Calling a Patient with Facetime: Current Trends in Telemedicine Today

Calling a Patient with Facetime:
Current Trends in Telemedicine Today

Could you use Facetime to call a patient?

Should you use Facetime to call a patient?

“There is going to be a significant physician
 workforce shortage under all of the likely
projections. We see that, quite frankly, only
  getting worse as the population ages.”
                 -Janis M. Orlowski, MD
              AAMC Chief Health Care Officer

• 19% deficit by 2025
 *Source: AAMC Complexities of
 Physician Supply and Demand:
 Projections from 2015 to 2030

• 1/3 of Physicians Retiring
• 12% Population growth
• Age > 65 to grow 55%
• Incidence of stroke
 increasing
• Limited number of
 graduates in stroke, neuro-
 critical care, dementia

70% of institutions note telemedicine as top or high priority
                *Source: 2018 REACH Telemedicine Industry Benchmark Survey

Telehealth Components

Telestroke & Teleneurology rank as 2 of the top 4 most
         mature programs around the country
             *Source: 2018 REACH Telemedicine Industry Benchmark Survey

Telestroke Model
 Conventionally operates via “Hub-and-Spoke” in which:

    o Specialist neurologists at the “hub” (Stroke Center) communicate with “spoke-
       Originating” site

    o ER doctors at spoke site consult hub doctors using telemedicine equipment

    o CT scans at the spoke site are shared electronically with the hub specialists

    o After examining the patient and reviewing images, recommendations are
       given to the ER provider to treat with tPA or recommend for embolectomy

o Protocols for hub-and-spoke must be made together

Benefits of Telestroke
 Greater access to specialists in underserved areas

 Improved patient outcomes
    o Increased TPA rates

    o Increased endovascular procedures

    o Resulting in reduced stroke mortality and long term disability

 Reduced delay in care leads to earlier diagnosis & treatment

 Operational Benefit
     Improved patient engagement & satisfaction

     Improved patient convenience

    o Increased HCAHP scores

Secondary Benefits of Telestroke
 Improved Image in local community

 Improved employee outcomes
    o Improved physician job satisfaction by providing flexibility of schedule

    o Improved institutional culture by reducing physician burnout

    o Improved recruitment due to telemedicine offerings

 Opportunity to scale out the benefits
    o Expansion into additional neurological service lines

    o Move from departmental to enterprise telemedicine programs

 Financial Benefit
     Increased Revenue Opportunity

     Cost Savings by reduced readmissions

54% of organizations have cost savings of at least 11%
                             *Source: 2017 Foley Telemedicine & Digital Health Survey

Given the relatively recent evolution of telestroke, existing data regarding the return on investment for
 the implementation of telestroke technology is limited. However all surveys unanimously indicate a
                                             significant ROI.

Telehealth Early Adopter
Source: “Telehealth Outpaced In- Person Visits Last Year” Telehealth News. October 2016

Could you use Facetime to call a patient?
  • FaceTime is well-within HIPAA regulations for telemedicine-use as a communications
    conduit.
  • A Business Associate agreement is encouraged for all vendors that acquire and store PHI.
    Exemptions of the Business Associate rule include communication platforms that are
    encrypted and transmit-only services. Since Apple’s policies on call handling and storage
    meet the exemption criteria, FaceTime qualifies as a communications conduit with no
    business associates agreement required.
  • Using FaceTime for telemedicine is permissible in and of itself. Although, it is advised to
    consider internal policies to minimize abuse of the platform in care delivery.
  • Using a company such as Simple Visit would be recommended
  • Source: Using Facetime for Telemedicine Visit by Simple Visit

Should you use Facetime to call a patient?

                   No

Thank you

        Rajiv Narula, MD
    Instructor of Neurology
  Director, Teleneuroscience
narula-rajiv@cooperhealth.edu
         732-789-7030