Telemedicine and Virtual Hospitals

This blog was originally published by Medlert Inc.

Telemedicine is making big headlines with predictions that one in six doctors visits in US and Canada will be virtual in 2014. Telemedicine could save US employers as much as $6 billion every year. Some predict telemedicine revenues will top $13 billion in the next four years.
 
Telemedicine Opens New Doors for Healthcare Collaboration

I wanted to know what people at forefront of pioneering new EMS models thought of telemedicine. I sat down with Glenn Leland, Chief Strategy Officer at ProTransport-1, a San Francisco-based ambulance transport company.
 
Leland talked about telemedicine’s potential to offer a foundation for new models of care collaboration and continuity of care between EMS and other healthcare providers, hospitalists, urgent care centers, and even primary care doctors.
 
Paramedic as Hospital Consultant
“Increasingly, the EMS team in the ambulance are connected,” said Leland. ”They have a computer. They have a camera. They have the ability to gather information about the patient, images, and biometric measurements. More and more, we’re going to want to make that available in a network-like environment where various providers, who will be involved in the patient’s care, can collaborate in real-time.”
 
“You could think of the paramedic as a consultant with the hospital, helping to decided whether this patient needs to go to the emergency department, directly to surgery, or whether they need to be admitted and to what floor and what hospital,” said Leland.
 
With technology enabling better collaboration, paramedics may have expanded role in directing patient care as an integral part of a healthcare team and a connected healthcare system.
 
In some cases, paramedics may initiate the decision to bypass the emergency department altogether in favor of taking the patient to an urgent care center, referring them back to primary care, or scheduling follow-up care through home visits or community paramedicine. In some places, such as Alameda County, California this is already happening.
 
In the future, paramedics may also have the option to admit a patient into a ‘virtual hospital’ by setting up a patient’s bed in the home for on-going telemedicine monitoring and treatment.
 
Virtual Hospitals: All You Need Is A Bed & Monitors
Today, hospitals are defined by physical structures, which house patients and healthcare professionals and in which medical care provided. Telemedicine and better patient monitoring and data collection systems open the door to caring for some patients in virtual hospitals.
 
Virtual hospitals are not contained within one physical structure but instead refer to collections of patients, who are being monitored or treated from different physical locations.
 
“You will still be treating patients in beds, but it might not be a patient in the fourth floor, room 417. It’s no longer traditional hospital bed structure,” said Leland. “It might be a bed in a skilled nursing facility or a bed in the patient’s home. It might be a bed in the back of an ambulance.”
We’re not there yet, of course, but it’s coming.
 
“Right now, hospitals are struggling just to deploy their EHR systems for traditional hospital bed management,” said Leland. “So it’s a stretch to also manage patients not within their four walls, but this is where we are headed.”
 
Leland pointed to how new virtual hospitals could make hospitals visits completely unnecessary for some patients or shorten hospital stays for others.
 
“If you go back a few years the average hospital stay was seven or eight days. With remote monitoring technology such as wearables, mobile technology, and video conferencing, we could discharge some patients much earlier in their treatment and still care for them at home,” said Leland.
 
EMS Offering Emergency Response for ‘Virtual Hospitals’
The challenge, of course, is when something goes unexpectedly wrong. Leland sees responding to these emergencies in virtual hospitals as another role for EMS in the future.
 
“EMS is essentially going to need to have the ability to be that out-of-hospital nursing staff,” said Leland for ‘virtual hospitals’ set up in home or another type of facility.