TED Community » Mark Treat

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  A comment on Conversation: What can a sustainable telemedicine business model look like, and how do we get buy-in from those with the resources to make it happen?

  Feb 20 2011: [Part 2 of thread from Mark Treat / was cut off]
  
  • New payment and reimbursement models which cover remote care – which is dependent upon proven financial models for remote care which justify the payment and reimbursement models. Justification is measured both in terms of health outcomes and cost savings
  
  Our observation is that even in the United States, where much of the health and technology infrastructure already exists, telemedicine programs often fail. The reason is that many of the pilot programs focus on one piece of the system (such as the introduction of an individual new technology or device), not the system as a whole. The changes in delivery processes and impact on other parts of the system are often ignored. Most importantly, the necessary support of the people who are stockholders in the system are also ignored. There must be a concerted effort to not only train the actors who participate in the system, but also properly communicate with them in order to overcome the natural human resistance to change.
  
  There is much discussion on the lack of money or reimbursement models which have certainly delayed the adoption of telemedicine. We must also recognize, however, that significant funds have been invested into pilot telemedicine programs. Unfortunately many of these programs have failed to take a holistic or systemic approach to the overall health delivery model and therefore have failed to demonstrate the promised value proposition. These failures can create reluctance to invest more heavily in rolling out telemedicine technologies. My sincere hope is that future programs will take a more holistic systemic approach to telemedicine.
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  A comment on Conversation: What can a sustainable telemedicine business model look like, and how do we get buy-in from those with the resources to make it happen?

  Feb 20 2011: There is no doubt that remote technologies which can measure patients biometrics and move the point of care from a physician to the patient have matured to the point where they are reliable, safe and secure. There is no greater opportunity to improve the healthcare system.
  
  Our company [www.nalarihealth.com] is focused on solving this exact question: how to create a sustainable telemedicine program in order to improve patient’s health, quality of life, access to care – and save money. Our focus is in the United States, which is challenging enough, however when you expand that to third world countries which lack much of the basic infrastructure (such as reliable connectivity) the challenge is even greater. The largest challenge however is not in overcoming the technology barriers (even the connectivity issues can be resolved with new secure wireless technologies) but rather in modifying the healthcare system as a whole such that the new business processes which are enabled by technology take hold.
  
  My belief is that a systemic approach must be taken in order to create sustainable improvements in any healthcare system. There are a number of critical success factors, which include:
  
  •Facilitating a process for individuals to find a physician and have a meaningful encounter with the physician, even if the physician is remote
  • Doctors adopting new ways to practice medicine and manage their patient relationships
  • Support for patient self-monitoring and management of their own health
  • Sophisticated remote patient monitoring, with analytics which trigger alerts and interventions targeted to specific needs of individual patients – before the patient requires hospitalization
  • Remote, low cost, care coordination by skilled professionals in both health and information technology to facilitate new remote care delivery models. Technology alone will not do it, people will be required.
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  A comment on Talk: Naomi Klein: Addicted to risk

  Feb 1 2011: This talk had a number of good key concepts that should be well communicated; unfortunately they may be lost because they are intertwined with political opinion. There was very limited fact-based discussion on specific issues or solutions, but a heavy spattering of attacks on big business, men and Sarah Palin. More emphasis on the importance of environment; real life solutions that balance technology, economic realities and environmental risk; and elaboration on the “circular stories” theme she closed with would have been more effective. Personally I share many of Naomi’s concerns, however found her recommended solutions diluted. With so much political opinion, the talk will resonate with likeminded individuals – but likely be dismissed by those of a different political persuasion. True progress on these issues will require a broader, evidence-based, non-political message.