Guest Post: The Potential for Telemedicine to Monitor and Improve Public Health

Today’s contributor, Charlotte Kellogg, has contributed a post about the ability for mhealth apps and telemedicine to monitor chronic illnesses. This blog has previously discussed potential drawbacks in telemedicine and Kellogg has built upon that by layering in a comparison of potential benefits and known drawbacks.  Kellogg is a writer and researcher for an public health education resource that offers information about public health certification, classes and programs.  

The Potential for Telemedicine to Monitor and Improve Public Health

The need for quality, consistent healthcare is growing in nearly every corner of the world. Modern scientists are finding new ways to treat conditions every day, but finding ways of bringing that care to the people who need it most is often logistically challenging—not to mention tremendously expensive. New developments in telemedicine, including mhealth, seek to bridge these divides.

Integrating technology into existing healthcare frameworks has the potential to help doctors and other medical providers work faster, more effectively, and with greater accuracy. More patients than ever before can be reached, and information that is centralized on a cloud-based server has much less of a chance of getting lost or overlooked, and can ensure more efficient coordination of care.

The cost savings alone are often substantial. For example, telemedicine has the potential to lower costs from preventing unneeded trips to the emergency room through reliable, real-time video communication between doctors and patients. Telemedicine also reduces the number of routine visits as doctors can effectively monitor a discharge patient from the comfort of their own home. This is especially pertinent for patients who live far from medical centers, as they will not need to travel to an office unless it is absolutely necessary.

Still, providers should be wary of jumping in too deep, too fast. The mobile health landscape is still very much under in the nascent stages of development, and improvements are needed before new technology will be able to fully manage chronic conditions and other public health concerns.

Benefits to Public Health

Health care providers across the board are finding tremendous success using telemedicine in the treatment of chronic conditions like congestive heart failure, diabetes, and HIV/AIDS. Doctors can equip patients with remote tracking devices, which allow for monitoring of blood pressure, glucose levels, and other vital statistics without requiring an in-person visit. Medical providers can also use technology to track pharmaceutical prescriptions and send patients personalized reminders of when and how each drug should be taken.

Telemedicine promises improved care to those living in rural or otherwise remote locations, as well. Patients are increasingly able to check their symptoms through mobile phone apps or online database systems, and also speak to physicians and other members of the care team through web-based video conferencing. This saves time and, increasingly, lives as patients become more empowered and are able to more readily determine when an injury or illness is something that should be waited out or needs immediate attention.

Potential Threats to Public Health

As advanced as many aspects of telemedicine are, the field is nevertheless still quite young. Providers and developers remain in the throes of figuring out how to tighten up on the platform’s accuracy and usability. In many cases the technology is very new and prone to have bugs in the code, and because these technologies are protected intellectual property, many of these bugs are not caught before the programs hit the market.

One of the biggest problem areas is the degree to which patients may elect to rely on apps or electronic information in place of, rather than in addition to, in-person primary care. “The problem with this kind of gold rush is that it attracts not only the best and brightest but also the fast and furious—IT developers looking for quick profits with minimal investment of resources,” Information Week said in a 2012 article evaluating some of the potential downsides of the telemedicine “revolution.”

There is also a concern when it comes to expectations. Medicine is an immensely nuanced field that often defies easy answers. A simple statement of symptoms can indicate a range of wildly different causes, which can lead patients and providers to overlook some of the most obvious possibilities. Researchers from Good Morning America exposed just how difficult online diagnoses can be when they visited three different telemedicine sites armed with the symptoms of Hodgkin’s Lymphoma—and did not get a correct diagnosis anywhere. “It’s totally, totally upsetting. It reduces medicine to piecemeal work,” Dr. Marie Savard, a medical contributor to the show, said in an article for ABC News.

While the diagnoses on these sites were incorrect, it is important to remember that the root cause of most misdiagnoses is poor communication. While these sites and tools may not be able to necessarily match symptoms with diseases, they can make it much easier for a patient to relay symptoms to a doctor who can then interpret the data.

In most cases, the benefits of telemedicine outweigh the potential risks, but there is still work to be done. The cost and time savings allowed through telemedicine, for example avoiding unnecessary appointments and being able to adjust dosage on prescriptions without needing to travel to a doctor’s office, are tremendous, and are likely to continue to grow in the years ahead. It is already the case that diabetes patients are more conveniently and effectively monitoring their health, something that has saved many lives and millions of dollars – something sure to continue as technology improves and people become more comfortable with telemedicine.

By 2020, expert patients will self-manage 95% of their preventive and chronic care

Patients titrating and administering their own medication? Sounds like some futuristic scene from a sci-fi movie where Doctors no longer exist and patients are in charge of their own healthcare.  But this is actually not so futuristic explains Dr. David Judge, medical director of the Ambulatory Practice of the Future (APF) at Mass General.  Diabetic patients are already successfully self medicating, and David plans to soon pilot similar care modalities for other patient populations such as those with chronic heart disease.

As a featured speaker at yesterday’s MassTLC Executive Summit, an event highlighting innovative technologies and applications and their impact on businesses and consumers today, David detailed how his team is deploying new tools to improve how care is delivered, and at the center of that care are the patients themselves. David’s vision of the patient of the future is a healthier, more informed and empowered patient in control of his/her own health destiny. To enable this vision, the APF is providing patients with tools that enable them to self manage, thereby allowing them to improve their health outcome and quality of life while at the same time allowing David and his care team to focus on spending more time with patients who need their care most.

At the summit, David also highlighted several pilots underway at the APF focused on innovating care delivery for primary care in partnership with the Center for Integration of Medicine & Innovative Technology. Fueled in part by the shortage of primary care providers, these projects focus on the exploration of new models of care delivery and are attempt to utilize all members of the care team to train and empower patients to be more proactive managers of their care. David calls this “patient apprenticeship” and the APFs initial findings are that this is a very successful and effective patient-centered care model. He went on to share his insight on the impact of ACOs, payment for value, culture change, informed patients and the increased demand for technologies to enable prevention and proactive disease management on care delivery.

The patient of the future will be here sooner than we expect explained David, as by 2020 he predicts expert patients will manage 95% of their preventive and chronic care. The patient of the future will be a healthier, more informed and empowered patient in control of his/her own health destiny.

To learn more about David Judge and his work at the Ambulatory Practice of the Future, visit


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SBR is at this year’s Mayo Center for Innovation Transform symposium to experience the revolution in care delivery. Joining today’s healthcare movers and shakers – innovators, leaders, designers, entrepreneurs, policymakers and business thinkers, SBR is excited to be at the forefront of innovation and design solutions that are reshaping how we think about care.

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Robert Fabricant of United Healthcare showing data from America’s Health Rankings.

David Ewing Duncan says most people don’t want to live past 80.

Laura Adams on her first medical mistake – Rx had been transcribed 6 times before she got it. Wrong dosage. Death by decimal point.

Dick Gephardt says there is no silver bullet for cutting health care costs. HRCA is probably too big but is a start on the hard work.

John Hockenberry says healthcare must be prepared for unexpected outcomes.

John Hockenberry describes the ‘unexpected outcome’ of his success after a car accident left him paraplegic.

Watch the Transform 2012 live stream here.