your pulse ox. Now there are glucometers, that just need sweat or skin access, so I can actually measure your glucose after you had your breakfast this morning. All this data can be collected, aggregated. There's AI apps, there's data analytics where the patient or the consumer doesn't even know that data is being collected, but wants that data collected, right? And wants to be able to give that access to the people that need to see that access.
DR. ALI: And so, I think there is even talks about when you use the restroom, right?
DR. RHEUBAN: Oh sure. That we can access your urine analysis, we can check for occult bloods in your stool that could be a predictor for colon cancer. That could be simple sensors that are put into-- as simple as a toilet system. And we can talk about sleep, sleep apnea, which is a big, chronic condition, that is a different chronic condition that affects the heart, not only the lungs, when you sleep. And I think that's a big area of interest right now in digital therapeutics is sleep apnea.
DR. RHEUBAN: So, the point is that, as things move forward, we look at the house, then going back to the apps that we talked about-- banking and booking flights and hotels. You have apps that let you in your door at home. You have Nest, that lets you access your air-conditioning before you get home. I see that there is a whole healthcare industry that can be integrated in our day-to-day routines that we don't even have to think about it. That that data is being collected as you manage your life and that your physician gets access, so when you're doing that quarterly review, it's more of an audit of that information, rather than having you have to actively collect that information.
DR. RHEUBAN: And I think you made a really good point about this is not just about physicians. This is about an entire workforce in healthcare that are engaged because there's going to be so much demand. It's advanced practice nurses, physicians' assistants, training nurses, training LPNs and CNAs and community health workers, to be part of this evolution in healthcare. There's going to be a lot of data to be analyzed and mined, and we just have to make sure we do it right and train everyone to work collaboratively and, certainly, at the top of their license.
DR. RHEUBAN: So, this is very exciting.
DR. ALI: It's very exciting.
DR. ALI: 2018, I think, is going to be a big year for all of us, and I look forward to actually collaborating and working with you, actually.
DR. RHEUBAN LAUGHING: I feel the same way. This is great!
DR. ALI: Because I think you kind of represent a lot of the academia, and kind of represent a lot of where industry is going.
DR. RHEUBAN: The innovators, yeah. And I want to also give a plug to the American Medical Association. So, the AMA has really transformed in terms of its engagement in telehealth. They have convened the AMA's Digital Medicine Payment Advisory Group. Because as we speak to what is going to incentivize systems and providers, we still have to work out the solutions and how it's integrated. So, the AMA has been extremely positive, and I'm grateful for that.
DR. ALI: Absolutely. I've attended a number of lectures at the AMA, and they do seem like they're really pushing to be a driver. They do recognize that this paradigm shift between fee-for-service and value-based systems, and I think they look at everything that we've talked about, from acute care to chronic care conditions. Especially in the cardiometabolic world, we can make a big impact, and I think telemedicine and wearables and digital therapeutics are going to be a big driving force.
DR. RHEUBAN: And "augmented" intelligence, "artificial" intelligence, however we want to--
DR. ALI: AI, data analytics.
DR. RHEUBAN: Machine learning, right.
DR. ALI: All of these things putting together and accessing. I think it's an exciting time in the telemedicine space.
Form Title Download
Video
Transcript
Form Title Bookmark
Entire Media
Segment(s)
Custom Clip
Start At:
End At:
Form Title Share
Entire Media
Segment(s)
Custom Clip
Start At:
End At:
Form Title Accessibility and Keyboard Shortcuts
The cadmore media player is a professional video and audio player experience designed to deliver media as well as relevant transcript, segmentation, and metadata. On the screen is a traditional html video player with buttons such as play, pause, forward, captioning, language and play speed selection and more. Adjacent to the video player are generally tabs, one of which shows a scrolling transcript of the video and the other shows any segmentation of the media, sometimes referred to as chapters. At the top of the video is a menu bar containing an Explore button and Tools button. The Explore button allows you to dig deeper into the video by opening up an explore dialog which contains tabs for a visual navigation of the video using thumbnails, an about tab which contains rich metadata about the media, a segments tab which contains further information about the video, and a related tab which contains links to other media related to this media. The tools button opens a menu with options for sharing the media on social media, creating bookmarking links, creating embed codes for your website, generating citations, and more.
Keyboard Shortcuts
Keyboard shortcuts only work while you are in forms mode. By entering forms mode, you will be able to quickly access portions of the media player with single key commands.
Spacebar: Play/Pause Toggle
I: Info Menu,
O: Tools Menu
T: Transcript Tab,
S: Segments Tab
F: Forward 15,
R: Rewind 15
L: Languages,
P: Playspeed
M: Mute Toggle,
V: Volume Bar
N: Video Only Toggle,
B: Full Screen Toggle
C: Captions Toggle
Escape: Closes dialogs and menus / Exits Player
Z: Next Transcript Chapter
X: Previous Transcript Chapter
Q: Next Transcript Paragraph
W: Previous Transcript Paragraph
Entire Media
Segment(s)
Custom Clip
Start At:
End At:
Embed Size
-
You Size - Responsive
-
We Size - Responsive
-
Picture Overlay Popup
-
400 x 225
-
512 x 288
-
400 x 700
-
768 x 1024
-
1024 x 512
-
1280 x 608
Form Title Cite
No citation provided.
Info
Segments
Related
Thumbnails
Exit Clip Mode
You have requested to see a portion of the video outside of the clip.
Click OK to switch to the full video or click if you would like to stay inside the clip. You can always go back to the clip with Tools and Clip Mode