Treating disease no longer demands you make a trip to the doctor's office. Video, sensors and other technology are bringing patients, doctors and other health care providers together, virtually. Health News Florida's Mary Shedden explains how this Spring, Legislators hope to better define the state's booming world of telemedicine.
This is just one of several hot health issues coming in the 2014 Legislative session. It gets underway March 4 in Tallahassee.Morning, noon and night, sensors track Ernestine Marshall's every move.
“See whenever I use my bathroom, it’s like inside the tank, there", Marshall described. "In other words, they know even when I use the bathroom. I guess they keep a record of us.”
It's been a year since the Tampa retiree volunteered to let her health insurance company track her daily activities. Motion-activated sensors on the toilet, the front door and the kitchen cabinet where she stores medications help manage her multiple sclerosis. If Marshall oversleeps or if she’s up and down during the night, sensors tucked into her bed trigger a check-in call from a Humana nurse.
“One thing about it, I like that they check", Marshall said. " 'Why’s she up at 2 o’clock in the morning. Why’s she up again 5 o’clock in the morning' ".
Marshall's experience is just one way technology that didn't exist a few years ago is changing how Americans are dealing with chronic conditions and acute disease. It's eliminating the burden of hours-long drives for patients, doctors, or both. And the tools bring experts to facilities that can't afford a fulltime specialist.
Florida’s legislature loves the idea. But it also needs to update the rules and keep up with this high-tech, hands-off approach to health care.
Representative Jason Brodeur says his House telemedicine bill creates a way for health care to be more direct and immediate. For example, patients experiencing a seizure can record it on their smart phone and email a short video to their doctor right away.
Some sticking points already have emerged in pre-session committee meetings. While insurance companies, hospitals and clinics clamor to use the tools, they can't agree about who exactly and when exactly telemedicine is most appropriate.
Chris Nuland is with Florida's chapter of the American College of Surgeons. He wants the law to make sure quality care isn't compromised by a video screen.
“When a rash or a boil appears, more than an image is necessary to examine that particular lesion", Nuland said. "You need to know are they running a fever? You need to know is the lesion is hard, soft? All of those make a difference.''
Others worry Florida won't be able to hold out-of-state physicians accountable if their remote decisions hurt a patient in the Sunshine state. Senator Arthenia Joyner says doctors practicing telemedicine from out-of state are needed to help address a growing shortage of primary care physicians.
"If telemedicine is going to to serve its purpose of providing quality accessible health care to persons, we are going to need to be able to have the access to doctors out of state", said Joyner.
And of course there's the issue of money. Should virtual docs get paid the same as those seeing patients face to face? Early versions of the Senate telemedicine bill will let health-care providers negotiate payments with insurance companies.
Layne Smith is from the Mayo Clinic in Jacksonville. The Minnesota-based hospital provides telemedicine services all over the country, such as stroke consults for a community hospital in Titusville. He says the value of telemedicine varies and negotiations should be left to those providing the care.
"It may be that we can offer telemedicine services more cheaply for folks", said Smith, "but it may be that in certain cases that we want to charge a premium for telemedicine serves.”
Legislators have 60 days to turn the ideas around telemedicine into policy. But for patients like Ernestine Marshall, this virtual world of health care already is very real.