Health Care and Technology

Support for telehealth services throughout state is rekindled

Rural areas especially could benefit from advances in technology.

September 13, 2019
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Someday, radar might be used to detect when you fall in your home by measuring your heart and breathing rates.

“The fall is a really big problem in health care,” said Kevin Lasser, the chief executive officer of JEMS Technology, a Troy-based health care technology company.

Indeed, the Centers for Disease Control and Prevention reports that falls cost U.S. health care systems $50 billion a year.

Technology could help. Companies like Lasser’s may use artificial intelligence to notify medical practitioners within 30 seconds of someone falling, as opposed to practitioners not hearing about the incident for sometimes hours.

Continued innovation in telehealth — providing online and video health care — is growing in Michigan despite challenges.

It won’t work with flu shots, but it is a promising development for psychiatry, dermatology and stroke care, according to Dr. Chad Ellimoottil, who spearheads the Telehealth Research Incubator at the University of Michigan.

Recently, the Michigan Department of Health and Human Services received a $1.6 million federal grant to improve rural telehealth services for children with epilepsy. More than 13,000 Michigan children up to 17 years old have active epilepsy, according to the department. The grant is meant to improve collaboration and communication between primary and specialty care providers.

And a bill that would allow for the expansion of remote pharmacies, sponsored by state Sen. Curt VanderWall, R-Ludington, passed the Michigan Senate Sept. 5 and is now before the House.

Ten years ago, JEMS Technology invented a live-streaming and secure video service for telehealth, Lasser said. The invention was the first of its kind in providing internet connection that safeguarded medical privacy.

Such technology has since spread nationwide. Now, JEMS Technology also has agreements with health systems in China.

“Telehealth has become a commodity,” Lasser said. “There’s a lot of different options, and that’s good because telehealth helps people.”

A resurgence in telehealth interest followed new federal rules that allow Medicare to cover it, according to health experts.

Blue Cross Blue Shield of Michigan began reimbursing some telehealth services in 2016, according to the nonprofit mutual insurance company’s medical policy. That was primarily to serve rural patients.

Some Michigan health departments have done very well and grown their telehealth services, but others still are falling behind, Ellimoottil said. In the last 12 months, some providers have held less than 10 telehealth visits, even though they initially showed interest in the services.

“They’re interested and they start to get their programs going, but they can’t sustain them,” he said.

Reliable access to the internet can partly explain the lack of sustainability. It is a concern of many experts in the health care industry.

Ellimoottil’s center analyzes the impact of telehealth on cost, quality, access and patient experience in Michigan. Michigan is about average for integrating telehealth services into its health care system, he said.

Michigan’s policy on telehealth is moderate, in which state law and Medicaid policy are mixed or moderately support the broad use of telehealth, according to Becker’s Hospital Review, a publication for hospital executives. States like Alaska, Minnesota and Nebraska are listed as progressive.

“I don’t think that we’re far ahead, and I don’t think that we’re necessarily far behind,” Ellimoottil said. “There’s only so much the state can do.”

Among the challenges is that video conferences can be burdensome to doctors and nurses with an already full workload, Lasser said.

“It’s an upward trend, but health care is not an industry that moves very fast,” Lasser said.

Others agree.

“We’re asking people to change the way they work, and that becomes a little bit more difficult,” said Bree Holtz, director of Michigan State University’s Health and Risk Communication graduate program. 

Requiring patients to drive to a clinic or hospital to utilize computer connections for specialist consultation prevents patients from connecting at home, Ellimoottil said.

Providers need a state license to see patients, and health licenses aren’t easily transferable between states. This problem prompted the creation of an interstate compact to issue licenses between states more easily. Michigan joined it in 2018.

Providers with the Veterans Health Administration can operate between states, avoiding this problem entirely.

“The VA has actually had really nice integration of telehealth and uses it quite a lot,” Holtz said.

As technology improves and becomes more distributed, telehealth may be inevitable for Michigan health systems, Holtz said.

“The doctors might have to adopt an integrated internet care (plan) faster than maybe they would want to or normally would,” she said.

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