Technology is bridging gaps in health care coverage with a virtual solution


In 1962, they imagined a future where a child who tried to use a “sick day” as an excuse to miss school (to avoid taking the dreaded “Space Calculus Test”), had his plot foiled by a house call with the doctor. In this scenario, the call to the doctor was answered immediately with the dedicated physician appearing on a monitor screen. He was able to see the patient, diagnose the problem, told Mom that her son was “fine”, and needed a full day of school. This scene played out on an episode of “The Jetsons” during a time when people had an optimistic view of medical advancements and diagnostic instruments of the future.

Today, technology is bridging gaps in health care coverage, offering a virtual solution for patients to communicate with their doctor when distances, location, or access present physical barriers. This is called “telemedicine,” and it is changing the face of healthcare. Telemedicine is defined as a cost-effective alternative to the more traditional face-to-face way of providing medical care with a distinct set of guidelines and insurance coverage approval steps. The goal of telemedicine is to deploy the latest technology to provide real-time communication between the patient and their doctor. This year, OakBend Medical Center, located in just outside of Houston, Texas, launched a telemedicine cart that allows cardiologists to virtually examine patients to determine whether they should be admitted to the hospital. We connected with Dr. Long Cao, a preventative cardiologist with Oak Bend Hospital, on a recent episode of HeartTalk presented by Capital Cardiology Associates.

“I was skeptical about how the patients would respond,” Dr. Cao shared. He was approached by hospital administrators who presented their rollout plan for the telemedicine cart. Dr. Cao’s apprehension was appropriately based. The technology’s start was a far picture than what was portrayed in the 1960s. “Everyone starts thinking of the early days; the early 2000s were when delays and images were fragmented. It felt primitive,” said Cao. As high-speed internet connections strengthed, pictures became clearer, sound quality improved, and data was transmitted in seconds — downloads opened almost immediately.

More than screen time

Video-conferencing is more mainstream thanks to webinars we attend, replacing in-person meeting. FaceTime enables us to “talk” with friends and family on our phones as though we were in the same room. “There are no delays; they can hear me, see me on screen. After a few minutes, we have a relationship, and they tell me what’s wrong and what is bothering them,” noted Dr. Cao. His patient visits are similar to the Jetson’s calling on their dedicated physician. “When the patient logs on, they see me waving and smiling. I try to make a joke to break the ice. I tell them, ‘Next you are going to see my hands come out of the side of the computer,’ and they start laughing. I introduce myself and say this doesn’t replace me being in front of you. The patients are very receptive.”

The telemedicine cart looks like any other piece of medical diagnostic equipment; however, Dr. Cao pointed out that it is loaded with the latest technology. It has multiple cameras and attachments that allow physicians to make remote patient visits. “The stethoscope attachment is very nice; it’s attached via Bluetooth. As I bring up the apparatus to listen to their heart, they can hear their heartbeat — see everything that I see on the monitors, making them actively involved and participating in their examination. There is also a sound wave feature that allows me to view the S1, S2, S3, and S4 (EKG) waves. This allows us to diagnose heart failure. It’s interspersing how these instruments are more accurate over distance than if they were in person. There is also an attachment for a camera that can zoom in 1000X, beyond what our human eyes can view. This camera can zoom into the wound to the point where I can see hair follicles and wound edging,” said Dr. Cao.

Hands off but still delivering a high-quality of care

Dr. Cao explained the importance of keeping the structure of the doctor visit, similar to the examination he would perform in person. There is a trained technician, either a medical assistant or registered nurse with the patient during the exam. “They would perform the exam while I ask the patient or technician questions on what they see or feel,” stated Dr. Cao. He sees roughly 30 patients a week using the cart. An estimated 7 million patients in the United States will use telemedicine services this year alone. As the services become more available, health care experts point that demand will continue to rise.

Telemedicine is also transforming patient care in rural and urban areas by offering advanced, specialized, and preventative care to patients that would not have local access. “Right now, we are at a time where we are seeing many heart failure patients. They are severe patients, but they can be managed if they are treated with appropriate medications. I’m not seeing heart attack patients. Those patients need to be seen immediately. However, for patients who have had a heart attack or have a week heart, who need monitoring of their medications, if there is a reservation on counseling them over the phone, this technology allows me to look at them, see their fluid levels, and treat them. Just being able to look at their leg swelling or other problems, listening to their heart, telemedicine allows me to adjust their medications or treat them at that time versus having them travel,” commented Dr. Cao. There is also a benefit to the physician. The downtime that would be spent traveling to the patient’s location can be directed to care and visits. “By removing the space barrier, I can segue and care for them. I could see them every month instead of them missing visits and needing hospital treatment.”

In the early 2000s, telemedicine was primarily paid out of pocket as it was seen as concierge medicine. Now that technology is more mainstream, insurance companies combined with patient demand has allowed for growth opportunities. New York became the twenty-second state to require private insurance companies to cover telehealth services when New York Governor Andrew Cuomo signed the State’s telehealth parity law, which went into effect Jan. 1, 2016. This law also authorized the New York Medicaid agency to increase coverage and reimbursement of telemedicine.

And what does the future hold for telemedicine? Will we ever live in a time where our dedicated physician is just a button away? “I could see the future where every house would have a monitor, and you will contract with a physician for treatment,” shared Dr. Cao.” We are also trying to introduce this to the EMS (Emergency Medical Services), my focus is on the heart, but there are trauma patients where we can start examining the patient while they are en route to the emergency room. For heart attack patients, I can see their EKG, exam the patient, and know that if this a severe heart attack, we can prepare the Cath lab for treatment. Where time is tissue – either in a stroke or heart attack – this technology can save lives.”

Written by Michael Arce, Marketing Coordinator, Capital Cardiology Associates
Any medical information published on this website is not intended as a substitute for informed medical advice, and you should not take any action before consulting with a healthcare professional.