Report: California's Health Care Spending Among Lowest In U.S.

California spends less than most states for Healthcare?  Telemedicine is going to need to be employed to create efficiencies as more people get health care under the health care reform mandate.

Mark Smith -- president and CEO of the California HealthCare Foundation -- said, "While we expand coverage, we have to work on making the system more affordable and more accessible to people." CHCF publishes California Healthline (Los Angeles Times, 12/7).

 

Read more: Report: California's Health Care Spending Among Lowest In U.S.

Using Video Conferencing Today

Using Video Today

Recruitment and retention of the rural clinical workforce that includes physicians, physician assistants, nurse practitioners and nurses is beset by ongoing problems associated with the isolation, pressures, and stress associated with the rural environment. One of the largest issues is access to continuing medical education (CME).

Whether through a new videoconferencing-based distance learning program (that can be the foundation for additional telemedicine) or leveraging existing telemedicine systems the result is increased access to CME and professional development through interactive training, live interaction between colleagues, and on-demand access to previously recorded educational material.

Med-RT can provide both the visual communications solution to connect teacher and student(s) in real-timeas well as the capability to record for later on-demand use.

The benefits:

  • maintaining patient care by not taking residents away from patients
  • saving time and money by reducing travel time between sites for residents and presenters
  • higher ranked enrollments by promoting the quality of instruction
  • mobile grand rounds presentation and recording

We can also provide other Enterprise Information Management solutions that includes Web 2.0 technologies such as Blogs, Instant Messaging (IM), Social Networking (with a focus on virtual worlds), Wikis, RSS, and Podcasting to enhance the learning experience.

More importantly by being a member of the Med-RT peering network we can:

  • support expansion of educational programs
  • allow access to a greater breadth of education
  • generate revenue by monetizing recorded material through making it available on-demand to other members of the network
  • integrated interpretive services

Med-RT can also support patient education through viewing of recorded video either during treatment or post-treatment from home over the Web. The latter provides the opportunity to reduce post-visit recidivism and promote continuity of care.

Watching video from home


Using Video AND Virtual Worlds Tomorrow...

Med-RT is working on building the first "real-time video interface for the virtual world" that brings together the benefits of videoconferencing and virtual world social community. This would provide the ability to seamlessly utilize multi-participant, real-time, video directly in-world, and dramatically enhance the use of virtual worlds as collaborative learning tools.

The use of videoconference technology for patient education in the treatment of chronic conditions, such as diabetes, as well as for the post-treatment of acute illnesses is now being established by numerous healthcare organizations. However, the experience, almost exclusively delivered on a one-to-one basis does not build, or leverage, any sense of community; put simply "you cannot just bump into someone on a videoconference". Even review of pre-recorded materials is a solo exercise, lacking any capability to gain interactive clarification. Conversely, the social environment of virtual worlds allows patients and caregivers to share experiences, content, and provide emotional support — one that often offers freedom from physical disability. Said by some to represent the future of collaborative education, the technology does have limitations in that there are things you cannot show, communicate, or demonstrate via an avatar today. This includes the ability to fully address the needs of the hearing impaired, to convey the complexity of emotion inherent in seeing someone’s actual face, or the ability to gauge understanding from body language. It is the combination that will allow us to push beyond the existing limits of both, and dramatically enhance patient education.

 

Choc and Med-RT Partner

 

June, 2008
Med-RT and CHOC partner to allow a local high school student, in his 3rd round of leukemia treatment, to watch his 2008 graduation that he would have otherwise completely missed. By taking one of the our Mobile Cart's for Telemedicine, pictured below in the bleachers, live video of the event was viewed bedside in high-definition on a Tandberg 1700 MXP. [CHOC Foundation - Making a Mark, October 2008]

Graduation via video


Telemedicine Business Case

 

Telemedicine Business Case and ROI

In essence the business case is a statement of the goals for the proposed telemedicine program(s) backed by the detailed financial analysis showing viability, sustainability and Return on Investment (ROI) in achieving those goals. Goals are most often defined in terms of Quality of Care, i.e.

  • Increased access to [Specialist] Care
  • Better patient outcomes and reduced recidivism
  • Improved patient satisfaction
  • Healthcare provider (e.g. physician) recruitment and retention
  • Other social benefits
With the financial analysis built from an understanding of a complete revenue and cost model:


Business Model - Financial Components


that is directly dependent on whether you are purely a clinical service satellite site, a clinical service provider, or a network of both. It is also dependent on the services (clinical, educational, interpretive, and administrative) that you plan to provide.

Business assumptions can be validated by deploying a single service initially (that addressing the highest need as identified by a Needs Assessment), however, an overall multi-service plan will provide the largest ROI.

Both Direct Revenue and Direct Cost variables are relatively straight forward, although it is recommended that different reimbursement assumptions, service volumes, and growth rates are modeled. However, for Enhanced Revenue/Reduced Cost and Indirect Cost the variables are more challenging:


 

Enhanced Revenue/Reduced CostExamples
Increased [internal] resource availability ER beds, specialists (through better utilization)
Reduced patient by-pass/walk-out Rural referral requiring patient to travel, ER overcrowding causing walk-out
Increased revenue per patient Patient retention [at rural facility]
Reduced travel Ambulance transport on referral, specialist travel to patient
Increased specialist service revenue Increased patient acquisition, efficiency of on-demand
Reduced cost of provider services Efficiency in interpreter services, on-demand specialists
Indirect CostExamples
Increased support demand Additional burden on internal IT/network support resources
Facilities Additional insurance, energy costs
Administration Contract and grant management

Additional information