Guide: Telemedicine benefits held back by lack of reimbursements
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As video becomes a core enterprise-communications tool, telemedicine solutions are poised to be advantageous for healthcare providers, patients and the channel partners that position themselves with the right array of solutions and services.
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Telemedicine solutions vary widely and include the use of video for basic patient consultation, specialist referral, remote patient monitoring, medical education and consumer public health information services, among other possibilities.
These solutions can now flourish because of improvements in technology, which include more reliable IP and Wi-Fi video delivery and better video performance on tablets and other devices. Increased customer comfort with video communications will also spur uptake.
The telemedicine solutions sale starts with network assessment
Providea Conferencing, a provider of visual collaboration and telepresence technology solutions, is driving pervasive HD video in healthcare by selling its ease of use, security and Quality of Service (QoS).
"We do that by focusing on the foundation of any effective video-conferencing solution -- the network," said Geoff Greenberg, senior sales engineer at Providea.
The company, which recently received the Cisco Architectural Excellence award for Collaboration Partner of the Year 2011 and Polycom Partner of the Year, U.S., starts with a network assessment of a customer's entire environment in order to determine the ability run real-time video. It also analyzes calling patterns, existing equipment, firewalls, security rules and policies. Then it runs simulations to ensure high-quality and robust video conferencing. Finally, the company makes recommendations on how to upgrade or implement IP infrastructure for video.
With about 25 to 30% of its solutions and managed services business targeting the healthcare sector, Providea sees a lot of larger hospitals offering remote diagnosis by specialists to rural facilities that would otherwise be unavailable to them.
"We also see a lot of private IP circuits for HD video in healthcare, particularly for communication between partner hospitals or physician organizations," said Greenberg.
Ways to deliver telemedicine solutions
According to the American Telemedicine Association, healthcare facilities use a number of delivery mechanisms for telemedicine solutions that include:
- Networks that link tertiary care hospitals and clinics with outlying clinics and community health centers in rural or suburban areas using dedicated high-speed lines or the Internet for telecommunication between sites.
- Point-to-point connections that rely on either private or leased networks to deliver services.
- Primary- or specialty-care-to-home connections. This involves connecting primary care providers, specialists and home health nurses to patients over single phone-video systems for interactive clinical consultations.
- Home-to-monitoring-center links that are used for cardiac, pulmonary or fetal monitoring, as well as home care or related services for patients. Normal phone lines are often used to communicate directly between the patient and the center, although some systems use the Internet.
- Web-based e-health patient service sites that provide direct consumer outreach and services over the Internet. Under telemedicine, these include sites that provide direct patient care.
Optimizing video for a less-expensive telemedicine solution
Vidyo, a provider of telepresence for the enterprise, offers low-cost HD multipoint video-conferencing and video collaboration to rural facilities and patients. These services require lower-cost delivery and solid mobile performance. Vidyo reduces telemedicine costs with its Adaptive Video Layering technology, which uses H.264 video coding compression technology to optimize video delivery to each endpoint. Beyond desktop video performance, the company aims to optimize application delivery to mobile endpoints, such as phones, tables and video-enabled, third-party medical devices, such as cart systems. H.264 compression technology -- which Cisco, Polycom and others offer -- cuts the amount of necessary bandwidth by up to 50% and aims to cut costs by as much as 80%.
Telemedicine solutions require technology and healthcare partner skills
To be successful in offering video conferencing services and solutions in the healthcare sector, partners need solid network-engineering skills and a thorough understanding of the healthcare industry. Sometimes they even hire medical professionals, who can better make the case to healthcare clients. They must also work harder to build end-user confidence through proof-of-concept work that involves infrastructure, application workflow and endpoint performance.
Given the variability of telemedicine applications, providers, users, endpoints and existing equipment, most channel partners work with multiple vendors in order to select the best fit for any individual client.
Providing ongoing support and managed services is more common in healthcare than most other verticals, said Tracy Mills, president of Interactive Digital Solutions (ID Solutions).
Customers often seek on-premise tier I and tier II monitoring and support services. If purchased equipment is installed in a collocation facility, the partner is often kept on board to manage it and provide disaster recovery services.
Partners have financial options when implementing telemedicine solutions
While the high price of video is still a purchasing obstacle for many healthcare entities, some channel partners bring grant-writing services to the table in order to help bridge the affordability gap.
Federal grants can cover not only the cost of video conferencing and networking equipment, but also acquisition licensing costs and professional development.
Perhaps the best news for partners working with telemedicine is President Obama's Affordable Care Act, which is expected to drive investments in telemedicine.
Examples of this act at work include the recently launched Health Care Innovation Challenge grant, which awarded $1 billion in grants to applications that implement compelling ideas to deliver better health and improved care at lower cost to people enrolled in Medicare, Medicaid and the Children’s Health Insurance Program (CHIP). Additionally, the $1 billion in grants in the Prevention and Wellness fund, to be made available this summer, can include services such as virtual visits to doctors and specialists.
"By bringing grant-writing services in-house, we add value for our customer by being equipment agnostic, and [we are] able to look at the big solution-and-services picture," says Kristin DeProspero, grant program director and virtual program director at Solutionz Conferencing Inc.