June 2010

Telemedicine

Author: Frank Dunne, Jr.

Let’s talk about health care for a minute. No specious statistics. No opinion poll numbers. Just a little bit of the common sense and market realities that are severely lacking in much of the public discourse on the subject, and a concept that could be part of the solution, although it is rarely mentioned.

For the moment, forget about terms and phrases like public option and universal coverage. Let the politicians and talking heads yammer on about that kind of stuff, which tends to obfuscate the real issue anyway.

Most of that debate is centered on the number of people in the United States who do not have health insurance coverage and the affordability of health care services. Fair enough. All we need to do then is make health insurance and medical services reasonably inexpensive and everybody would be happy, right?

Right.

And which is a better way to improve quality and reduce costs: adding complexity by piling on thousands of pages of regulation and bureaucracy, or making it simpler and more efficient?

Exactly.

Bureaucracy and the inefficiencies that it engenders are the reasons that health care services and insurance have become so expensive. In chapter four of his book, The Revolution: A Manifesto, U.S. Congressman (and physician), Ron Paul gives a very straightforward explanation of the American health care system’s current state. The chapter, which covers all aspects of economic freedom, if not the entire book, is highly recommended reading. For now, here is an excerpt:
“…for decades the United States had a health care system that was the envy of the world. We had the finest doctors and hospitals, patients received high-quality, affordable medical care, and thousands of privately funded charities provided health services for the poor…People had insurance policies for serious health problems but paid cash for routine doctor visits. That makes sense: Insurance is intended to protect against unforeseen and catastrophic events like fire, floods, or grave illness…Something has obviously gone wrong with the system when we need insurance for routine visits and checkups, which are entirely predictable…

Today most Americans obtain health care either through a Health Maintenance Organization (HMO) or similar managed-care organization, or through Medicare or Medicaid. Since it is very hard to make actuarial estimates for routine health care, HMOs charge most members a similar monthly premium. Because HMOs always want to minimize their costs, they often deny payment for various drugs, treatments, and procedures. Similarly, Medicare does not have unlimited funds, so it generally covers only a portion of any costs. The result of all this is that doctors and patients cannot simply decide what treatment is appropriate. Instead, they constantly find themselves being second-guessed by HMO accountants and government bureaucrats.

When a third party is paying the bills and malpractice lawsuits loom, doctors have every incentive to maximize costs and order all possible tests and treatments. The incentive to cut costs is lost, as physicians (now working essentially as low-level employees) seek to make as much as they can in the new corporate environment and charge the maximum the HMOs allow. Before 1965, physicians and hospitals (like all other private entities competing for your dollar) strove to charge the minimum; because payment now comes so largely from third parties, they instead charge the maximum. At the same time, patients suffer when legitimate and necessary treatment is denied.”

In short, let’s return to a system where doctors are doctors—not doctors/billing specialists…and patients pay for the routine services and non-emergent maladies at prices that the market will bear (a.k.a. competition). That would leave insurance to do what it is meant to do: mitigate the risk of catastrophic illnesses and injuries with premiums based on actuarial calculations.

Does that sound old fashioned to you? Okay, then. How about we throw in a dash of modern technology?

Telemedicine, or telehealth, is not a new concept, but perhaps now more than ever, its time has come. Basically defined, telemedicine is the sharing of medical information or services via telecommunications. In the past, it by and large referred to health professionals communicating with one another. Today, though, the broad reach of the Internet and wireless communications in the consumer sector allows telemedicine to operate on a much broader scope, making affordable health care services available to just about everybody.

Hilton Head-based Integrated Select, Inc. (IS) brings wireless and Internet technology-based products to market. Recently, IS partnered with telemedicine provider, 1-800MD, to develop a business model that will propel telemedicine into the mainstream.

HERE’S HOW IT WORKS:
1. A member requests a physician consultation by phone or e-mail, and completes or updates a personal health history and disclosure (PHH) form.

2. The physician reviews the PHH and contacts the member within two hours for a consultation via telephone, e-mail or videoconference.

3. The physician conducts the consultation and recommends an appropriate treatment.

The costs will vary among service providers, but the charge per consultation is generally in line with insurance companies’ co-pay amounts. It’s like having a doctor’s care in your pocket 24/7 wherever you happen to be.

IS has developed a business-to-business model for telemedicine that allows organizations (business, government, educational) to provide the service to customers and employees. For example, a university would be able to offer the service to students for less than $30 per semester. “Once the health care debate started intensifying, our end user surveys started spiking,” said IS president, Michael Iaquinta. “One hundred percent of the people with kids in college surveyed said they would buy it if it was reasonably priced.”

It might not be the be-all, end-all solution to all issues in the health care industry, but you have to admit that telemedicine does address the two most important components—affordability and accessibility—and it belongs in the conversation.

“We want to deliver a health care solution to the people who can’t afford it, but we don’t want to do it in a socialistic way,” said Iaquinta.

Here are some resources to learn more about telemedicine:
www.1800md.com
www.telemedicine.com
http://www.integratedselect.com/

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HEALTHCARE EVERYWHERE MEDICAL RECORDS

“It is truly amazing in this day and age that a used car dealer can get your credit report in a matter of a few seconds yet an emergency room physician can’t get your medical records when you are brought to the hospital unconscious or in a coma. In fact, the most critical time in an emergency room can be trying to collect information that could keep you alive. How do they get your medical history? How long will it take? Too long without your help.”
— Healthcare Everywhere Medical Records

Imagine a scenario: It’s another spectacular Hilton Head Island springtime afternoon and you’re taking a leisurely bicycle ride along a portion of the Island’s miles of bike paths, minding your own business. One of those dreaded blind intersections lies ahead. You – a conscientious and astute Local – proceed with the utmost caution.

It doesn’t matter, though. Out of nowhere appears a mini-van with a clamshell on the roof, thirteen bicycles dangling from the tailgate and…of course…out-of-state plates. Your prudence and experience are to no avail. The last thing you remember is a white gold pearl left front fender, then the lights go out.

You are rushed to the ER, unconscious and therefore unable to inform the doctors that you are allergic to certain medications. Because your cell phone was smashed to bits in the wreck, they can’t search through your contacts for “Mom,” “Dad,” “Sweetbaby,” or “Doc.”

But wait. What’s that in the patient’s wallet? A credit card? No, it’s some sort of flash drive, and it contains your entire medical history. The ER doctors can now safely administer care, and you are soon back in the saddle, no worse for wear.

A few years back, Hilton Head’s Neil Deir had an experience like that when he suffered a heart attack in Manhattan, and could not communicate with doctors. It inspired he and his son Sean, to develop a line of medical flash drive products called Healthcare Everywhere Medical Records.

“You could be allergic to something that they want to give you and if they give it to you and you’re unconscious you could be dead, and the point is that 100,000 people die every year because of lack of good medical history in an emergency room,” according to Deir. “When you can’t speak, it can speak for you and it fits just about every computer in the world.”

Healthcare Everywhere Medical Records flash drives are USB devices and you can choose from a variety of shapes and sizes. A credit card sized model fits right in your wallet, or you might opt for a wristband or necklace if you are prone to losing things.

Your critical medical information is accessible to doctors and emergency responders, but you can also password protect other information that you don’t want to make available without your consent.

Healthcare Everywhere Medical Records flash drives costs range from about $40 to $45, depending on the model. That’s a pretty small price to pay for the peace of mind that it can deliver.

To find out more about Healthcare Everywhere Medical Records, visit their Web site at www.hcemr.com or send an email to info@hcemr.com.

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