Name:
Rheuban: Telemedicine Ch. 01: History of Telehealth
Description:
Rheuban: Telemedicine Ch. 01: History of Telehealth
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Duration:
T00H04M57S
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Upload Date:
2022-08-30T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
DR. ALI: I think maybe I knew your approach because I read your book, which was a great read, and I think you touched upon the history and I think... we were just having a conversation about how cardiology were really some of the first, I think verticals of physicians who actually were early adopters of remote monitoring. So, Holters, event recorders, but then, in your book I think you even talked about the American Civil War, or going way back where there is telegrams and--
DR. RHEUBAN: Sure.
DR. ALI: --you know, communicating.
DR. ALI: have been operational in the United States for more than 50 years. It's just the transformation of digital technologies has allowed us to really advance into everyday healthcare. And our program at the University of Virginia began 20 some odd years ago based on the premise that necessity was the mother of invention. We had patients who were remote from our institution in rural locations who otherwise had no access in their community, so, it was driven by a need. But, fast forward to 2018, digital technology is here; consumers are demanding access to care over using convenient technologies, and so it behooves us to establish high quality programs that comport to the standards of care and improve access and have the policies aligned with what we're doing.
DR. ALI: Yeah, I agree. So I think, I agree with you that in 2018, now we have-- Medicine was probably the slowest adopter of technology. I mean, if you even look at electronic medical records, and since now we are in that era-- I mean, we have digital banking, you can book your flights, your hotels. People, now, consumers are saying, "Well, why aren't we doing that in medicine?" And the consumers are driving this. It's not so much, I don't think medicine initially were the drivers.
DR. ALI: I think the consumers were saying, "Hey, I want healthcare when I want it, where I want it and when I need it." And now, the conversation I think is, so, how do we start doing delivery care models, and we're not just digital therapeutics, which is I think the new term of how do we start prescribing digital health apps to patients for chronic conditions or acute conditions, and we have the auspice on top of that which is the Hippocratic oath, which is first do no harm, so how do we start using these digital technologies, but still like you said, deliver high quality of care, and at what standards are we going to, as clinicians, hold ourselves when we have consumers saying, "I want care now," and how do we bridge that?
DR. ALI: I think that's the fundamental question, and then we need the support of clinical trials to show, "Are these delivery models working?" And also keeping at the high safety levels. And you're the expert as former ATA president. Just looking at where you've started back in, was it 2009?
DR. RHEUBAN: Well, 2009 as ATA president, more than 10 years behind that's when we lunched our program in the mid '90s, early to mid-90s, yeah.
DR. ALI: Which you guys were early adopters if it was back in the mid '90s, and I think now, we look at what is the current state. I mean we're seeing healthcare insurances now saying, "Hey, we can't ignore this anymore. Our policyholders are demanding this so we have no choice but to adopt it." Where are you seeing the barriers right now in the telemedicine space?
DR. RHEUBAN: Well, there's a lot of elements that we need to advance. We absolutely need to develop the evidence so, those are our trials. We want to provide high quality care. We need to know and assure consumers. We need to assure providers. We need to assure payers. We needed to assure regulators that we're providing high quality care to advance legislation and policies that support telehealth. And healthcare's so heavily regulated that that has been a barrier in and of itself-- well-intentioned but sometimes slows us down.
DR. RHEUBAN: So, when we first started, technology was expensive. We didn't have the broadband networks. We didn't have provider understanding. We didn't have patients who understood, but as technology has evolved, and the networks have evolved, you said it very articulately, people are using technology for everything else, and they want to use it for healthcare. So, we need to make sure that we comport to the standards of care that what we do aligns with the evidence and best practices and do no harm.
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