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By Alsten Tauro

Yesterday I looked at the growing “acceptance” of telehealth by consumers, payers, health plans, and provider organizations – The Telehealth Market – Now, Soon, & Future. My focus was on the changing environmental factors that are making telehealth increasingly feasible. These factors are many, including a need to expand access to services in different areas of the country, a push for increased efficiency in service delivery, and consumer desire for convenience and care.

But what I didn’t consider in yesterday’s piece were the technologies that are the foundation for this increased acceptance and adoption. A 2015 Healthcare Information and Management Systems Society (HIMSS) survey (see Essentials Brief: Telemedicine Study), identified the nine most widely used telehealth technologies in 2014 – two-way video, image sharing technology, email, patient portals, group video conferencing, medication management, scheduling tools, remote patient monitoring, and smart phones.

But this is now. If you look past the telehealth technologies that have already earned “traditional” status in the field, there is a whole new arsenal of technologies that will likely be the foundation for telehealth in the future. I think the future technologies will move “beyond the computer screen” to include more robot-delivered assistance, remote monitoring peripherals, mobile apps, and kiosks. And what was really exciting, was having a chance to see the future now – during my session at The 2015 OPEN MINDS Technology & Informatics Institute, Next Generation Service Delivery: The Future Of Telehealth Technology. My co-presenters, Randall Holley, Director of Information Technology, Commonwealth Care of Roanoke (CCR) and Kishor Joshi, M.B.A., Chief Executive Officer, Pertexa Healthcare Technologies, Inc., both presented their current work in the field – what I like to call the “next generation” of telehealth.

Randall Holley, Director of Information Technology, Commonwealth Care of Roanoke (CCR)

Smart glass technology for telehealth – Mr. Holley discussed the use of smart glass technology for wound care in a pilot program at CCR. CCR is a long-term rehab company based in Virginia; the organization operates 12 skilled nursing facilities (SNFs) with a total of 1,390 beds. The CCR pilot program tested two different types of smart glass technologies in five of their SNFs – Google Glass and Vuzix glasses. Both technologies are head-mounted, wearable camera devices that are worn by nurses during a patient examination. The smart glasses transmit what the wearer sees via an integrated camera and a HIPAA-compliant IT platform to a supervising nurse located at a different site within the same facility. Through an ipad or laptop computer, the supervising nurse can see everything the nurse is seeing in the patient room. Additionally, the smart glasses displays information to the wearer from the supervising nurse, including feedback about the nurse’s actions and consultation about the best course of treatment for the patient. Essentially, this technology enables the supervising nurse to do “virtual rounds” on patients needing wound care (see Smart Glasses Help Rehab Nurses Deliver Better Care in First Program of Its Kind). CCR initially utilized Google Glass technology, but found that the Vuzix glasses had better resolution on the camera technology.

Through their pilot program, CCR found that using smart glasses in their wound care program reduced hospital admissions and the trauma of transporting patients in need of wound care; importantly, the patients themselves were overwhelmingly receptive to the smart glass technology. In the future, CCR plans to expand the use of the smart glasses to additional facilities and utilize the technology in new ways – potentially for telemedicine encounters with medical/surgical staff and as part of their readmission/transfer prevention program.

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Kishor Joshi, CEO, Pertexa Healthcare Technologies

Telehealth via robots – Mr. Joshi presented his work at Pertexa Healthcare Technologies, Inc. in the development of RITA (Robotic Intelligent Telehealth Assistant). Still in the testing stages, RITA is a five-foot tall mobile robot that functions much like a smartphone, with three high-definition monitors and wireless technology. RITA is designed to be used in hospitals and clinics and run by nurses or technicians to connect with remote physicians or specialists for patient care consultations. The nurse/technician can send patient vitals and other data (lab results, x-rays, etc.) to the remote physician in real time by using the monitors, touch screens, and USB-enabled medical devices (such as a heart monitor or blood pressure cuff). The remote physician can control the camera on the robot themselves, enabling them to zoom in or examine the patient from a different angle while consulting with the nurse and patient via video (see PTZOptics/Pertexa Robotic Telemedicine Case Study). The three monitors allow for the display of x-rays, lab results, and other patient info, while the remote physician is still featured on screen and engaged with the patient and nurse.

RITA features an “open architecture,” meaning that clinics and hospitals can install whatever software they currently use onto the system – including their existing electronic health record system (EHR). RITA is currently being tested in a pilot program at a rural clinic, and preliminary findings show positive results (see Pertexa’s Next Generation Telehealth Robot Launched in California’s Newest Tech Hotspot).

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While it may seem a bit premature to be looking at smart glass and robots as platforms for telehealth, when most payers and provider organizations are struggling to find a way to make traditional telehealth work, these new technologies represent a new era of innovation and a range of opportunities to increase access to care, improve quality, and increase efficiency in service delivery.  Only time will tell how effective this “next generation” of telehealth will be. For more, make sure to check out the upcoming session, Setting & Managing Your Tech Budget: A Facilitated Discussion Session, at The 2016 OPEN MINDS Performance Management Institute.

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