Telehealth, often used interchangeably with telemedicine, refers to healthcare providers using electronic, telecommunications technology to meet, examine, diagnose, and treat patients from a distance. This remote, long-distance method of contacting, caring for, and monitoring patients is changing how healthcare is being delivered around the world, according to Yulun Wang, founder of InTouch Health.
|Yulun Wang demonstrates telehealth through his phone at Myongji Hospital located in Goyang, Gyeonggi Province, Thursday by connecting with VITA at an affiliate hospital in Santa Barbara, Calif.|
Telehealth can include anything from two clinicians’ conferencing through video chat with surgeons performing robotic surgery to caregivers monitoring a patient at home through a continual stream of patient health data. Amid the tsunami of changes hitting the healthcare industry, renowned U.S. physician Lynda Chin noted telehealth to be the “front door to the healthcare system.”
Entrepreneur and inventor Yulun Wang, the founder of telehealth firm InTouch Health and medical devices company Computer Motion, told Korea Biomedical Review Thursday how InTouch has helped significantly change how physicians meet, diagnose, and treat patients. He noted especially how telehealth arms specialists with electronic medical information and then disseminates their specialty knowledge to everyone in the care team.
Wang made headlines in the U.S. for developing the first FDA-cleared surgical robot dubbed the Automated Endoscopic System for Optimal Positioning (AESOP) in 1990, completing the world’s first global telesurgery in the Transatlantic Lindbergh Operation in 2001, and most recently for making considerable progress in developing telestroke services.
He currently serves as the chairman and chief innovation officer of the Santa Barbara, Calif.-based InTouch Health, which has become a leading telehealth provider since its foundation in 2002.
In the U.S., Wang noted that telehealth had the biggest impact in cases where getting the right specialist to a patient suffering an unscheduled event of both high clinical and financial consequence was difficult, which was exemplified by stroke care.
As a case in point, InTouch Health - which has strong partnerships with both the Mayo Clinic and the Cleveland Clinic - completed 130,000 stroke cases through its “Telestroke” services in this year alone, successfully helping 90 percent of patients get treated within the golden “door to needle” time.
Telestroke, a portmanteau of telehealth and stroke, allows stroke experts to advise general medical professionals on how to assess and treat patients correctly within a limited time frame critical for recovery.
Through telestroke, the neurologist remotely communicates with the medical caregiver through a digital interface and assesses the patient, ultimately deciding whether to administer a tPA, or a clot-busting drug for acute ischemic strokes.
“Those at outlying hospitals started doing things that they couldn’t have done without the supervision of larger hospitals, such as administering tPA,” Wang said. Telestroke, along with telehealth, has, for the most part, taken grasp in the U.S., with the American Heart Association and the American Stroke Association both listing it as a Class II recommendation.
Wang pointed out that although regulatory issues such as reimbursement initially served as significant challenges in the U.S., InTouch was able to move past them because the outcomes achieved were remarkably positive. The company now has around 150 telestroke networks in the U.S., with smaller hospitals able to handle acute stroke patients that were previously primarily treated only at large hospitals.
Bright outlook of telehealth in Korea, too
Responding to the question of whether telemedicine could be successful in Korea, Wang noted virtual healthcare delivery to be inevitable not just in Korea but around the world. “I can’t answer the question of how quickly Korean doctors will adopt telemedicine, but in my opinion, virtual care delivery is inevitable around the world because it makes things better, cheaper, and faster,” Wang said. “That ultimately always wins out.”
|Yulun Wang (Courtesy: Myongji Hospital)|
He noted that the service could be applied to not just strokes but also to mental health, cardiology, orthopedics, and pediatrics, among others, and generally across the entire continuum of care such as community-based, acute, and post-acute care.
Currently, physicians at hospitals are limited by physical space, only able to treat those within their vicinity. Korean physicians, too, suffer from this constraint, and could benefit from telehealth that helps physicians maintain a higher number of patients who may be out of reach, he said.
Despite its benefits, telehealth has seen a high number of obstacles in Korea with physicians mainly opposing it. The resistance to telehealth comes from worries of misdiagnosis and from concerns of patients skipping local clinics to go straight to large hospitals in Seoul. Local physicians, who rely heavily on diagnosing, prescriptions and treatment of general patients for their livelihood, have primarily viewed telehealth as a risk.
Regarding physician resistance and reluctance to telehealth, Wang noted that the U.S. dealt with a similar challenge with much physician pushback. As an example, the medical board in the state of Texas took a telemedicine company to court, saying that the doctor had to first conduct an in-person visit with the patient before using telemedicine. “Obviously, if you had to have an in-person visit first, then it nullifies the purpose of telemedicine,” he said, explaining that the company took the case to the Supreme Court and won.
Physicians concerned about people going to major cities and hubs are also not a problem unique to Korea, Wang said. “It may be acuter in Korea, but the fact is that if you can distribute expertise outwards, then you can make it better for the patient, make the center hospital less congested, and lower the cost and improve convenience for everybody.”
Wang added that telehealth is “going through a standard adoption life cycle of new technology. The thing should be questioned and challenged, but things are going to change slowly but surely.”
In this way, telehealth will enable health systems to virtualize care in a way that online banking systems helped virtualize money transactions, Wang said, pointing out that around 50 to 70 percent of in-person visits can be virtualized.
“Telehealth now enables health systems to virtualize care similar to what an online banking system did for banking systems,” Wang said. Whereas people used to go to brick-and-mortar banks in the past, an online system laid on top of the real bank changed how people deposit and transfer money.
“Healthcare will be like how banking is done now, but I don’t know if that will take five or 10 years. Telemedicine and virtual care are, however, inevitable,” Wang said. “The fourth industrial revolution is going to hit healthcare about now.”
Wang, while demonstrating how he could move the Vita-RP model in his Santa Barbara office and check the patients there, showed how transatlantic check-ups could be possible anytime, anywhere, thereby increasing the quality of care across the globe.
“Although moving from paper to electronic is fundamentally important, putting virtual care on top of that is incredibly so, and this is what will enable the explosion of the fourth revolution,” he said.