Monday, November 16, 2009

Telemedicine Ballyhoo

The road from hype to real is bumpy. Many telemedicine applications are, finally, now on that road, some ahead, some far behind. To shepherd the applications along some tough decisions needs to be made.

Gartner, a consulting firm has created a “hype cycle,” a graphic representation of the sudden growth, adjusting dip and final adoption of specific technologies. Several people, including myself, have indicated that many applications of telemedicine are starting to enter such a hype cycle. M-health is one clear example where the amount of public comment and exposure has accelerated. Other services have clearly moved beyond early adoption and into the mainstream of health delivery bypassing any public hype. Two examples are teleradiology, used by a large percentage of hospitals, and remote cardiac monitoring, serving 4 million patients in the U.S. The practices are sound, the effects are clear and there are structures in place to appropriately regulate providers. But much of these services have been growing without any public attention.

For those involved in telemedicine for any length of time, the idea of telemedicine being the latest hype in health care is amusing. ATA started in 1993 and it has taken years to get telemedicine recognized by the medicine and technology communities.

So the rise in press coverage over the past two years has been amazing. The chart shown here depicts the increase in the number of articles per month about telemedicine or telehealth, growing from 600 in January 2008 to 2,200 in October 2009.

This increased attention comes with both the good and the bad. Increased attention by payers in the U.S. and other countries has spurred investments, changed policies and increased adoption. However, we need to be prepared for unwanted attention to inappropriate applications that pass themselves off as telemedicine.

Now that cheap-to-develop and easy-to-access applications are available directly to the consumer via such devices as mobile phones and Internet web pages, a host of quack applications have emerged. Just because it is remote healthcare doesn’t mean it is good healthcare.

ATA has opposed any attempt to have the U.S Food and Drug Administration regulate core computing technology and telecommunications devices used in telemedicine. A cell phone and a PC are not medical devices. However, there is a clear and growing need to regulate the growing list of pseudo-medical applications that are becoming widely available to consumers. The technology and telecommunications industry needs to get behind such regulation and should recognize their potential legal exposure by ignoring what is being offered to their customers.

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