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Calling a Patient with Facetime: Current Trends in Telemedicine Today
Could you use Facetime to call a patient?
Should you use Facetime to call a patient?
“There is going to be a significant physician workforce shortage under all of the likely
projections. We see that, quite frankly, only getting worse as the population ages.”
-Janis M. Orlowski, MD AAMC Chief Health Care Officer
• 19% deficit by 2025 *Source: AAMC Complexities of Physician Supply and Demand: Projections from 2015 to 2030
• 1/3 of Physicians Retiring
• 12% Population growth
• Age > 65 to grow 55%
• Incidence of stroke increasing
• Limited number of graduates in stroke, neuro-critical care, dementia
70% of institutions note telemedicine as top or high priority *Source: 2018 REACH Telemedicine Industry Benchmark Survey
Telehealth Components
Telestroke & Teleneurology rank as 2 of the top 4 most mature programs around the country
*Source: 2018 REACH Telemedicine Industry Benchmark Survey
Telestroke Model Conventionally operates via “Hub-and-Spoke” in which:
o Specialist neurologists at the “hub” (Stroke Center) communicate with “spoke-
Originating” site
o ER doctors at spoke site consult hub doctors using telemedicine equipment
o CT scans at the spoke site are shared electronically with the hub specialists
o After examining the patient and reviewing images, recommendations are
given to the ER provider to treat with tPA or recommend for embolectomy
o Protocols for hub-and-spoke must be made together
Benefits of Telestroke Greater access to specialists in underserved areas
Improved patient outcomes
o Increased TPA rates
o Increased endovascular procedures
o Resulting in reduced stroke mortality and long term disability
Reduced delay in care leads to earlier diagnosis & treatment
Operational Benefit
Improved patient engagement & satisfaction
Improved patient convenience
o Increased HCAHP scores
Secondary Benefits of Telestroke
Improved Image in local community
Improved employee outcomes
o Improved physician job satisfaction by providing flexibility of schedule
o Improved institutional culture by reducing physician burnout
o Improved recruitment due to telemedicine offerings
Opportunity to scale out the benefits
o Expansion into additional neurological service lines
o Move from departmental to enterprise telemedicine programs
Financial Benefit
Increased Revenue Opportunity
Cost Savings by reduced readmissions
54% of organizations have cost savings of at least 11% *Source: 2017 Foley Telemedicine & Digital Health Survey
Given the relatively recent evolution of telestroke, existing data regarding the return on investment for the implementation of telestroke technology is limited. However all surveys unanimously indicate a
significant ROI.
Telehealth Early Adopter Source: “Telehealth Outpaced In- Person Visits Last Year” Telehealth News. October 2016
Could you use Facetime to call a patient? • FaceTime is well-within HIPAA regulations for telemedicine-use as a communications
conduit. • A Business Associate agreement is encouraged for all vendors that acquire and store PHI.
Exemptions of the Business Associate rule include communication platforms that are encrypted and transmit-only services. Since Apple’s policies on call handling and storage meet the exemption criteria, FaceTime qualifies as a communications conduit with no business associates agreement required.
• Using FaceTime for telemedicine is permissible in and of itself. Although, it is advised to consider internal policies to minimize abuse of the platform in care delivery.
• Using a company such as Simple Visit would be recommended • Source: Using Facetime for Telemedicine Visit by Simple Visit
Should you use Facetime to call a patient?
No
Thank you
Rajiv Narula, MD Instructor of Neurology
Director, Teleneuroscience [email protected]
732-789-7030
