Telemedicine: Leading the Way to Virtual Care Delivery

By Sarah Sonies

Health care and insurance specialists predict that within a few years, almost the majority of health care will be delivered virtually.

In remarks two weeks ago in the opening of the 2014 American Telemedicine Association (ATA 2014) annual meeting and technology trade show, Edward M. Brown, ATA president and CEO of the Ontario Telemedicine Network (OTN) discussed the future of technology in care delivery.

“I fully believe that within the next five years, more than 50 percent of health care delivery will be virtual,” said Brown.

Following Brown’s remarks was a conversation and live-streamed interview where Stephen Hemsley, UnitedHealth Group President and Chief Executive Officer, and Dr. Reed Tuckson, ATA Vice President and ATA 2014 Program Chair, discussed the recent changes in insurance coverage and the role of telemedicine.

Hemsley defined telemedicine as any care that occurs outside of the physician’s office or traditional health care setting; he called for disruptive innovation in care delivery models and treatment applications.

Speakers at the Baltimore meeting emphasized the versatility of virtual care models and consults, innovative uses of asynchronous technology, and the use of mobile technology to improve access and care across the continuum (mHealth).

Among patient-centered care and clinical case study sessions, the meeting featured a dynamic mental health track; institutions shared their progress in implementing telemedicine across health systems facilitate communication between mental health patients and providers.

In a session moderated by Elizabeth Brooks, PhD, assistant professor of psychology at the University of Colorado Anschutz Medical Campus, panelists from the Harvard Global Mental Health Program and the University of California Davis highlighted innovations in mental health care, including patient-driven data generation.

Peter Yellowlees, MD, professor of psychiatry and director of health informatics at UC Davis, shared a pilot study conducted with patients to record their behavior and upload footage to a secure video channel, allowing patients to self-generate data for later observation. While the data analysis remains in the early stage, Yellowlees indicated that the study improved access to and comfort with mental health services over a longer period of time.

“Traditionally, we’ve delivered care directly in the here and now, whether face-to-face or not. The big change is that we are collecting data at one time, then reviewing, consulting, and using it at a different time. Health care is increasingly moving into an area where we are doing more asynchronous work,” he said.

Panelists predicted that patients will increasingly generate their own mental health data for diagnostic purposes from mobile devices and mainstream media tools. Others predicted that mobile health technology and telemedicine will become an increasingly valuable tool in disaster relief efforts.

John Piette, PhD, professor of internal medicine at the University of Michigan highlighted an intervention using mHealth tools to improve care for patients with non-communicable diseases in less-developed countries. In a pilot study in Bolivia with adults suffering from hypertension or diabetes, providers made automated phone calls to patients’ cellphones or landlines with medication and self-care reminders. The UM investigators found that, despite limited experience with mHealth,  patients and health systems in underserved countries can use mHealth platforms for improving the quality and intensity of non-communicable disease care.

The conference also featured rounds of startups pitching ideas to aid the growth of digital health and telemedicine. The ATA Innovation Spotlight included startups like New Millennia Health, a company that provides an online learning platform for wellness and diabetes management; and CaptureProof, a diagnostic software maker using patent photographs protected by secure data encryption used by dermatologists and surgeons.

To view the full session and keynote abstract agenda from ATA 2014, please click here.

ssonies1Sarah Sonies is associate editor of Wing of Zock. She can be reached at or on Twitter @ssonies.