Telemedicine Comes of Age (Rohit Varma)

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Speaker Presentation from U.S. News Healthcare of Tomorrow leadership summit, November 2-4, 2016 in Washington, DC. Find out more about this forum at www.usnewshot.com.

Healthcare

Telemedicine Comes of Age

Rohit Varma, M.D., M.P.H.
Interim Dean – Keck School of Medicine of USC
Director – USC Roski Eye InsAtute

November 3, 2016

•  Telemedicine is evolving
•  Introducing the USC Virtual
Care Clinic
•  Why USC is unique when it
comes to digital health
innovation
•  What the future looks like
Overview
2

3
Technology moves fast …
… and medicine has to keep pace

4
Smartphones Worldwide = 2.6 billion
Smartphones U.S. = 80% penetration
12,000 wearables for health tracking
165,000 medical apps
More than 100 million telemedicine visits in 2015
Most are 35-54 years old
Worldwide ¾ use internet daily
76% on internet engage in social media

5
Patients want:
•  On demand response
•  Borderless access to experts
•  Trusted, personalized medical
and clinical trial information
•  Non-judgmental environment
•  Empowerment to manage
chronic illness
•  Secure personal health data

6
Providers want:
•  Reduced hospital readmissions
($26 billion annually)
•  Reduced physician time paperwork vs
patient care
(60% of time spent on paperwork instead
of patient interactions)
•  Medication adherence
(chronic illness patients take only 50% of
medications prescribed)
•  Digital tools promise improved
population health data and meaningful-
use rule usage

§  Located in Los Angeles
§  Top 10 in California ranked in
7 special>es - US News & World
Report
§  3 hospitals
§  More than 40 outpa>ent clinics
§  Founded 1885
§  1,500 full->me faculty
physicians
§  1,200 students
§  World-class research (top in NIH
grants)
§  Ranked 31 - US News & World
Report
§  Established 1880
§  Ranked 15 in the na>on
(Wall Street Journal/Times Higher
Educa>on)
•  Na>on’s #1 cinema school, #3
na>onally ranked business school, #9
engineering school, more Olympic
medalists than any other university,
home to 1 of only 2 commercial
quantum computers (other one at
NASA/Google facility)

USC’s Unique Cross-School Collaborations
First & Only
Digital Health
Fellowship

10
Virtual Doctors Digital Medicine
Innovative
Wearables & Apps
Evidence-based data &
clinical trial info
HIPAA compliant
cloud computing
8Foundational partners
Holistic Virtual Care Solution
Hollywood’s Best
digital storytellers
Reliable App
Evaluation
Award-winning
Design

VSP Global – Keck Medicine of USC Pilot Study
12
•  First wearable in eyeglasses
•  USC Roski Eye Institute clinical
partner in this VCC project
•  Studying biometrics and inﬂuence
of philanthropic giving on health

13
The future of telemedicine
•  Payer models; reimbursements
•  Regulatory issues
•  Physician & medical student training
•  Scalability to other health systems

Thank you
Rohit Varma, MD, MPH
rohit.varma@med.usc.edu
Keckmedicine.org
@KeckMedUSC
USCEye.org
@USCEye

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Disinfection of medical instruments is important for preventing the spread of disease. Cleaning and disinfecting reusable equipment after it comes into contact with patients can be expensive, both in the cost of the disinfection procedure, but also in terms of time away from the patients themselves. Not all medical instruments can be fully sterilized after each use. Thankfully, not all reusable instruments need the highest level of disinfection. But how to determine the minimum level of disinfection in a given situation? Earle H. Spaulding devised a rational approach to disinfection and sterilization of patient-care items and equipment Spaulding believed the nature of disinfection could be understood readily if instruments and items for patient care were categorized as critical, semi-critical, and non-critical according to the degree of risk for infection involved in use of the items. Spaulding recognized that the need for disinfection of equipment in medical settings ranged from non-critical to semi-critical to critical, depending on the likelihood of spreading disease. For example, sterilization is necessary for equipment that comes into contact with a patient’s bloodstream or sterile tissue. This category of equipment, such as surgical knives, is designated “critical” because it presents a high risk of disease transmission from patient to patient. Equipment that only touches healthy, unbroken skin presents a low risk of contamination because intact skin acts as an effective barrier to most microorganisms. Examples in this “non-critical” category include bedpans, blood-pressure cuffs, and bedrails. In between those two scenarios, a “semi-critical” level of disinfection presents a medium risk of contamination. This would include equipment such as endoscopes used on mucous membranes or areas of broken skin.

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