With a quick photograph by the pediatrician, a “mystery rash” can be diagnosed remotely.
“Hey, can you take a look at my patient’s rash?”
This question comes up on an almost-weekly basis at Martha Eliot Health Center, the community health center of Boston Children’s Hospital where I see children for primary care. While dermatologic conditions are common in pediatrics, and we, in the primary care setting, often know what to do about them, patients sometimes come in with rashes that don’t look like anything we’ve seen before. In these situations, we wish we could have a trained dermatologist just take a look, but the demand for new dermatology appointments at Boston Children’s is high and wait times for non-urgent clinic visits can be long.
From the dermatologists’ perspective, a large proportion of the patients in their clinic actually don’t actually need to be there—they have common conditions that can be managed in the primary care setting, in the patient’s medical home, in a much more convenient and cost-effective way. Full story »
Telemedicine has the potential to transform healthcare and lower costs. A new Massachusetts law requires insurers to pay for it—but with a potential loophole.
The mandate for broader access to health care in Massachusetts has brought millions of newly insured patients into the system. At the same time, the cost of health care in Massachusetts has continued to rise, and care access issues have emerged.
This past August, Massachusetts Governor Deval Patrick signed a new law that attempts to lower costs by shifting providers away from fee-for-service payment to alternative payment models (APMs) in which they incur more financial risk, and encouraging the development of accountable care organizations (ACOs).
One provision of this law requires insurers to pay providers for services delivered remotely via “telemedicine.” Full story »
Boston Children's David Casavant, MD, in a mock TeleConnect drill with South Shore Hospital.
Naomi Fried, PhD, is Boston Children’s Hospital’s chief innovation officer. Shawn Farrell, MBA, Telehealth Program Manager at Boston Children’s Hospital, contributed to this post.
Imagine yourself in an emergency department taking care of a very sick child. Should he be transferred to a higher-level care setting? Can he safely go by ambulance, rather than helicopter? As a doctor, you would like to consult virtually with colleagues and experts at remote locations.
Then imagine yourself in a large room in the heart of Silicon Valley, just a stone’s throw from Cupertino and Apple headquarters. In that room are 5,000 of the biggest thinkers in health care and technology, exploring the next major paradigm shift in care delivery: telehealth. You realize that health care is on the brink of a telehealth explosion.
[Ed. note: Tune in to the livestream Monday at 9:30 a.m. ET]
Can the inventors of Watson help save sick children in the developing world? A “cloud-based” pediatric learning module, conceived by Children’s Hospital Boston and built by IBM Interactive, is being beta-tested this year in 20 countries. Provisionally called OpenPediatrics, it will give 1,000 doctors and nurses on five continents the next best thing to hands-on training. (Above is just a preview). Full story »
President Obama signs the Patient Protection and Affordable Care Act, March 23, 2010 (Pete Souza/Wikimedia Commons)
National healthcare reform, including President Obama’s Affordable Care Act of 2010, is being driven by widespread dissatisfaction with the high cost and limited accessibility of care. Although we’ve yet to feel the full impact of these national reforms, the reform experience in Massachusetts indicates that mandated universal coverage, by itself, has failed to drive down costs.
So, in Massachusetts, we’re now in the next phase of healthcare reform, focusing on how to control and cut costs while still providing nearly universal access to high quality services and care. The need to bring down costs is stimulating healthcare innovation in three major areas – perhaps offering some lessons for the nation as it moves toward universal care. Full story »
The most expensive way to deliver care is in a hospital – but discharging patients too soon can lead to complications and rehospitalizations. That’s where robots can help – and sometimes a robot can be as simple as a video/audio system that can roll around under remote control, transmitting communications over a Verizon 4G cellular network.
Instead of having to drag kids back to the hospital for frequent office checks after surgery, Hiep Nguyen, a urologist/surgeon at Children’s Hospital Boston, can call the family at home and do the check remotely. You’d think it might feel impersonal and alienating, but the opposite seems to be true. “Families love the robot,” says Nguyen. “They feel secure that they have a lifeline to their doctor.”
Hospital innovators are beginning to turn to robotic systems – some as simple as a cell phone that enables video conferencing between doctor and patient – to enhance patient care and lower costs (see yesterday’s post). The Child Life department at Children’s Hospital Boston asked kids staying at the hospital to share their ideas for robots that could help them and assist their doctors and nurses. A few hospital staff got in the spirit, too. At left and below are a few of their submissions. Click to enlarge them.
>>>Designed first with legos, “Harold” has two antennae that function both as hands and an FM radio, so it can help carry things around the hospital while rockin’ to some tunes. Full story »
This robot, proposed by a patient at Children's Hospital Boston, would check vitals and tell stories.
It can’t be ignored that dramatic transformation in our healthcare system is imminent. The economy, market forces and increasing political demands will soon force physicians and healthcare professionals to change how we take care of our patients. Just as the days of housecalls are gone, so is our current system of delivering care.
The rising cost of healthcare now has the government and insurance companies placing more emphasis on controlling costs, sometimes at the expense of quality. They demand that we become more efficient and manage an even greater number of patients. Advancements in medical technology are believed to be a principal cause of the rising cost of healthcare: While they have improved patient care, they often come with a high price tag.
Does that mean we should abandon them? My answer is to play with robots. Full story »
