While studies have shown that successful use of videoconferencing and real-time communications can profoundly benefit patients and doctors alike, how do we define success?
Telemedicine has been in use now since the 80′s but due to complexity, specialized equipment, expensive network infrastructure and poor Medicare/Medicaid reimbursement policies, it remained limited to a small number of users. These challenges made it impractical to use televideo technologies for care delivery on a larger scale.
Today, low cost and ubiquitous technologies do exist that can facilitate a world in which videoconferencing has a place on the desk of every doctor, nurse and clinician. However, what is needed at the clinician level are applications designed specifically for the health care industry with televideo as a method of communications.
What does this mean?
As studies have shown that health care outcomes improve when truly collaborative communication takes place among patients, doctors and specialists, televideo is becoming more mainstream. But for televideo to be both successful and effective, televideo technologies must be user friendly, highly secure, low cost and fully customizable.
Is that all?
Fixing televideo goes beyond cost and complexity. While there are a number of innovative televideo technologies, there is still the problem of integrating televideo seamlessly into clinical workflow. The success of any technology depends only 10 percent on the technology and 90 percent on how the technology is integrated with existing workflows.
To deliver care successfully and effectively across the healthcare continuum, televideo must be mapped to existing workflows to improve patient and clinician use experiences and to minimize change management issues.
Change is good but it’s not always great.
To make televideo great, let’s start with improving the usability.
Although there is apparent and intuitive conflict in the data in this report, it maybe should not have been published until a proper study could have been done. The report said, The use of telemedicine reduced ICU mortality by 20% and shortened the average length of stay in the ICU by 1.26 days. That’s great! But then it went on. The researchers said, However, telemedicine wasn’t associated with a reduction in inhospital mortality or overall length of stay. Tele-ICU care might reduce the mortality for ICU patients while the patients are still in the ICU, but this benefit could be eroded once patients are transferred to the floor. Now here is the intuitive disconnect in the data: If there were no changes in the length of stay or mortality rates overall, then the rates had to increase somewhere and somehow to offset the observed gains using ICU telemedicine. Something increased to make up the offsetting improvement of a 20% reduction in mortality, i.e. 20% more of the ICU patients died after going back into the hospital during the rest of their stay. And the reduction of stay of 1.26 days had to be offset by those exiting the ICU by staying another 1.26 days longer. The numbers have to balance out somehow, this is simple math! Healthcare is probably the most difficult industry for adopting change. But here is the good news here (in my opinion). ICU Telemedicine is helping to improve outcomes and the intuitive disconnect in the data is likely due from trying to make use of the disparate data from 13 different study reports or there might be an overly cautious approach (possible reluctance) to adopting these practices. Technology will help to make medicine better and mankind healthier, embrace it, then it will happen faster.
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