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Doctors in the digital age, medicine takes a turn towards technology

The way people receive medical care in Arizona and across the globe is transforming. Physicians have been able to diagnose disease, provide consultations during surgery and help family members care for patients suffering serious illnesses via video.

This new sector of health care is known as telehealth or telemedicine, and it’s a growing industry.

“It’s been estimated this past year that the number of people receiving telemedicine services went up from about 10 million to 15 million [in the U.S.],” said Dr. Ronald S. Weinstein, a co-founder of Arizona Telemedicine Program and pioneer of robotic telemedicine.

The Arizona Telemedicine Program, based out of the UA, leads the nation in the number of papers published on telehealth, and has become a global leader since its founding in 1996.

ATP provides opportunities for students and health care providers alike to learn about telemedicine. Its educational programs have been taught internationally with organizations like the U.S. Army, using ATP to provide assistance abroad.

“We provided technical assistance to Panama and educational assistance to Panama for about nine years, resulting in the establishment of a rural telemedicine program in Panama and then that spread to other areas in Latin America,” Weinstein said on a contract made with the U.S. Army.

Through its own Arizona Telemedicine Council, ATP is also involved with advocating for telemedicine at the state level. The council meets quarterly in the state capitol with leaders from health organizations to government officials.

“Medicare has very strict rules on what is reimbursable, so if a visit doesn’t qualify as a face-to-face visit then the health care agency isn’t paid,” said Dr. Kimberly Shea, ATP’s assistant director of telenursing and an assistant professor in the College of Nursing.

“Each state has different regulations as to what qualifies for telehealth reimbursement. This results in the need for lobbying at the state level for change,” she said.

With new industries like telehealth, old regulations need to be re-evaluated.

One obstacle ATP encountered as it first began expanding its network, was the lack of broadband infrastructure in Arizona, specifically in rural Arizona.

In 2007, ATP was awarded part of a $15.56 million grant from the Federal Communications Commission and was able to upgrade and expand the broadband network in the American Southwest.

Weinstein said new areas to watch telemedicine transform include mobile health, which takes place over smartphones, and retail telehealth. Mobile health is based on apps that can be downloaded onto a smartphone.

“It’s now possible, for example, to put an inexpensive app and a small case hardware into a smartphone,” Weinstein said. “It can actually do electrocardiograms on patients through smartphones, and patients’ lives have been saved.”

ATP works with all of the telemedicine networks in the state, including the Mayo Clinic, which has shown that patient diagnosis over a smartphone is possible.

“There are over 100,000 apps that have been developed for mobile health and the FDA is approving many of them,” Weinstein said. “As rapidly as they approve them, they are going into the marketplace.”

As for retail telehealth, large pharmaceutical companies like CVS and Walgreens are looking to vend these health services in the near future. In a 2015 press release, UnitedHealthcare announced it would provide coverage for virtual care provider visits in 2016.

ATP is also working to expand its telenursing interventions.

Shea shared that ATP, the College of Nursing and Banner–Health University Medical Center are looking toward the possibility for a telenursing infrastructure that would serve Tucson and its surrounding regions. Banner-Health University Medical Center Phoenix currently provides telenursing services in the Phoenix area.

She said it is a slow process because Banner’s partnership with the university is still fairly new, and the various regulations and criteria it is required to meet make it difficult to combine the programs.

“We are working with Banner as this rolls out to actually combine our use of nursing students with the use that they have of technology,” Shea said. 


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