A recent article in Dark Daily provided me with a useful way to better understand the field of telemedicine by dividing it into three segments (see: Telemedicine Gaining Momentum in US as Large Employers Look for Ways to Decrease Costs; Trend Has Implications for Pathology Groups and Medical Laboratories). Below is an excerpt from it:
[A recent article] divides telemedicine technology into three distinct segments:
2. Remote patient monitoring
In an article...[written[ for MedCityNews (see: Telemedicine: Take a lesson from retail to improve patient adoption),...[the author] calls provider-to-provider telemedicine the “most evolved to-date” segment of the telehealth trend. She highlights ICU stroke care with remote consults and monitoring as an example of its “success,” and notes a large potential for growth in remote patient monitoring (RPM).....However,...[she] also notes consumer acceptance of patient-to-provider telemedicine has fallen short of industry expectations. While virtual office visits...grab headlines,...“several factors” are hindering adoption. “Reimbursement is not yet universal,”....“but consumers are growing used to paying more out-of-pocket with high-deductible plans. Physicians have long resisted change in how they practice, and many remain lukewarm at best about telemedicine.
I have blogged extensively about telemedicine and remote monitoring (see, for example: Telemedicine and Home Monitoring Will Promote Healthcare Transformation) but have largely ignored provider-to-provider interactions except for my discussions about virtual critical care (see: Centralized Cardiac Monitoring Center Developed by Cleveland Clinic). The excerpt above, cites ICU stroke care and remote consults as a key area for the development of provider-to-provide interactions. Here is an article on that topic for reference: Remote Evaluation of the Patient With Acute Stroke.
I think that provider-to-provider remote consultation is going to be very helpful for increasing the quality of care in rural hospitals. We are on the cusp of understanding how such consultations needs to be structured for optimal quality and efficiency. An article published in 2013 examined some aspects of this process (see: Provider-to-Provider Electronic Communication in the Era of Meaningful Use: A Review of the Evidence). Here is a relevant paragraph from the introduction to the article referring to the types of communication that are required for provider-to-provider communication:
Coordination of care within a practice, during transitions of care, and between primary and specialty care teams requires more than data exchange; it requires effective communication among healthcare providers. In clinical terms, data exchange, communication, and care coordination are related, but they represent distinct concepts. Data exchange refers to transfer of information between settings, independent of the individuals involved, whereas communication is the multistep process that enables information exchange between two people. Care coordination, as defined by O'Malley, is “integration of care in consultation with patients, their families and caregivers across all of a patient's conditions, needs, clinicians and settings.”
The study ends with the following conclusion: the principal findings of the literature review underline the paucity of quantitative data surrounding provider-to-provider communication. It looks like the advocates for provider-to-provider communication as a key component of telemedicine have their future work cut out for them.