| | October 20179CIOReviewIt could be a connection directly with a patient in their home over their personal computer. Consider the new mother who has little local family support is sent home with her first child only after a few nights, the child contracts colic. Imagine the mother's feeling of support and comfort if at 3:00AM, she could connect with an inexpensive video camera on her computer back to the maternity staff who could guide her back to a hopeful calm child. The concepts of offering more offerings that are complex have greater challenges to address. The options are as varying as the methods. One group may have geographic challenges in providing care, but through a telemedicine approach find a way to offer their specialists to areas in their covered areas. In a different market, others may struggle with a competitive environment and want to reach a new customer base. It is at this point many organizations become frozen with their plans. Consider what the greatest need in the community and what would have the greatest support from the physician community. Begin with an offering that would provide an initial success of adoption.Technology ApproachTechnology is generally at the heart of most offerings, but in reality today is the simplest of the issues to address. In very recent history, vendors have offered elaborate telemedicine carts customized to address the needs of a given specialty. These carts generally came with a very high price tag and had limited use. Today, providers are understanding more of what they desire and what is needed and vendors of telemedicine carts are learning the need to provide a more universal cart design which based upon a modular design can be utilized for multiple services with limited manipulation of the cart itself. The cart maybe an obstetric device in the morning, only to be switch to a cardiology device in the afternoon.The once concern of the in-house network becoming a limiting factor is moving to the wayside as improved network technology and methods of video transmissions and provisions of broader network bands in most communities move the issue to the side for the majority of interested parties. For those still in need, the federal government has instated programs to promote the establishment of services to those underserved areas.Method of ExecutionOnce a supportive physician body is in place and service(s) to be offer have been determined, it is now a question of how to execute on the decision. Not every organization may have capacity within their staff to draw against, nor the expertise. A number of different groups are now offering to provide telemedicine services to healthcare organizations. Some general thoughts with using outside providers include their willingness to accept the credentialing process; their willingness to use existing technology versus their own tools; their agreement to document in the existing electronic medical record; open to working under existing contractual payments and collaborative billing. Other organizations are creating dedicated locations or rooms which are staffed by professionals. This offer generally requires a contractual arrangement with physicians to insure their income. Both approaches have benefits, but it will be the culture of the organization to know the best fit.It is doubtful that anyone at NASA ever considers they would be changing the face of medicine some fifty years later, but those early days for the concerns of our astronauts are today evolving the everyday application to effective and more convenient patient care to all. There can be no telemedicine program without engaged and supportive physiciansLynn Gibson
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