Worcester Business Journal

6 Worcester Business Journal • August 1, 2016 www.wbjournal.com I n years past, every skin rash or sore throat meant calling a doctor and trying to get in for the next available appointment. But now, digital screen- ings of medical conditions before an appointment – or in some cases, in place of one – are becoming more widespread. The concept is called telemedicine, and it is basically the use of telecommu- nication or information technology to provide medical services remotely. Doctors can consult with, diagnose or treat patients using electronic media such as audio, video or advanced data monitoring services. Though the first telemedicine tech- nologies were released decades ago, its rollout has been somewhat limited in Massachusetts, according to the state Health Policy Commission. But it is becoming more widespread, as technol- ogy becomes more and more prevalent, health networks implement it and insur- ers adopt appropriate payment plans. Some health networks, including UMass Memorial Health Care, have implement- ed it successfully. The question of how to reimburse telemedical services is also being considered by the legislature. Telemedicine isn't a substitute for the longstanding doctor/patient relationship nurtured through years of physical vis- its, but it can supplement that, said Dr. Craig Lilly, professor of medicine, anes- thesiology and surgery at UMass Medical School, and director of the eICU tele- medicine program at UMass Memorial Medical Center. It can also be a time and cost saver, he said. "For a lot of folks, the convenience of being able to access a camera or micro- phone allows prescribing physicians to make diagnosis and start a treatment plan with the same doctor we see in the office," said Lilly. Digitally monitoring patients Lilly said the way he sees it, telemedi- cine breaks down into three forms. The first is when a patient gets remote care from a doctor he or she has an estab- lished relationship with. In that case, the provider knows a patient's history and can give advice about a specific problem in the context of that prior relationship. The second is in the case of an acute problem – like a rash, for example. An emergency room or primary care doctor might not know exactly what the rash is or where it came from. Instead of book- ing a specialist appointment for days or even weeks in the future, he or she could use telemedicine to bring in a remote expert, in this case a dermatologist, to provide an on-the-spot consultation. "The difference is, right there, that day when you have it, you get the exper- tise … and you just move the whole cal- endar of getting the problem taken care of sooner. You get a definitive answer sooner," Lilly said. The third form would apply to a patient in an established healthcare sys- tem with an electronic health record. Telemedicine applies to the process of organizing the information, so an off- site physician or provider can help to make sure patients stay on track with their treatment plans established by a long-term care doctor. The second and third forms depend on having a health information system that can electronically analyze health data, Lilly said. "The electronic recording of basic medical information makes it easier for patients so they don't have to repeat their story over and over again," he said. The third form of telemedicine was the subject of research published in 2013 that included Lilly. The 2013 study involved so-called eICUs, which pair voice, data and video monitoring technology with traditional bedside care. The advanced monitoring technology allows doctors and nurse practitioners to detect which patients are at-risk so they can monitor those patients and keep them from taking a turn for the A t t o r n e y s & B u s i n e s s A d v i s o r s W W W . D A R R O W E V E R E T T . C O M R H O D E I S L A N D | M A S S A C H U S E T T S | N E W Y O R K deal·mak·ers ˈdēlˌmākər/ noun 1. (See DarrowEverett L L P) State, UMass taking telemedicine to next level BY LAURA FINALDI Worcester Business Journal Staff Writer Technology being development by Boston technology startup 3derm could eventually offer 3-D photos of skin conditions to doctors, so they could better assess patients' needs remotely. P H O T O / C O U R T E S Y

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