Telehealth travels the healthcare spectrum

April 14, 2012 in Medical Technology

Barriers remain to wide use, but cloud technology may help meet the challenges

True to its Greek prefix meaning “distance,” the telehealth concept has come a long way in serving as a legitimate platform for virtual patient care. New technologies, applications and approaches are facilitating the category’s growth as healthcare providers search for IT systems with the broadest capabilities.

The growth potential for telehealth has attracted the attention of some major corporations. For instance, Redmond, Wash.-based Microsoft has sharpened its focus on the telehealth field with its new Office 365 system, which operates email, shared calendars, instant messaging, video and document collaboration in the cloud. Office 365 is embedded with privacy and security capabilities, enabling health organizations to comply with leading information privacy and security standards.

Dennis Schmuland, chief health strategy officer at Microsoft, says the company wants to advance the category’s definition and purpose beyond its original “telemedicine” roots.

“Telemedicine is using technology to improve and extend access and expertise to underserved areas,” he said. “Telehealth includes telemedicine, but expands those possibilities.”

While telehealth has made substantial progress in recent years, traditional barriers are still blocking it from breakthrough acceptance and utilization, Schmuland said. Among them are lack of reimbursement, a “costly and cumbersome” technology infrastructure and cross-state licensure. Cloud technology, he said, provides a solution to all these challenges.

“The cloud-based unified approach takes all the communication methods and pulls them together while cutting through the barriers so that you have a simple way to communicate across all those channels,” he said.

In order to bring the cloud in line with HIPAA requirements, Microsoft has embedded privacy and security capabilities into Office 365, Schmuland said. Moving to the cloud allows small practices to take advantage of this service, whereas it previously had only been suitable for larger organizations, he said.

For instance, Dallas Neurosurgical Spine is using a telemedicine system with MS Lync Online for consultations with rural patients.

“The capabilities offered by Lync Online are cornerstone to our telemedicine program,” said Michael Desaloms, MD, neurosurgeon with the clinic. “As we expand our telemedicine services more broadly to the rural areas around Dallas-Fort Worth – as well as to other parts of the world such as Saudi Arabia and Peru to reach underserved communities – the need for inexpensive, commercial off-the-shelf technologies like Lync Online will be critical to making remote consultations and training practical and affordable for more people.”

‘Mobilizing’ medicine

Huntersville, N.C.-based Rubbermaid Medical Solutions has also become heavily involved in telehealth, evidenced by the launch of its new Mobile Technology Cabinet – a system that blends the aesthetics of a cabinet with the flexibility of a mobile computing cart, said Kevin J. Boyle, RMS business leader.

The evolution into telehealth grew out of the company’s cart business, Boyle said, because customers were looking for advanced functionality.

“We started to get requests for camera brackets on the carts,” he said. “Our strengths are ergonomics and the human factor and to bring technology and users together. So we went to work making sure we had the right mix, the right partners and the right solution. We ended up with a suite of global end points that go into workplace clinics, schools and institutions.”

The RMS system provides for live interaction in what Boyle describes as “telemedicine, televisits and teleconsults.” The technology, he said, is designed for user simplicity and features touch-screen interfaces, video applications and “clean” cable integration.

“We come in with no preconceived notion, which has been an advantage,” he said. “We want users to understand the objectives of deployment and how to operationalize them. There are so many benefits telehealth can bring and we are trying to step up to the challenge.”

Guarding data

The burgeoning telehealth category is growing in myriad directions and dimensions, which means data encryption is paramount in order to protect sensitive information from falling into the hands of hackers and identity thieves. Yet it is a challenge that Linthicum, MD-based Ciena is prepared to handle, company representatives say.

“With all these new health apps from telemedicine to EHRs, the demands for bandwidth and storage are huge and there needs to be connectivity for them,” said Jim Gerrity, Ciena’s director of global industry marketing. “On top of that, they tend to include other administrative and clinical functions and they need something to collect and distribute the information. The issue is the overriding need to protect the information and the best solution is to consolidate multiple networks into one.”

Malcolm Loro, Ciena’s director of product marketing, says the most critical juncture for data protection is while it is “in flight” as opposed to data that is “at rest.” Loro explains that firewalls and user credentialing has made “at rest” data reliably secure, but that it can become jeopardized once it leaves the data center to travel somewhere else.

“To a large degree optical networks are secure, but they are susceptible to eavesdropping through fiber manipulation,” Loro said. “So the goal is to encrypt the in-flight information. Hackers have figured out how to get users to accidentally give information, but eavesdropping is more sophisticated because you’re not aware of it. Even in fiber networks, they can bend the line so that it is interrupted and the hacking is undetected.”

Ciena deploys encryption techniques at the lower layer – Ethernet or below – to cover the data stream and protect the network, Loro said. For telehealth, he says it is the best method.

“Layer 3 encryption techniques properly cover the information and it works most of the time,” he said. “But for time sensitivity in an emergency or disaster recovery, there is a latency that slows down the traffic and it becomes inefficient.”

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