Telemedicine Prescribed To Improve Health Care

Telehealth ranges from video carts and robots, to streaming video and data
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Electronic transmission of medical data—including by videoconferencing, still images, e-health patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers—are what comprise “telemedicine and telehealth,” says an organization that promotes the use of remote medical technologies.

Telemedicine is not a separate medical specialty, and the products and services related to telemedicine are often part of a larger investment by health care institutions in either information technology or the delivery of clinical care, says the American Telemedicine Association (ATA).

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Vgo The ATA is not promoting radical departures from health care, Benjamin Forstag, the association’s director of communications, tells Government Video. Rather, the association advocates taking those video tools and integrating them into healthcare services to improve the existing system, he said. For telemedicine to be effective, the products and services have to be integrated into clinical practices, and be “applied in meaningful ways with patients,” he added. Such products and services are as varied as the programs and strategies they are used to support. Some of them are:


Rubbermaid Healthcare has developed the Rubbermaid Telemedicine Cart, a mobile video collaboration unit that provides live video consultations across distances, says Kevin Boyle, the company’s business leader. The Rubbermaid Telemedicine Cart is an easy-to-use mobile computing platform that takes high-definition (HD) video conferencing, full computing platform, networked medical data, content sharing, plug-n-play peripheral connectivity and Internet access wherever it is needed, the firm says. It can be deployed at a surgery center, operating room, emergency room, clinic, hospital ward, a doctor’s office, or a patient’s bedside, according to the company.

What Rubbermaid Healthcare has done with the Telemedicine Cart is leverage existing technologies from some of the leaders in video conferencing—such as Cisco and Polycom—and aggregated them, along with other Rubbermaid products, into a Food and Drug Administration (FDA) certified telemedicine system, Boyle said. The mobile video unit can be wheeled to where it is needed and a specialist—such as a vascular neurologist— located elsewhere can do a consultation, he said. This has been very popular in small, rural communities that might not have a specialist available, he said, adding, “We can go into medical centers to improve patient care and reduce costs.”

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Rubbermaid Healthcare’s Telemedicine Cart VGO

Vgo—which is the name of both the company and product—says the robotic telepresence it is offering can improve a health-care facility’s productivity while reducing costs. Through two-way, real-time audiovisual communication, with remote control mobility, Vgo enables medical professionals to be in two places at once, says Ned Samonite, Vgo’s vice president of products. Facilities that are using Vgo are those that have highly trained and skilled staffers that are “precious resources within a facility,” he said. Not only can Vgo operators use the system’s video conferencing and telepresence technology to interact with the patients and staff at a health-care facility, but, by simply using a home computer, a remote user can move the Vgo around a facility, Samonite said. Doctors typically conduct hospital rounds once daily, but the Vgo enables those same doctors to perform night and weekend rounds from their home or office, he added. “So with the Vgo, the level of care increases while saving travel time, even if it’s just an hour,” he said.


Vgo is not the only telemedicine product that is mobile, for smartphones have enabled health-care providers to support patients in between visits and reach out to patients as needed, says Malind Peeples, vice president of clinical advocacy for WellDoc, a health-care company focused on using technology to improve disease management outcomes and reduce health care costs.

WellDoc offers “Diabetes Manager,” a patient coaching solution for health-care providers that is FDA cleared for use with patients who have type 2 diabetes, Peeples said. The Diabetes Manager is being deployed as a disease management product in partnership with AT&T, and it is going to health-plans and self-insured employers, she said. By managing diabetes, the device is expected to cut costs among those patients, she added. That claim is based on a George Washington University Medical Center yearlong study of Medicaid patients who were provided with the Diabetes Manager. Those patients had a 50 percent decrease in hospitalizations and ER visits, “two of the most costly drivers for diabetes care,” she said.

A successful health-care solution goes beyond traditional data collection and sharing, but translating data into valuable information and actionable knowledge is the answer, according to WellDoc. Effective solutions must employ advanced analytics, user segmentation, behavioral change and in time feedback. In addition, solutions must be simple to use and create a desire for users to engage and stay engaged, the company says.

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WellDoc’s Diabetes Manager IQAPP
While WellDoc enables health-care providers to review patient information, IQMax’s IQApp toolset enables providers to view patient information, get alerts and consult with peers regarding a specific patient, says Chris Damvakaris, the company’s vice president of sales and marketing. The IQApp toolset provides real-time patient information at the point of care for providers, he added.

IQMax obtains that information using an interface engine called IQ Connect that enables its users to pull information from local systems, Damvakaris said. That information is moved to IQMax’s “IQ Exchange,” and that exchange application enables IQMax to use rules to determine who has access, and what are the workflow rules built into the system before patient information is forwarded to the mobile devices, he said. However, while mobile devices receive the information, they do not retain the data. The information is provided in a “browser session, so once the application’s time is out, or is exited by the user, the information is gone,” he said. The system works both on WiFi within a facility, and on cellular, so physicians who are home and want to get an early start on their schedules, can log in, synchronize and see those patients and their information, Damvakaris said.


Mobility and patient information/records being made available to doctors wherever they are, is the focus of the wireless array offered by Xirrus, because when video of patient symptoms is streamed to a physician at another location within the facility, health-care providers accomplish more, said Brian Mason, Xirrus’ director of product marketing.

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The Xirrus Wireless Array provides more bandwidth and better scalability into health-care type environments, Mason said. When a facility-wide wireless network is deployed, there is less infrastructure disturbance in comparison to either wired or conventional wireless devices. “What we’re trying to do with the Xirrus Array is to help people understand that as they roll out new applications, such as electronic health records, they need a wireless technology,” he said.

The wireless solutions offered by Xirrus support the unique requirements of health-care environments, particularly in terms of device density, traffic capacity and the ability to scale on demand, the company says. Most WiFi access points have two radios, with each radio providing a certain amount of bandwidth supporting a certain amount of devices, Mason said. However, the Xirrus Array has eight radios and four times the bandwidth handling capabilities, as well as four times the number of devices, or applications, all to provide clinicians with information they need, he said.


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