Research Paper on "Healthcare Management Information Systems Telemedicine"

Research Paper 10 pages (3032 words) Sources: 10

[EXCERPT] . . . .

Healthcare Management Information Systems

Telemedicine

Telemedicine can be traced far back in the 1960 when the National Aeronautics and Space Administration (NASA) provided health care to it astronauts Bashshur & Armstrong, 1976.

The medical service was provided to the astronauts from a medical van that was linked to medical specialists equipped with a two way microwave telemedicine and audio transmission. The service was meant to telemeter astronaut's physiological response while on their space mission in their space suits

In 1967 a medical station was established in Massachusetts general hospital to cater for airport employees and deliver emergency medical attention and care to commuters. The diagnosis and evaluation of treatments was undertaken by selected nurses overseen by physicians Williams, May C.R., & Esmail a., 2002()

Further developments in the field of telemedicine were made to guarantee efficiency and accuracy in diagnosis. The need for remote video led NASA to conduct a survey establishing the minimal television system required for diagnosis. The study conducted marks the video conferencing which was used to provide video images through diagnosis and treatment.

Application of telemedicine in recent time has developed to be part of emergency preparedness and disaster response. Incidences of natural calamities have received attention from specialist even when physical presence in duly unavailable. In the current millennium it is appreciated that telemedicine has contributed to rural areas across the state providing much needed support the health institutions are physically incapacitated to provide.

Telemedicine

Telemedicine according to Mort, May, and Williams (2003)

, telemedicine involves monitoring, treatment and diagnosis where patients and doctors are detached by space and time. Medication is through information technologies. In this aspect Telemedicine has capability to improve on efficiency and cost of treatment where the patient doctors and hospital management benefit. With Telemedicine, a vision of a global hospital is prospected where geographical barriers are broken. Cartwright (2000)

, argues that Telemedicine will most likely bring forth a new pattern of global village and thus a new global paternalism will consequently emerge.

Telemedicine is argued to be affording clinical practice to explore more possibilities other than just increased access to health care. Cartwright (2000)

, observed that with Telemedicine there will be prominent increases in access to quality healthcare that is affordable and most importantly efficient in terms of delivery and a healing. The effectiveness observed by Cartwright, is discussed by Williams et al. (2001)

, with specific reference to delivery efficiency. Edwards, Hall, and Shaw (2005)

, explored the policy implication and management aspects that telemedicine improved.

Application and Use of Telemedicine

Telemedicine encompasses care giving methods in a virtual health care institution. It entails the interplay of clinical and information technology applications that capture medical information to investigate, diagnose, consult and treat. The application of the procedure uses secure internet web-based connections and a help desk for end users Cartwright, 2000()

The technology utilizes the use of a standard telephone connection, personal computers, internet connections, still images and video outputs for virtual communication, robotics an satellite transmission. In addition to this it is noted by Bar-Yam (2006)

that smart phones have enabled enhancing care provision by facilitating fast and clear access to digital image and correspondence between the patient and physician.

Telemedicine applications are in most case real time-based which enable healthcare providers to observe patients and test the likely results there by render clinical assessments with no constraints of distance or geographical barriers Bar-Yam, 2006()

Concerns arising from the use of Telemedicine

With the continued growth and embrace of telemedicine services a variety of issues are coming up. As an integral part of many health institution telemedicine is setting in matters concerning administration, delivery of payments and privacy.

Licensing

It is appreciated that as telemedicine is breaking geographical barriers issues touching on licensing are coming up. It practically impossible for medical practitioners to obtain licenses in each and every state that telemedicine will offer them an avenue to operate. As Williams et al. (2002)

, puts it, it practically for health practitioners to take exams in different states and regions and travel for interviews all in the name of obtaining licenses to practice. The cost involved in this procedure given the stretched avenue provided by telemedicine makes it virtually impossible. The concern in this case is the possibility of adapting international procedural standards that will accommodate the operations of telemedicine.

The first challenges -- which are interrelated in many respects -- that legally hinder the development of telemedicine include issues related to interstate licensing, legal liabilities, and institutional credentialing of physicians Roback & Herzog, 2003.

Unfortunately, many of these legal matters are still unanswered and unresolved within both the U.S. health care and judicial systems. For example, in interstate medical transactions where mechanical devices are used for surgery or radiology, if there is a mechanical failure or glitch that results in harming the patient, deciding on who is responsible for that accident is debatable and can be a major headache for legal authorities. Another key issue implicit in this scenario is that these practitioners who are treating and communicating with the patient are operating out of different states.

Because laws regarding telemedicine and health care certification are unique in each state, legal liability, malpractice, and jurisdiction become serious matters of concern for the judicial, legal, and medical systems Turner, 2003.

For instance, in the event that an inexperienced physician located in Arizona is physically operating on a patient and is engaged in a live telemedicine communication with a specialist in New York whose guidance and direction botch the surgery and result in the patient's death, the prosecutors and legal officials in Arizona would find difficulty in placing blame and litigation on the party in New York. An issue like this one is a typical scenario in which telemedicine presents some legal and licensing issues. However, as telemedicine and its associated technology evolve, feasible solutions (i.e., legal policies and amendments) to these problems should be discovered and made available.

Patient Information Confidentiality

Privacy of information is queried to the extent that the information transferred through the technology media is only used for treatment purposes only. Chance for such information licking will be termed as a breach of rule governing safeguard of patient information. Whether Telemedicine technology and associated media are protective of the interests and privacy of a patient is a concern.

A handicap in evolution of telemedicine touches on issues concerning patient privacy. According to Mort et al. (2003)

, because many individuals (i.e., technicians, nurses, etc.) are generally involved in telemedicine communication, exposure of confidential records to all parties concerned becomes a threat to the privacy of that patient. Additionally, even though medical doctors accept the obligation of maintaining their patients' privacy rights, the other assisting parties involved in the telemedicine communication may not be held to the same standard Turner, 2003.

As a result of this risk to patients' privacy rights, telemedicine has struggled to gain acceptance from the legal and medical communities Bar-Yam, 2006.

However, again, as time progresses and this issue is tackled by the medical and legal communities alike, solutions should be found to eliminate privacy risks to patients. Furthermore, these solutions should generate increased acceptance of telemedicine practices by all parties concerned and, likewise, should alleviate the fear and frequency of breaches to patient privacy laws.

Health Insurance Companies Resistance

The most significant challenge according to Turner (2003)

that telemedicine faces in gaining adoption is the difficulty of receiving reimbursement for services from insurance companies that oppose unconventional consultations, such as the ones absent of face-to-face contact. For instance, according to Brookfield and Smith (2006)

, the U.S. Health Care Financing Administration, a national organization in charge of major health insurance companies, stipulates that reimbursement for medical services is usually available only when direct physical communication (i.e., a face-to-face appointment) is held. However, this stipulation is not universal and required of all states. There are some states that do not demand this immediate presence in medical consultations, such as California, Texas, and Oklahoma. Plus, these states even go as far as permitting such telemedicine services as appropriate substitutes for face-to-face appointments if recommended by the attending practitioners, Turner, 2003()

Payments

How payments and reimbursements are undertaken is not clear. As far as payments is concerned, there are geographical barriers Edwards et al., 2005.

Concern comes as to whether the methods of payments should be similar to those practiced where physical contact is made. Then again which are the ideal standard measures that can apply globally? To the extent of management what portion of the fee should go to the institution and the physician? These concerns are arising due to lack of a conceptualized manner to plan and amalgamate the global economies.

Determination of benefits and cost associated with Telemedicine especially in the case that it a developing innovation is not certain. The cost and benefits associated with Telemedicine has not been conceptualized in its full sense. The technology investment cost and the resultants benefits to an institution, the patient and… READ MORE

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