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Northern Arizona Telemedicine Alliance Tech Talk

“Does anyone know of a USB microphone that can be daisy-chained?” “We held a camera ‘bake-off’ to see which ones perform best.” “We’re having trouble with inbound video calls coming through the firewall.” “How do you manage secure sign-ons for a conference room laptop?” “Does anyone have ideas for power-supply and cord management of a telehealth tablet at a remote site?”

These are the kinds of telehealth-related questions and issues that can take up hours of a technical person’s time when they’re doing all the research themselves. And often, IT people in a health-care setting are wearing a number of hats and can’t devote all their attention to telehealth issues and questions.

That’s why the members of the Northern Arizona Telemedicine Alliance (NATA) decided to hold monthly “Tech Talks” to share information and work together.

Historic event:  Dr. Achyut Bhattacharyya and Dr. Weinstein, in Tucson,  rendering the first telepathology diagnosis for a patient in China, on October 4, 1993. Starting then, telepathology has evolved into a significant industry in China.

Thirty years after the invention of telepathology, the Food and Drug Administration has approved the technology for primary pathology diagnoses.

Ronald S. Weinstein, MD, founding director of the Arizona Telemedicine Program, based at the University of Arizona College of Medicine –Tucson, was chair of pathology at what is now Rush University Medical Center in Chicago in the mid-1980s when he developed his idea of diagnosing surgical pathology slides from a distance.

He has since been recognized as the “father of telepathology.”

In the March 14 edition of the journal Circulation, the American Heart Association published what is described as the first comprehensive scientific statement on the growing use of telemedicine in pediatric cardiology.

“In most cases, the potential advantages of telemedicine in pediatric cardiology are numerous, including improving access to care, improving quality and saving lives,” the heart association stated. “In addition, this appears to be occurring with enhanced patient and practitioner satisfaction and cost-efficient medicine.”

Faculty and colleagues with the Arizona Telemedicine Program, based at the University of Arizona College of Medicine in Tucson, also point to telemedicine’s progress over the last decade or so.

The care continuum increasingly relies on the skilled nursing facility to extend patient care beyond the acute care facility before the patient is sent home.  The hospitals are under pressure to treat only the most acute conditions and then move the patient to facilities with lower costs of care.  Accordingly, skilled nursing facilities are accepting patients who are frailer and more complicated.  “Between 2005 and 2009, the percentage of Medicare SNF patients with eight or more co-mobidities increased from 74.8 to 86.9 percent..”  And, the “proportion of patients in SNFs categorized as having major or extreme severity of illness increased from about 45 percent in 2005 to 53 percent in 2009.”

Image courtesy of thedo.osteopathic.org

In a watershed moment for the expansion of telemedicine, the Interstate Medical Licensure Compact Commission is now processing applications to allow physicians to practice telemedicine across state lines with greater ease.  Nineteen states have passed legislation to adopt the Interstate Medical Licensure Compact, which allows physicians to obtain a license to practice medicine in any Compact state through a simplified application process.  Under the new system, participating state medical boards retain their licensing and disciplinary authority, but agree to share information essential to licensing, creating a streamlined process.

Shubh Kaur, MD

When endocrinologist Shubh Kaur, MD, was first approached to consider telehealth visits with patients in the Douglas and Safford areas, she was immediately intrigued. 

It seemed an appropriate solution for patients whose zip codes made it difficult to get specialty care without a lengthy drive. 

But she was also new to the technology. “I had an open mind about what the interaction would be like, but I was very interested in the question of patient experience, and whether it would be effective in building relationships.” 

Telemedicine is advancing how we treat drug and alcohol addiction. That’s good news for the 21 million people in this country with substance use disorders (SUDs). Here’s why, from my perspective as an addiction clinician.

Substance abuse is now a major public health crisis that demands urgent priority and the application of new and innovative solutions that can help close the treatment gap. At a time when drug overdose is the fastest-growing cause of accidental death, and when more people have SUDs than cancer, telehealth treatment for addiction promises to reach a whole swath of people in need of treatment, for whom geography or other factors — stigma can be another one — were once an obstacle to help. It still remains the case, for example, that patients in rural areas of the country have to drive long distances to get to a treatment center or to see an addiction specialist for medication-assisted treatment. Telemedicine is reducing the burden of such barriers.


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