Briefing on Connected Health

Karen DeSalvo MD, the newly appointed HHS National Coordinator for HIT, and keynote speaker at the briefing to unveil the February 2014 issue of the Health Affairs Journal titled “Early Evidence, Future Promise of Connected Health”. The Journal examines the successes and missing links in connected health that includes telehealth, telemedicine, and health IT. The articles focus on best practices along with the gaps in adoption and use.

Dr. DeSalvo, previously the New Orleans Health Commissioner and the Senior Health Policy Advisor for New Orleans Mayor Mitchell Landreu, understands the importance of connected health especially in a hurricane like Katrina. As she told the attendees, “It is vital to develop EHRs and health IT when dealing with emergencies and disasters.” She described how the healthcare system was basically wiped out in New Orleans during the time of Katrina. It was like flying blind with no communication and people were very isolated.

During her post Katrina days in New Orleans, Dr. DeSalvo advocated increasing the use of health IT and worked to redesign the health system with technology. She also led projects to increase access to care by increasing the city’s neighborhood-based medical homes for low income, uninsured, and for other vulnerable populations in the New Orleans area.

The February issue has several articles devoted specifically to telehealth. Joseph Kvedar, MD Founder and Director for the Center for Connected Health at Partners Healthcare appeared via Skype to discuss his thoughts on connected health.

Dr. Kvedar foresees a big wave of telehealth in all areas on the horizon. He sees advances that will incorporate intelligent algorithms when caring for patients, the development of sensors in the marketplace to determine blood pressure, cholesterol levels, other silent illnesses, and the development of personalized programs that are totally unique to the individual.

Dr. Kvedar was one of the co-authors with Julia Adler-Milstein, PhD, Assistant Professor at the School of Information and the School of Public Health at the University of Michigan, and David Bates, MD, Chief of the Division of General Medicine at Brigham and Women’s Hospital for the Journal article “Telehealth Among U.S. Hospitals: Several Factors, Including State Reimbursement and Licensure Policies, Influence Adoption”.

The article examined current national data on hospitals and adoption of telehealth and found key differences in the types of hospitals that embrace telehealth along with variations in the use of telehealth in hospitals across state lines.

The authors found that as hospitals seek new strategies for improving care, the findings in the article should help policy makers encourage the use of telehealth in hospitals to improve the quality and efficiency of care so that hospitals will have a competitive advantage.

The authors determined that state policies are influential and suggests looking to state legislatures. According to the findings, if states wish to promote the use of telehealth, they need to explore private payer reimbursements and relax licensure requirements.

Another article “Use of Telemedicine can Reduce Hospitalizations of Nursing Home Residents and Generate Savings for Medicare” authored by David C Grabowski PhD a Professor of Healthcare Policy, Harvard Medical School, and A. James O’ Malley Professor at the Geisel School of Medicine at Dartmouth discusses how a randomized study of eleven facilities in a for-profit nursing home chain in Massachusetts was conducted.

The authors wanted to determine if switching from on-call physician care during off hours to two-way video conferencing would reduce hospitalizations and/or costs. They concluded that nursing homes that were engaged in telemedicine could reduce hospitalizations and save Medicare a net $120,000 each year.

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