From Hospital Halls to Cyberspace

by Josh Tapper

Imagine a 75-year-old receiving wireless medication reminders straight to his beeping wristband. Or an 80-year-old with a new hip, using an on-body sensor connected to another embedded in her carpet, tracking her movement patterns in case her mobility worsens.

With a pending shortage of up to 200,000 doctors by 2020, according to the Association of American Medical Colleges, and caregivers graying along with their patients, the frontier of medical care may lie in cyberspace.

From remote patient-monitoring to doctor-patient video conferencing, telemedicine — also called telehealth or e-care — can save the country billions, the Federal Communications Commission reported in its recent National Broadband Plan. As the population ages and its need for the frequent health services associated with chronic illnesses intensifies, telemedicine aims to use intervention and prevention to keep patients out of hospitals and nursing homes.

In the future, “we won’t talk about telemedicine as something unique,” says Dale Alverson, medical director at the Center for Telehealth and Cybermedicine Research at the University of New Mexico. “We’re going to start seeing it as part of the medical home.”

At the Metropolitan Jewish Health System in New York, 170 home care patients already use equipment that allows them to monitor their own heart rates and blood sugar levels. Hooked up to a local modem, the devices transfer a patient’s health data to a web portal where the patient’s doctors or nurses can access it. Metropolitan spends $60 to $100 dollars per patient each month to provide the service for free, says Laurie Chichester, vice president of home care services.

“I was skeptical the older population would take to technology,” Chichester adds. “I was shocked. They love the technology.”

Although developers and advocates have promoted telemedicine for years, Alice Borelli of Intel Corporation points to barriers — including Medicare reimbursement policies, inadequate broadband in parts of the country, and seniors’ supposed wariness of new technology — that have kept telemedicine a mostly conceptual solution.

Medicare won’t reimburse for telehealth. The Centers for Medicare and Medicaid Services steers just $2 million of its $468 billion Medicare budget toward telemedicine services, Borelli says. For five years, Medicare has rejected the American Telemedicine Association’s proposals to include e-care.

FDA approval for telemedicine technologies might prompt Medicare to take action. And on the research and development front, Intel has recommended a federal consortium to evaluate telemedicine technology.

Cost savings may speed its adoption. The Department of Veterans Affairs, the world’s largest user of telehealth services, has found that while home care costs $13,000 per patient annually and VA nursing homes can run up to $77,000, telemedicine costs the VA only $1,600 a year.

Telemedicine can’t replace hospitals or nursing homes, but it can delay the need for them. “If we don’t take action, we’re going to be so far behind the eight ball,” Borelli warns. “We can move 30 to 40 percent of health care to the home.”

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