Name:
Rheuban: Telemedicine Ch. 02: Workforce, Definitions, and Models
Description:
Rheuban: Telemedicine Ch. 02: Workforce, Definitions, and Models
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T00H05M28S
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Upload Date:
2022-02-27T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
DR. ALI: Agreed that-- I often get asked by consumers and even physicians so, what is telemedicine? Like what is it? And I usually respond that this is a way for two individuals, two parties to communicate using video chat, right? But with the umbrella of it being HIPAA compliant with the security and concerns of the patient-physician relationship and that interaction. Now, we are not doing it in person, we're doing it virtually, but I think the key concept is here is can we provide the level of service at the standard of care that we would in person?
DR. ALI: And I think that's where a lot of state level and federal level-- there is discussions and it hasn't been clearly defined and I think that's where, as you said, that the data analytics, the trials need to be done, and I think the healthcare insurances-- I believe Omada and one of the healthcare insurances are working together on a program for example, like diabetes prevention program, just to give an example. And when I look at telemedicine, I try to break it down into four very broad categories.
DR. ALI: I look at acute care. I look at chronic care. I look at mental health because that is a very big area of telemedicine impact. And I think also post care, so when I talk about post care, that could be postpartum, that could be after surgery. And so it's not really considered acute, it's not chronic, somewhere in-between, but it is post care after an event. And that could become a chronic care condition, for example, after a stroke.
DR. ALI: That's an acute event and now there's a chronic condition that we have to deal with. And so, I think those are very four broad categories. There may be some other categories that you have in mind, but I think that is where the interplay of how do we take care of these patients especially if they don't have access to great medical centers like you and I work in. There's a lot of remote towns and cities that unfortunately don't have enough access to care, and I think that's a big bridge that we can bring together through telemedicine and digital therapeutics.
DR. ALI: What's your thoughts on that?
DR. RHEUBAN: I completely agree.
DR. RHEUBAN: All of those buckets are totally appropriate, and then you also want to consider the delivery mechanisms which fall in sort of similar buckets whether it's live interactive video based services, or storing forward services. Storing forward meaning the asynchronous transfer of images and data for analysis by a provider with intervention to follow, and then remote monitoring tools, which can blend a little with storing forward as well where biometric or physiologic data are sent from any number of settings, primarily the home, to an entity whether it's the hospital system, whether it's a company that manages the data and then informs the provider.
DR. RHEUBAN: And then, there's mobile health which can include all of the-- all of those systems or delivery mechanisms. And so, you can apply any of those to the various buckets you've identified, and suddenly, you have a really complex web of opportunity. And all opportunity obviously needs to evaluated and done right.
DR. ALI: So, how do we do it right? What's your thoughts on that?
DR. RHEUBAN: Well again, I think partnerships are really helpful for me and my own program at UVA. We have measured performance metrics, clinical outcomes metrics, but I think we're also-- whether it's the payers including Congress as they look for federal government subsidized, or federal government programs need to understand what the financial outcomes are as well. And so, that's why I think partnerships with the payer community is most helpful because the keys to the kingdom often reside within those payer communities as well.
DR. RHEUBAN: We are all about partnerships to understand the outcomes of what we do. And I think it's, you know, the time is here and now, and actually 2018 is a great year for telehealth.
DR. ALI: Yeah, I think 2018 is a great year. I think one of the biggest barriers that I have seen in-- just in practicing medicine as a whole, and I'm going to ask you about what your thoughts are about maybe future of where we are going with telemedicine but-- and I'm going to premise it with this one statement. As physicians you're pediatric cardiology, I'm adult cardiology, we know what we are doing; we have very great metrics for diagnosis and treatment, very evidence-based, corporate utilization criteria; we have guidelines.
DR. ALI: We talk to patients, we make diagnoses and treatments. The biggest barrier that I see in medicine as a whole where telemedicine, digital therapeutics can fill a void is behavioral changes and compliance. I think compliance is a big area that up until now physicians have not had the opportunity to monitor patients to see if they're actually taking their advice and moving that forward.