By EMILY MULLIN
Scripps Howard News Service
October 20, 2009
"We need to use technology to change the organizational structure of health care," Darrell West, vice president of the Brookings Institution, said at a recent panel discussion at the Washington-based think tank.
Telemedicine, a developing area in clinical medicine, uses technology to do things like transfer medical information electronically and have medical consultations or examinations from remote locations.
The health-care bill passed by the Senate Finance Committee contains some provisions for telemedicine, but West said in an interview that the bill "does not go far enough." West said telemedicine services need to be more widely available to the public no matter what kind of health reform Congress approves.
"There needs to be policy changes that recognize the virtues of telemedicine," West said.
Technology and telemedicine can help put patients in charge of their own health care, West said, while reducing costs and cutting the amount of time patients spend at the doctor's office. New technologies such as digital monitoring devices can be used at home to check a patient's weight or glucose levels.
West wrote a report issued this month that illustrates Americans' willingness to integrate technology in their health-care services.
The report says that polls have found that large majorities of people would like to get e-mail reminders from their doctors when they are due for a visit and the ability to schedule a doctor's appointment online. They also said they want access to an electronic version of their medical records and would like to use a home monitoring device.
Dr. Karen Rheuban, medical director of the Office of Telemedicine at the University of Virginia Hospital, said the main obstacle for incorporating new technology in health care is that Medicare and many private insurance companies do not reimburse doctors for telemedicine services. Costs are shifted to patients.
"We face a lot of challenges, but we can provide a lot of services through telemedicine," Rheuban said.
Some of those services include dermatology consultations, screenings for diabetes and mammography.
Rheuban said these services are especially useful for patients living in rural areas that don't have access to medical specialists. She said Web consultations and examinations eliminate the "hardship" of hours of driving to see a medical practitioner, which also helps patients save money on unnecessary doctor visits.
A major challenge for telemedicine advocates like Rheuban is funding. She said the federal government has not invested enough in the field of telemedicine.
"We are absolutely desperate for an alignment of policies to make this work," Rheuban said.
Ellen Blackler, executive director of public policy at AT&T, said the telephone and Internet company is developing several health-care technologies that could help patients take control of their health care. One of those technologies is a device that looks like a cable modem that will be used to collect patients' data and send it to their health-care providers.
Another AT&T development is a digital insert that fits inside shoes. It senses balance to determine the cause of a fall. Blackler said this invention would be particularly useful for elderly people who live by themselves.
"It's really designed to be an independent living tool," Blackler said.
But Blackler said there are problems getting these technologies to market because of reimbursement issues. Another major barrier is Internet access. Blackler said lack of access to technology is a problem, especially among the elderly.
"The 'digital divide' is a big problem because senior citizens are the group that is least likely to use digital technology," West said.
Blackler agreed that a health-care bill should include provisions and more funding for telemedicine.
"The world's economy moves electronically, why not health care?" Blackler said.
Scripps Howard News Service, http://www.scrippsnews.com
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