Adopting New Technology Into Society: Going From an Idea to an Institution

Adopting New Technology Into Society: Going From an Idea to an Institution

Michael J. Ackerman, Ph.D.Assistant Director

High Performance Computing and CommunicationsNational Library of Medicine

TelemedicineTelemedicine

Using telecommunications and computers to provide information to support medical decision making

• Medical Records• Literature search• Decision support• Consultation and Conferencing

TELEMedicine:

Telemedicine and Telecommunications:

Telemedicine and Telecommunications:

Options for the New CenturyOptions for the New Century

March 13-14, 2001Natcher Conference Center

Beth Israel Deaconess Medical Center, Boston, MA

Baby CareLinkBaby CareLink

Video house calls for patients with special needs

Video house calls for patients with special needs

National Laboratory for the Study of Rural Telemedicine,University of Iowa, Iowa City, IA

University of Alaska at Anchorage, Anchorage, AK

Lessons Learned: Patient’s view

Lessons Learned: Patient’s view

• Acceptable to patient

• Satisfied with encounters, perception of better quality of healthcare encounter

• More personal responsibility for healthcare

• Ploy by HMO to prevent referral to specialist

Lessons Learned: Payor’s viewLessons Learned: Payor’s view

• Unanticipated social and economic barriers

• Cost “savings” is based on method of cost accounting

• Lack of equipment and communications standards

• Patient demand, as a market force, will drive adoption of telemedicine

• No business plan to support telemedicine after grant is completed

• Healthcare system must adapt in order tobenefit from the immediacy and quick

turn-around afforded by telemedicine

Telemedicine and Home Healthcare

Telemedicine and Home Healthcare

September 14 - 16, 2003 Ft. Lauderdale, FL

Types of telehome health careTypes of telehome health care

• Three types of modalities– data only– video/audio only– video/audio and data

Current findings: Patient’s / Client’s view

Current findings: Patient’s / Client’s view

• Acceptable to patient– Study after study demonstrates positive

perceptions

• Satisfied with system– Perception of better quality and more caring

– Feeling of greater independence and confidence

• Feeling of more personalresponsibility for healthcare

Current findings: Provider’s viewCurrent findings: Provider’s view

• Nurses’ responses - cautious enthusiasm: – Significant learning curve among nurses– Comfort and ease with technology will come

with time (Dansky and Bowles, 2002)

• Providers may actually be the most significant barrier to diffusion of telehome health

• Providers tend to be predisposed to avoid the use of telehome health equipment (Whitten, Doolittle, Mackert & Rush, in press)

Current findings: Payor’s viewCurrent findings: Payor’s view

• Cost “savings”

– based on how cost accounting is applied

– must be realized within reporting period

• Problems with interoperability of equipment

• Last mile problems - POTS is the common denominator

– most equipment designed for 33 kbit channel

• Patient and family demand, as a market force, will drive adoption of home telehealth

• Healthcare system must better integrate telehealth model into the care model

TelemedicineTelemedicine

People:• Patients

• Providers

• Payers

“Well, www.what’swrongwithme?.com says it’s just a virus, but I came to you for a second opinion.”

“Well, www.what’swrongwithme?.com says it’s just a virus, but I came to you for a second opinion.”

National Library of MedicineNational Library of Medicine

www.nlm.nih.gov