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TeleHealth Technology Landscape - Marc Goldyne
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TeleHealth Technology Landscape - Marc Goldyne

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Panel Session: TeleHealth Technology Landscape ...

Panel Session: TeleHealth Technology Landscape
Moderator: Dave Marvit, VP, Internet Services Innovation Group, Fujitsu Laboratories of America
Panelists:
Dr. Marc Goldyne, Chair Teledermatology SIG, American Telemedicine Association
Dr. Linda Branagan, Principal, SecondLook
John DeSouza, CEO, MedHelp

Fujitsu Labs of America Technology Symposium 2011
Healthcare Technology Convergence: Smart Consumers Meet Care Delivery of the Future
June 01, 2011
Computer History Museum
Mountain View, CA

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  • Competing Business Agendas are overwhelmingly driven by economic rather than moral incentives, and without moral incentives, healthcare becomes the dysfunctional, bottom- line- is- everything system that now consumes 15 % of the GDP. Competing Business Agendas are overwhelmingly driven by economic rather than moral incentives, and without moral incentives, healthcare becomes the dysfunctional, bottom- line- is- everything system that now consumes 15 % of the GDP. Healthcare Business Agendas are overwhelmingly driven by economic rather than moral incentives, and without moral incentives, healthcare becomes the dysfunctional, bottom- line- is- everything system that now consumes 15 % of the GDP.

TeleHealth Technology Landscape - Marc Goldyne TeleHealth Technology Landscape - Marc Goldyne Presentation Transcript

  • Referring Provider Patient data + images Specialist Evaluate data - Generate Consult Encrypted E-mail Store & Forward Teledermatology 4 2 1 3 © M. Goldyne 2009 9
  • Store & Forward Teledermatology in the Netherlands Leonard Witkamp, PhD, MD , KSYOS Virtual TeleMedical Center, Amstelveen, Netherlands M.E. Goldyne, MD, PhD, FAAD 2009
    • In a study of 6000 patients, 65% of live referrals were prevented.
    • 4000 general practitioners communicate with 164 dermatologists.
    • All health insurances reimburse for this service.
    • A teleconsult costs 40% less than an in person, office consult.
    • In 2008, they did 25,000 consults
  • Teledermatology Office - 1997 Ft. Miley VA Medical Center, S.F. Digital Arts and Sciences Software plus Intel-Proshare Cost : $6000 Primary Care Satellite Santa Rosa – Director refused to use.
  • Increased Patient Access = Consultant Centers 2002 2009 = A/BCTP referral site (e-mail based) = TDS referral site ( web based) © M. Goldyne 2009 Anthem/Blue Cross and TeleDerm Solutions Telemedicine Program Referral Centers 23
  • Enter “Store and Forward” - 2002
  • The Supply of Care Providers
  • 1999: Blue Cross of California SSP HFP Telemedicine Project
  • 1999:Blue Cross HFP Network Teledermatology “Hub” (Live-interactive Network using ISDN) Specialty Hub Site General Spoke Site San Francisco and UC Davis
  • Who Pays in California? (99243)
    • Anthem/Blue Cross/MediCal: - $50
    • Blue Shield: - $90
    • CalPERs: - $80
    • Delta Health Services: - $80
    • EHS Fresno (IPA): - $65
    • Health Net/MediCal: - $60
    • MediCal (yes and no): - $60
    • Self-Pay: - $60
    • Independence Med Grp (IPA): - $60
    M.E. Goldyne, MD, PhD, FAAD 2011
  • Teledermatology Office - 2002 M.E. Goldyne, MD, PhD 2006
  • Teledermatology Office - 2002 M.E. Goldyne, MD, PhD 2006
  • Kaiser Permanente San Diego Dr. Jeffrey Benabio
    • Using store and forward technology to connect primary care physicians to dermatologist
    • Electronic medical records
    • Began January 2010
    • 30 consults daily
    • 4,000 completed consults in first year of operation (40% did not require visit to dermatologist).
  • What are obstacles to integrating teledermatology into U.S. healthcare infrastructure ? M.E. Goldyne, MD, PhD, FAAD 2011
  • Health Insurance Industry Pharmaceutical Industry Physician / Provider Patient Technology Industry Health Care Bureaucracy Problem of Different Agendas M.E. Goldyne, MD, PhD, FAAD 2011
  • Commentaries abound
    • We have “space age technology with stone age institutions”. ( Jakobson KR (UI College of Law): Space-age medicine, stone-age government: how Medicare reimbursement of telemedicine services is depriving the elderly of quality medical treatment. Spec Law Dig Health Care Law 274:9-37, 2002)
    • “ You can’t get a person to understand what they are not paid to understand”. (Upton Sinclair and Al Gore)
    • The inertia generated by legacy systems is not to be underestimated.
    M.E. Goldyne, MD, PhD, FAAD 2011
  • Innovation in Medicine M.E. Goldyne, MD, PhD, FAAD 2009 “ It will take 20-25 years for Telemedicine to become mainstream” Dr. Alan Rosenberg Vice President of Medical Policy, Technology Assessment and Credentialing Programs for WellPoint @ AAD Directors Summit 2003.
  • Of the almost 3000 rural teleconsultations I have done since 2000, the referring provider had an incorrect diagnosis over 50% of the time. That is precisely why delivering specialist expertise with low cost store and forward technology not only can increase patient access, but also improve health care, educate primary care providers at the point of service, and save money! Improves health care delivery
  • Kaiser Permanente San Diego Dr. Jeffrey Benabio
    • Using store and forward technology to connect primary care physicians to dermatologist
    • Electronic medical records
    • Began January 2010
    • 30 consults daily
    • 4,000 completed consults in first year of operation (40% did not require visit to dermatologist).
  • Broad Adoption will require…
    • Institutional commitments.
    • Certification and training of telemedicine site coordinators.
    • Less attention to hardware and software; more attention to “peopleware”.
    • 4. Economic incentive for PCPs and Specialists.
    M.E. Goldyne, MD, PhD, FAAD 2009