High-Tech House Calls

Advances in telemedicine may benefit patients with chronic conditions in remote areas — and cut health care costs, too

Imagine this: You’re driving through rush hour on I-75, panicked and stressed after a long week. You feel your heart rate start to rise, and you have trouble breathing. Your earring with a heart rate monitor senses the increase and sends the data to your smartphone. It connects to your car, which recognizes you’re in danger of losing control of your ability to drive. The vehicle automatically pulls over so you can rest.

There’s also this scenario: It’s 9 p.m. in January. You have a scratchy voice and a sore throat; you think you have strep throat and need a prescription, but don’t want to drive to a health clinic and wait. You grab your smartphone and open up an application that allows you to connect with a doctor virtually like “Dial a Doctor.” After a video chat for 15 minutes, the physician diagnoses you and writes a prescription.

While the first scenario isn’t a possibility — yet — the ability to video chat with a doctor from home is. Telemedicine is a relatively new field without a lot of long-term evidence, but advocates say such advances show promise — and are a big step in the right direction to cut rising health care costs amid the increased prevalence of chronic disease, says Amar Basu, an associate professor in the departments of electrical and computer, as well as biomedical, engineering at Wayne State University.

“Chronic diseases cost our health care system because a patient has to be admitted and re-admitted [to a hospital], and there’s a lot of service-based fees associated with that,” Basu says.

He says preventive medicine — working to maintain one’s well-being and prevent diseases through exercise, healthy eating habits, etc. — is one way to curb frequent visits. Basu is developing a heart rate monitor that people would wear as an earring. He says the wearer will be able to tell which physical and psychological situations cause a spike in their heart rate, as the device is constantly monitoring the wearer.

Gary Strumolo, manager of vehicle design and infotronics for Ford Motor Co., says he’s working to “bring health wellness inside the vehicle to leverage” the car’s connectivity capabilities. Wearable devices, such as the Fitbit or the Apple Watch, and perhaps Basu’s heart rate monitor one day, can use the same technology as a vehicle’s infotainment system to connect.

He says the vehicle, where many metro Detroiters spend a great deal of time, is a convenient place to monitor chronic illnesses such as diabetes, asthma, and heart disease.

Some of this technology is already available, like an Allergy Alert app in which drivers can connect their smartphones to a Ford vehicle and request to hear the types of allergen conditions they could encounter on their route that may cause a flare-up in symptoms.

Metro Detroit hospitals such as St. Joseph Mercy Oakland and those in the Henry Ford Health System are also tapping into telemedicine services. Dr. Melody Eide, a Henry Ford dermatologist based in Troy and the medical director of the hospital’s virtual care initiatives, helped to start a program in which patients admitted to Henry Ford West Bloomfield Hospital with a skin issue can have a video examination with a specialist at Henry Ford Hospital in Detroit, saving driving time to another appointment.

For patients with chronic conditions who live in rural areas or who are elderly and may have difficulty getting to and from a hospital, St. Joseph Mercy Oakland has a specialty network that connects patients at member hospitals across the state with specialists at its hospital. The network is based off the technology at the hospital’s Michigan Stroke Network, a program that connects a neurologist with a patient at a partner hospital through a robot with a video camera attached so the neurologist can do an exam and take a patient’s history.

Dr. Sanjeev Kaul, an associate professor of urology and the director of robotic surgery at St. Joseph Oakland, says video technology has helped him to do virtual consults with patients in the western and northern areas of Michigan who don’t have access to the specialists often found in metro Detroit.

One of Kaul’s patients, Mark Therrian, 54, lives in St. Ignace. Therrian has diabetes and both of his kidneys have failed, so he drives an hour both ways for dialysis treatments three times a week. A tumor was found on Therrian’s right kidney, and Kaul will operate on him using a robot to remove his kidney, a minimally invasive procedure.

Kaul suggested a video consult with Therrian before the surgery. Instead of driving several hours to see Kaul in person, Therrian drove to a hospital in Grayling where video technology was set up. Kaul asked him about his medical history and asked to see his abdomen to look at his scar tissue from a previous surgery.

“I can speak to [the patients] while they’re sitting in a hospital that’s much closer to where they live rather than having to drive four-and-a-half hours to come to see me,” Kaul says. “If we can get most of their pre-operative [care] and assessments done in that way, then we can then save [the patients] a lot of difficulty.”

Kaul says the technology exists for a doctor to perform a surgery through a robot in Detroit that connects with a robot in a surgical room in northern Michigan. He would manipulate the robot remotely to operate on a patient like Therrian. He says limitations exist, like obtaining a dedicated Internet connection, but patients in remote areas could someday receive treatment spanning from a consultation to surgery without traveling far from their homes.

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