Monday, March 30, 2020

VIDEO CONSULTS SPIKE AMID COVID- ENTER THE AGE OF TELEMEDICINE



As the global pandemic from this novel Coronavirus continues to fill our emergency rooms, it has also brought the patient care industry to a drastically slow crawl- almost to the point of scaring away caregivers and patients alike from the risk of a lethal contact.  The record numbers of global cases from the highly contagious disease have greatly affected a vast majority of elderly patients and the immune-compromised individuals.  These are the same members of the community who visit their doctors most frequently – making them more susceptible to exposure.

Cancer patients in particular are caught in a dreadful situation where an already damaged or weakened immune system from medical treatments could makes a trip to the cancer care facility could prove to be fatal.  It is a common belief that cancer therapies (and having cancer itself) usually carries the side effect of a weakened immune system- leaving the patient defenseless from any infectious illness, especially viral infections like COVID-19.

A recent update in this medical predicament is the relaunch of the digital patient care and communication program called TELEMEDICINE.  Originally designed as a backup consultation idea for far-away patients, this concept is quickly becoming headline news in the medical field and a sound alternative to maintaining patient care without the worry of breaking the national quarantine.
Recently recognized as “the digital house call”, the use of VIDEO CONFERENCING tools like SKYPE and ZOOM are creating a parallel spike to the number of infected cases with a significant rise in installations and tech upgrades in medical offices nationwide.  Offering this option of a virtual consultation not only maintains safety for all patients and staff, but also streamlines one’s time by completely eliminating travel and time spent in the waiting room.



“Safety is now the number one concern when it comes to medical innovation”, states cancer radiologist Dr. Robert Bard at an interview with MPR news. “The age of Corona can also (someday) be known as the age of TeleMedicine.  This all came down at a time when, fortunately we have this already proven technology that responds to this very health crisis… people no longer have to fear getting sick on the commute to their doctor’s appointment or wait in a crowded room full of strangers with varying health conditions. There’s so much that we can do with our current technology- especially this web-based solution that takes away any concern for contamination or the risk of accelerating anyone’s pre-existing illnesses!”

RISK MANAGEMENT AND THE IMMMUNE SYSTEM
New solutions like TeleMedicine are just some of the ways that the medical community is keeping all patients safe from harm- including the very air in health centers that were supposed to heal them. According to Dr. Aisha Hasan, Immunology research specialist in adoptive T-cell therapy at Memorial Sloan Kettering calls , the Coronavirus infection is largely  an “immune system” issue.

We now know that the most at-risk individuals are those above 65, infants under the age of one, those on immunosuppressant medications (for conditions such as arthritis, lupus, Crohns disease, ulcerative colitis) and cancer patients undergoing chemotherapy.  For anybody who has any disruption in their T-cell immunity (which is what controls viral infections), the risk of contracting the illness is much higher  because this virus appears to have a high level of pathogenicity in the respiratory tract – which is the one area  that can really take off and create havoc in the body.  The “viral dose” or number of viral particles that enter the body impacts the severity of the illness. The unchecked high viral load quickly creates severe inflammation in the lungs, necessitating the use of artificial ventilation.

New prevention measures like TeleMedicine are now being implemented worldwide as part of the social distancing measures that we are asked to follow.  The Covid-19 virus has a dual mode of transmission;  droplet infection and direct contact.  A popular area for sick people are usually places like a doctors office- where coughs and sneezes become droplets in the air that could then be taken in and breathed in by someone nearby.  In the same waiting room, direct contact can also be an easy transporter when someone sneezes or touches their hand, then touches a doorknob, a banister, an armrest, a pen or a magazine.


The majority of the public with a normal immune system can prevent this disease from its fatal effects. But due to its unusually long shelf-life, we can all be carriers that can inadvertently affect others- making this a highly contagious virus.

LEGAL PLATFORM OPTIONS OF TELEMEDICINE
Technically speaking, TeleMedicine is defined as the VIRTUAL ALTERNATIVE to the doctor-patient experience using various forms of communication technology instead of the physical face-to-face dimension.  Thanks to the information explosion of our era, a wide list of web-based platforms are available that allows a private file-sharing or audio-visual exchange.

Meanwhile, regulatory restrictions call for strict privacy and data protection when it comes to TeleMedicine. HIPAA (Health Insurance Portability and Accountability Act ) has been established with the proper safeguards for patient information.  Among its tenets, HIPAA mandates industry-wide standards for health care information on electronic billing and other processes and the protection and confidential handling of protected health information in medical community pertaining to privacy.  To respond to this, custom software, hardware, internet security programs, firewalls, web-hosts and all parts of the communication line of TeleMedicine must comply to specific security and privacy standards.

THE “WIN-WIN” OF REINVENTING PATIENT CARE 
The “virtual house call” has quickly become a seemingly forced upgrade to most medical practices. As a solution that has always been available since the early days of the internet (from paperless office to private video conferencing), the idea of a patient staying home while seeing their doctor is not a luxury at all, but a mandated law to self-quarantine for the safety of that patient and all those they come in contact with.

We can now streamline any doctor visit that means a consult, getting a prescription or a referral with TeleMedicine. Elderly patients or those with chronic conditions may find it difficult (and even precarious) to travel to their doctors' office and sit in a waiting room with other sick people with unknown conditions. Advancing this scenario to an electronic doctor's visit or TELEMEDICINE is an available reality that can easily address this concern. SO MUCH CAN BE DONE FROM HOME!

Other benefits include:  • Convenient & Cost Effective  • No Transportation needed  • No need for time off work or child care  • Eliminate the waiting room   • Quicker access to all specialists  • Improved access to files and prescriptions


POINT OF CARE ALTERNATIVE 1: TELERADIOLOGY
Of course not everything can be done over the internet.  Drawing blood, taking one’s temperature and blood, MRI’s/Ultrasound Imaging and other POINT OF CARE services continue to be done on-site in front of a physical medical professional. But this consideration is now the next growing element of the electronic upgrade trend and is being addressed individually by each service or practice type.

1) SCAN FOR EMERGENCY REMOTE LOCATIONS: 
By combining live access and use of selected portable diagnostic ultrasound technologies, your practice can easily scan many parts of the patient to help detect and diagnose countless physicological, biochemical, neurological or musculoskeletal disorders quickly, accurately and efficiently. Any visiting facility that sees patients can be a Tele-Scan -including emergent care clinics, hospital emergency rooms, PCP's office, PT's, Chiropractors, specialists, ambulatory transport vehicles etc.

TELE-SCANS provide all medical practices with access to portable digital imaging field scanners designed to safely and accurately scan a wide range of organs and issues. Tele-Scan digital ultrasound scanners are powerful enough to capture images, videos and study blood flow from just about any depth in the body. TELE-SCANNING provides effective training on the use of scanning technology for every day patient use.  The concept of TELE-SCAN program are designed to transmit all patients' scans via secure web to our central diagnostic specialists (expert imaging readers/diagnosticians) who can safely and accurately identify any and all issues.

2) TELERADIOLOGY
Through private web portals, physicians anywhere can have access to radiology specialists by enabling file transfer and retrieval of patient images electronically. Doctor-to-doctor collaboration is now made simple regardless of ones physical office location. Image files of varying sizes and applications like x-rays, CTs, Ultrasound files and MRI's are often what is shared. Teleradiology is a great benefit to patient care by allowing radiologists to diagnose, analyze and generate reports on the patient's condition REMOTELY.   TeleRadiology is 24-7 and is accessible from any location--  a major advantage to the medical community because sub-specialists like pediatric radiologists,  neuroradiologist,  MRI or musculoskeletal radiologist are usually found in major cities during daytime hours.

Other Point-of-Care programs will be discussed in PART 2 of this article about “Satellite POC Centers”. 

For more information, visit: http://telemedscans.com/



REFERENCES

https://www.webmd.com/lung/news/20200325/covid-19-may-delay-some-cancer-treatments#1

https://en.wikipedia.org/wiki/Teleradiology


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