The doctor will see you now (from far, far away)

Aug. 11, 2015

Doctors love their iPads and their iPhones: 87 percent of providers use mobile devices in their workplace for communications, access to information sources, and to run clinical software applications.1 This trend is a boon for healthcare innovation. With such widespread use, mobile devices are a ready-made platform for modernizing patient-provider communications, provide-to-provider consultations, and more.

The benefits realized by mobile access to information and expertise are ideally suited to the needs of healthcare. Mobile technology can be used in many ways, telehealth being one of them. The next generation of telehealth is powered by the explosion of mobile devices and broader access to wireless connectivity,
combined with the increasing acceptance of private and public cloud technologies, to create a robust and cost-effective platform. The power of telehealth to improve care is putting it on a high-growth trajectory. As telehealth adoption gains speed, mobile technology use at healthcare organizations is increasing. With these two trends on a sharp upward curve, they are converging to create mobile telehealth. Mobile telehealth extends remote access (via smartphones and tablets) to patient information, providers, and patient monitoring tools.

Another area that benefits from mobility is telestroke, which now has programs that integrate mobile image-viewing capabilities to save valuable minutes in accessing images, thereby cutting the time it takes to begin diagnosis. For the past 20 years, telestroke has offered a solution to this problem, linking local doctors via video conferencing systems with stroke specialists to consult on patient care. This expansion of telestroke to mobile technology untethers providers from the fixed, point-to-point workstations of original telestroke systems installed in the early 2000s. These systems require specialists to move to a single workstation, where they must sit to view images and communicate remotely with providers to diagnose patients. For today’s doctors, who are used to the convenience of mobile devices, moving to and working at a fixed workstation is constricting.

Telestroke is revolutionizing care by bringing the expertise of stroke specialists to small rural and community hospitals. Instead of spending time transporting a patient to the physical location of the specialist, telestroke connects the specialist to rural providers using real-time image-viewing and video communications. With access to patient images and input from the provider treating the patient, the remotely located specialist can diagnose and recommend treatment from a distance. Telestroke supports faster, more accurate diagnosis and quicker treatment that saves lives.

In a recent survey of healthcare leaders, 90 percent report they are developing telehealth offerings.2 With smartphones and tablets already in the hands of 83 percent3 of physicians, telehealth offerings that properly support mobile devices have a huge user base ready and able to adopt a telehealth application.

Tools for sharing high-resolution images on mobile devices make it possible for radiologists to bring their images to both patient care teams and patients. A mobile image viewer that supports access to images from any picture archiving and communication system (PACS) offers an immediate and simple solution for enterprise image interoperability. For example, armed with these tools, a radiologist can bring images directly to meetings on an iPad and explain findings and diagnosis in greater detail, instead of sending a report to a patient care team.

Specifically, medical institutions like Nebraska Medicine, the United States Department of Veterans Affairs, and Intermountain Healthcare are demonstrating a powerful and broad shift to mobile telehealth applications.

Nebraska Medicine set out to trial a telehealth program that would enhance neurosurgeons’ ability to quickly differentiate between cases needing immediate intervention and transfer to higher levels of care, versus cases that could be treated locally at rural and community hospitals. The ability to quickly determine required levels of care significantly eases the burden on the patient, their family, and specialty care locations. The telehealth pilot used a unique, virtual imaging platform created from iPads, enterprise image-viewing software, and cloud technology. In partnership with a rural hospital more than 100 miles away, stroke specialists at Nebraska Medicine were provided with remote, mobile access to patients’ stroke images.

In 50-plus exams, image transmissions from the cloud-based server to the iPad tablet were viewable with 100 percent uptime, and not a single byte of personal health information was transferred to the tablet at any time, making the entire system fully HIPAA compliant. Results on download speeds used in the pilot were faster than using a teleradiology client on an iPad. The radiologists are appreciative, because they are no longer restricted by their desk computers and now can quickly and securely access time-sensitive information, from any location, via their mobile devices.

“I enjoy contributing to patient care, but firing up an off-site computer and connecting to patient images using a Web browser just isn’t consistent or reliable,” says Dr. Jason Helvey, Neuro Radiologist with Nebraska Medical Center. “Mobile access takes away the pain of the afterhours consult and allows me to participate using my mobile device from wherever I am. Using mobile access to patient images makes my knowledge, skills, and experience accessible to my trainees, referring providers, and patients much more readily and effectively.”

The VA enables nationwide mobile access to medical images

United States Department of Veterans Affairs (VA) is a nationwide integrated healthcare system with more than 1,700 sites. They are leaders in the use of mHealth technologies that connect patients to healthcare services remotely. In 2003, the VA entered the telehealth field with a Patient Viewer application that enabled clinicians to search and view a patient record, access laboratory data, medications, and more. Over the years, the VA has continued to enhance their Web-based applications, and clinicians will soon have on-demand, secure Web and mobile access to radiological images across a variety of mobile and desktop devices. The solution will help the VA improve care by accelerating and improving diagnosis and treatment, strengthening collaboration, and expanding telehealth options.

The imaging picture gets a lot clearer for clinicians at Intermountain Healthcare

Intermountain Healthcare, a not-for-profit health system based in Salt Lake City, UT, set out to make millions of images easily accessible to over 10,000 practitioners, referring physicians, and other occasional users across 22 hospitals and 180 clinics. With an IT environment that includes multiple vendor archives, combined with different viewers, it was difficult to access and share images easily across the organization. Intermountain’s providers now have Web-based viewing access to images, no matter what system originates them, from a single interface.

Intermountain has a proprietary EMR connected with eight data archives, comprised of seven PACS and a VNA from a number of different vendors. A virtual database system is created that eliminates the need to copy or move data. All clinicians now have access to a true enterprise viewer and have gained important functionality, including multi-user collaboration and mobile access with diagnostic capability. The system also makes it easier for providers to integrate images into electronic health records and share images with other healthcare providers.

“Simple, universal access to images across Intermountain Healthcare was the driving factor to move to an enterprise-wide viewer,” says Geoff Duke, Director, Imaging Informatics at Intermountain Healthcare. “We wanted a solution that did not require any downloads, was fully secure, had the proper FDA clearances for diagnosis, worked with our entire IT infrastructure, and met the speed and scalability requirements that are always at the top of our user lists.”

These are just a few of the many examples of mobile applications making a difference. Technology that enables medical practitioners to make diagnoses faster and with the same level of accuracy is particularly important in acute and emergency settings, where seconds can be the difference between the life and death of the patient.

References:
  1. Ventola, C. Lee, “Mobile Devices and Apps for Healthcare Professionals: Uses and Beneifts,” Pharmacy and Therapeutics, Vol. 39, May 2014.
  2. http://www.foley.com/2014-telemedicine-survey-executive-summary/
  3. 3rd Annual HIMSS Analytics Mobile Survey, February 26, 2014.

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