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Healthcare AV: Doctor/Patient Collaboration

Transforming healthcare with AV and mobile

Healthcare AV: Doctor/Patient Collaboration

Dec 4, 2014 9:29 AM, By Karen Mitchell

Transforming healthcare with AV and mobile

MAP VTC Videoconferencing and Presentation Cart

An upcoming wave — some would say a tsunami — of aging baby boomers is changing the face of AV healthcare integration.

“We struggle the world over with how to provide better care at reduced cost,” says Dr. Deborah A. Jeffries, director of global healthcare marketing, Polycom. “This challenge will only increase as we see the impact of the aging baby boomers and their numbers being counted in the ranks of those dealing with COPD, CHF, diabetes, and CAD. Here in the U.S. we have seen the recent introduction of healthcare reform and new models of care and payment as we try to get on top of this ever-increasing wave of patient demand and practitioner shortage.”

And no matter how healthy we aspire to be and how much we pay attention as we age, we will need more healthcare services as we get older, says Joseph Kvedar, MD. Dr. Kvedar is the founder and director of the Center for Connected Health, and he also launched the first physician-to-physician online consultation service in an academic setting, which today electronically links patients from around the world and their local providers with leading specialists at Harvard-affiliated teaching hospitals.

As demographics converge with the revolution in mobile communication, there will be enormous opportunities along with increasing patient demand for better, faster, and more personalized care. “This is a generation of people who have always had high expectations and are never really happy with service not provided in a certain way, a customized way,” says Dr. Kvedar.

Coupled with the growing need is impending physician shortage, cautions Tapan Mehta, Cisco Global Healthcare lead. “We have witnessed sporadic dips in physician availability within certain specialties, but as the current population gets older and their health requires more attention, doctors will be hard pressed to meet this demand.”

He says we need to “virtualize” healthcare and make our current healthcare resources work smarter and more efficiently. “We need to maximize a doctor’s use of his or her time and expertise. To do that, a greater use of new AV technologies must be implemented.

Mehta points to a recent study, conducted by Cisco, finding that 70 percent of patients are comfortable communicating with doctors via texting, email, and video instead of seeing them in person. Nineteen percent prefer a video chat consultation with a doctor. “From appointment and treatment reminders to information regarding drug side effects, patients are already hungry for a digital interaction with their healthcare providers,” he concludes.

In today’s healthcare world, expertise often is contained in a fixed location or an individual person. (A surgeon who has become an expert in a specific area can be in only one place at a time.) “With advanced AV technologies, that doctor can broaden his scope of care,” says Mehta. “Thanks to advanced technologies such as Cisco Health- Presence, high-definition video, advanced audio, third-party medical devices, and collaboration tools all combine to transmit unmodified medical information end to end, helping to enable convenient access to efficient, high-quality patient care and clinical collaboration across any distance. Cisco HealthPresence also makes it easier to bring routine care and follow-up visits into patients’ homes, a valuable service to elderly, frail, and chronically ill patients.”

Aging boomers will require improved access to care, and, at the same time, at a lower cost, adds Dr. Brian Rosenfeld, chief medical officer, Philips Healthcare. “We believe that coordinated telehealth is really the best, and maybe only, way to do this.”

“We believe that patient management won’t necessarily be at the doctor’s office, but at a telehealth center, where teams of care providers will coordinate patients’ care and interact with the primary care physicians in a seamless way,” Dr. Rosenfeld says. “The remote technologies will include two-way AV, physiological and psychological parameters, and quality of life indicators.”

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Healthcare AV: Doctor/Patient Collaboration

Dec 4, 2014 9:29 AM, By Karen Mitchell

Transforming healthcare with AV and mobile

As we see the growth of connected devices and the expansion of the network as a platform, we will surely see a growth of patient management technologies such as videoconferencing, Mehta says. “For instance, a resident will soon be able to sit at home in front of his connected television, computer, or tablet and videoconference with his healthcare provider for a check-up. Wearable technologies will be able to send vital information to providers, allowing for continued monitoring of at-risk patients from home. With Cisco HealthPresence and other high-end partner-led telehealth solutions, we’re already here to a degree; these solutions bring the benefits of telepresence to patients and healthcare staff with a mobile telemedicine cart.”

Now that technology has caught up, especially on the mobile side, there’s a chance to deliver healthcare services in a way that will augment a patient’s relationship with the healthcare provider, and, in some cases, disrupt it, explains Dr. Kvedar. “As we see it at the Center for Connected Health, mobile technologies are already starting to change care delivery, empowering people to take more control of their own care and communicate differently, and often better, with their providers.”

While there will always be a need for face-to-face meetings with a provider, many routine interactions can be accomplished using technology. “This technology may fill in gaps that you may or not realize exist when you visit the doctor,” Dr. Kvedar continues. “No experience is perfect, and patients/consumers who are clever will fill those gaps with opportunities such as mobile technology.”

While there will always be a need for face-to-face meetings with a provider, many routine interactions can be accomplished using technology.

An industry as large as healthcare needs disrupting, Dr. Kvedar argues. “Examples include retail mini-clinics and service through mobile phones, and medical decisions made through algorithms. We’re starting to see online portals and prescribing. For example, an app that allows you to take a picture of a mole to see if you should see a doctor, or a photo of a lab strip to be analyzed by computer in the cloud.”

In addition to smart phones, there are sensor devices available such as a Withings Smart Body Analyzer, a consumer scale that measures weight, body fat, heart rate, and air quality. These out-of-the-box sensors can transmit data to the cloud, Dr. Kvedar explains. “At the Center, we just achieved a significant milestone: For the first time patient data collected at home (including vital signs such as blood pressure, weight, and blood glucose) was viewable through the Partners HealthCare medical records system, allowing this important data to be accessible within the established clinical workflow. This individual patient data is transmitted securely via computer, smartphone, or tablet to the Center’s remote monitoring database, enabling Partners’ healthcare providers at hospitals, including Massachusetts General Hospital and Brigham and Women’s Hospital, to easily and seamlessly access personal health data for patients enrolled in our connected health programs.”

Over the next several years, personal health management will undergo a major transformation, especially with the advent of multiple sensory-based devices. “Smart surfaces — such as digital mirrors and wearable/implantable technology — can give users a better grasp on their everyday health,” Mehta offers. “When this information is shared securely with doctors, they are given a more complete picture of their patient’s health and can make a more informed diagnosis. Patients are also able to take more responsibility when it comes to their personal health, which will (hopefully) lead to less time in the hospital.

“These new technologies will find their way into areas such as videoconferencing and we will see healthcare move from being a series of static events to an ongoing process in our daily lives,” he adds.

AV tools could very well include digital mirrors for stroke and orthopedic rehab, and for maintaining physical agility for the aging-in-place group of patients,” says Dr. Rosenfeld. “And, there may be other, less expensive tools that could offer similar interactions. AV tools can now assess a patient’s vital signs and the opportunity to perform psychological profiling from visual recognition, for example, to determine if the patient is depressed, is on the horizon.”

“We’re in the very early stages, but with very promising entrants in this space to integrate this technology into day-to-day life,” explains Dr. Kvedar. “The digital mirror can see heart rate; similarly, there are now bath mats that will measure body weight or even the way your feet fall on the mat — very important for those who may have diabetic ulcers.”

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Healthcare AV: Doctor/Patient Collaboration

Dec 4, 2014 9:29 AM, By Karen Mitchell

Transforming healthcare with AV and mobile

Over the next several years, personal health management will undergo a major transformation, especially with the advent of multiple sensory-based devices.

Compared to five years ago, the technologies are becoming easier to use, with, for example, Bluetooth, Dr. Kvedar adds. “Back when it was used as a wireless earpiece for a mobile phone, there were issues. Now, those issues have been solved and Bluetooth has created a version, Bluetooth LE, that doesn’t drain as much energy and, therefore, makes it a better solution for healthcare applications.”

Mehta notes that data connections will be managed with a set of best practices and guiding principles, the network foundation that helps enable reliable, seamless, and highly secure health data communications across the healthcare continuum of care. “We’re beginning to implement this with the Cisco Medical- Grade Network (MGN), which will provide efficient communications among clinicians, patients, administrators, and partners, regulatory requirements for patient privacy and data security, and anytime/anywhere information capture and access for wired and wireless applications and devices.”

MGN also provides converged data, voice, and video networks, identity and policy-based security from inside the network to beyond organizational walls, and the transfer and storage of the large amounts of data created by healthcare applications.

Obviously, this is a challenge in a world that wants greater access, but at the same time wants data security, Dr. Rosenfeld concludes. “Generally, the AV interactions do not need to be recorded, and as such shouldn’t pose any problems; and those that need to be recorded (e.g., stroke rehab to document status) will need to be securely put into the patient’s EMR or data repository.”

Telehealth Carts

The advent of portable videoconferencing systems has revolutionized remote patient monitoring. For AV integrators, the question is how they can best outfit clinics and hospitals with these systems.

“We never know where clinical expertise might be needed,” says Dr. Deborah A. Jeffries, director global healthcare marketing, Polycom, “so having the ability to move a telehealth solution to the patient point of care is extremely important.”

For that reason, she says, mobile telehealth carts with the ability to integrate medical devices to meet a variety of specific clinical applications are important. “For instance, a psychiatrist will just need a basic set up that allows them to have a highlevel interaction between the patient and themselves via video, while an ear, nose, and throat doctor will need otoscopes to look in ears and laryngoscopes to look deeply in the throat. The cart platform needs to scale and offer the right I/O interfaces depending on the application.”

Now that they have been around for more than 20 years, and with the widespread use of Skype and other similar video communication systems, the very idea of videoconferencing carts is becoming a little less of a novelty. Still there are considerations when combining it with healthcare.

For example, Middle Atlantic’s VTC Series videoconferencing cart is designed to hold equipment within the protected body of the cart, which makes the exposed areas easier to clean and disinfect, he says. It is also designed to hold a UPS low in the base section, which improves stability and safety during movement, but can also keep the system powered while moving between usage locations to reduce the need for rebooting the system. The mounting system is flexible for both video screen and camera location, above or below a single screen, or between two screens.

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