With the advancement of technology, we have seen incredible changes in the way patients and providers are able to manage healthcare.
With faster internet connections, smartphones and changing insurance standards, more health providers are turning to electronics to help them communicate with patients and other providers.
In this segment, Dr. Santosh Menon discusses telemedicine and the advancements that set The Christ Hospital Health Network apart as our providers can better manage heart failure patients using telemedicine technology.
Selected Podcast
How Telemedicine is Transforming Healthcare
Featured Speaker:
Today Dr. Menon is a cardiologist specializing in heart failure and he serves as the Medical Director of the Carl and Edyth Lindner Heart Failure Treatment Center at The Christ Hospital.
Santosh Menon, MD
Santosh Menon, MD was born on the southern tip of India. His family moved to the Princeton area of New Jersey, where he was raised. As he grew up, he was influenced by the physicians surrounding him. Many of his aunts, uncles and family friends were physicians, as well as his older brother.Today Dr. Menon is a cardiologist specializing in heart failure and he serves as the Medical Director of the Carl and Edyth Lindner Heart Failure Treatment Center at The Christ Hospital.
Transcription:
How Telemedicine is Transforming Healthcare
Melanie Cole (Host): With the advancement of technology, we've seen incredible changes in the way patients and providers were able to manage healthcare. With ever faster internet connections, smartphones and the even changing insurance standards, more health providers are turning to electronic communications to help them communicate with patients and other providers. My guest today is Dr. Santosh Menon. He's a cardiologist specializing in heart failure and the medical director of the Carl and Edyth Lindner Heart Failure Treatment Center with The Christ Hospital Health Network. Welcome to the show, doctor. Tell us a little bit about telemedicine and what is the evolution of telemedicine, as it's going now?
Dr. Santosh Menon, MD (Guest): Well, telemedicine's come a long way. Previously, it was just a phone call to a patient to discuss issues and make a decision. Now, we have video conferencing where you can see the patient, exam the patient, and talk with them and look at their information and make a decision.
Melanie: Wow. So, it really is the future for patients and providers, and it's happening at The Christ Hospital. So describe a little bit about the current program that you just started at the Rural and Remote Cardiovascular Outpatient Offices and which offices have it? What is it going to do for them?
Dr. Menon: We have offices in several locations. Several of them are in rural areas. These patients have limited access to cardiologists because of distance, and so we were going to increase their access to not just cardiologists, but subspecialists within cardiology, such as vascular surgeons, heart surgeons, and also bring the other specialties that do not exist in these neighborhoods such as endocrinology and pulmonary. One of the ones where we have started already is Adams County, which is about 60 miles due east in Appalachia, and it's a very robust community, but because of geographical locations, they have limited access in terms of physicians coming out there to see patients, and the patients from that area traveling to the big city to get the care that they need. So, we devised a way of having telemedicine where the patient gets face to face visits with the physician of their specialty, gets examined, and they review all the data and discuss with the patient, answer their questions and come with a game plan, and this has really increased the accessibility of these patients to these subspecialists.
Melanie: So what functionality does it provide from a clinical perspective? Are you able to prescribe medication or, you know, help somebody with some of their symptoms? How does it really work?
Dr. Menon: Absolutely. It's difficult to tell a patient's symptom over the phone. Telemedicine allows you to see the patient, talk to the patient, examine the patient, and come up with a plan, and we send in prescriptions electronically. We order tests electronically, or we tell the nurse what tests we need. So, basically we are in the room with the patient whether it's in the office outpatient setting or an inpatient setting, such as we see consults, and these patients were they not to have telemedicine, would have to travel all the way to Cincinnati to see the doctor for a few minutes and come up with a plan, and that is a tremendous stressor for these patients.
Melanie: So what about specialists? How will this impact them, and they won't have to take time out to travel as you're speaking about to see patients?
Dr. Menon: Our specialists, such as for example, endocrinology, our diabetic specialist, and our lung specialist, they have a limited number of physicians that can travel, so traveling for them is difficult. This puts them virtually in the clinic -- in that area -- to see the patients that have lung and diabetic issues and take care of their problems without having them travel all the way to these clinics or have these patients come all the way to the big city to be seen by these specialists.
Melanie: So what about cost-effectiveness? Is it cost-effective and are you seeing that it's satisfying for patients and providers? Does it offer a lower cost for the hospitals in general?
Dr. Menon: It does. I think the benefits to the hospital is that their patients get seen locally, and, of course, they benefit from the patient being seen locally as well as the tests being ordered locally instead of them traveling and getting the tests done, such as, for example, in Cincinnati. It is very cost-effective for physicians. Travel time has always been a down time for us. We cannot do anything except drive to these places, and now you can without driving see patients, make a decision, and order the appropriate tests, and it reduces the drive and the fatigue from the driving for these physicians.
Melanie: And what about insurance? How is that relating telemedicine and how are the insurance companies -- are they appreciating this?
Dr. Menon: There's a big movement. It is a new way of thinking -- this telemedicine, but right now, Medicare reimburses for rural telehealth. That is -- I believe -- more than 50 miles from your original location. That is from let's say Christ's Hospital to Adams County. It's over 50 miles, and they are embracing it, and other insurance companies are following, and this will only grow. There's a movement within the government to increase accessibility for patients -- all about accessibility in these rural areas. Not just Adams County, but we have many other counties where they are just not being serviced by the correct amount of physicians and their subspecialties. So, I think it's going to grow, especially as the technology gets better, cheaper, and is more accurate.
Melanie: So elaborate on some of your treatments, like CardioMEMs that help providers better manage heart failure patients so using telemedicine technology for something like CardioMEMs?
Dr. Menon: CardioMEMs is an implantable device, a tiny one, that's put in the pulmonary artery in the lungs, and it monitors the pressures, such as what we call the filling pressures in our patients with congestive heart failure. That means that if they are getting short of breath, by the time they get short of breath, it's almost too late. They'll have to come to the hospital to get treated. Well, what we have found is that these pressures -- these filling pressures -- go up as they get short of breath even before they get short of breath. So, these patients are transmitting on a daily basis, and we see a rise in the filling pressures, maybe we can tackle that and prevent a hospitalization and keep them at home. So, it's -- the device transmits through Bluetooth through a pad that they lie on and that transmits to a secure website, and we get the data within parameters and when there's an alert -- when they go outside their filling pressures, that is their parameters -- it transmits to us, and we act accordingly.
Melanie: That's really great, and it certainly is -- would seem to be the wave of the future and certainly quite a diversion from the old days when a pacemaker would be checked remotely by plugging their phone into something. So, this is really great. Now where do you see this going in the future? Give us a little blueprint for the future research of telemedicine.
Dr. Menon: I think that telemedicine will continue to grow. As there's a shortage of physicians, especially in the underserved areas, but I also feel that people cannot take time off from their day to go see their physician for a routine visit. They can do it via a kiosk where they are examined, their blood pressure is checked, their questions are answered, and a prescription is given if necessary or a test is ordered. So, I think it's all about accessibility and especially the younger generation. They believe in the technology, and I think that telemedicine will continue to grow as it becomes more accessible.
Melanie: So, in summary, Dr. Menon, please, tell other physicians what you'd like them to know about telemedicine offered at The Christ Hospital Health Network.
Dr. Menon: The telemedicine program is growing, and we’re going to use it across service lines meaning that right now, we're doing cardiology, but like I said, we're going to do pulmonary and endocrine. We're also going to do orthopedics, spine, wound care and so on. So, every specialty within The Christ Hospital will have telemedicine for these rural areas as well as the rules change even to local hospitals that do not have these services.
Melanie: That's fantastic. Thank you so much for being with us today. You're listening to Expert Insights Physician Views and News with The Christ Hospital Health Network. To learn more about Dr. Menon or for information on other physicians with The Christ Hospital Health Network, please visit tchpconnect.org. That's tchpconnect.org. This is Melanie Cole. Thanks so much for listening.
How Telemedicine is Transforming Healthcare
Melanie Cole (Host): With the advancement of technology, we've seen incredible changes in the way patients and providers were able to manage healthcare. With ever faster internet connections, smartphones and the even changing insurance standards, more health providers are turning to electronic communications to help them communicate with patients and other providers. My guest today is Dr. Santosh Menon. He's a cardiologist specializing in heart failure and the medical director of the Carl and Edyth Lindner Heart Failure Treatment Center with The Christ Hospital Health Network. Welcome to the show, doctor. Tell us a little bit about telemedicine and what is the evolution of telemedicine, as it's going now?
Dr. Santosh Menon, MD (Guest): Well, telemedicine's come a long way. Previously, it was just a phone call to a patient to discuss issues and make a decision. Now, we have video conferencing where you can see the patient, exam the patient, and talk with them and look at their information and make a decision.
Melanie: Wow. So, it really is the future for patients and providers, and it's happening at The Christ Hospital. So describe a little bit about the current program that you just started at the Rural and Remote Cardiovascular Outpatient Offices and which offices have it? What is it going to do for them?
Dr. Menon: We have offices in several locations. Several of them are in rural areas. These patients have limited access to cardiologists because of distance, and so we were going to increase their access to not just cardiologists, but subspecialists within cardiology, such as vascular surgeons, heart surgeons, and also bring the other specialties that do not exist in these neighborhoods such as endocrinology and pulmonary. One of the ones where we have started already is Adams County, which is about 60 miles due east in Appalachia, and it's a very robust community, but because of geographical locations, they have limited access in terms of physicians coming out there to see patients, and the patients from that area traveling to the big city to get the care that they need. So, we devised a way of having telemedicine where the patient gets face to face visits with the physician of their specialty, gets examined, and they review all the data and discuss with the patient, answer their questions and come with a game plan, and this has really increased the accessibility of these patients to these subspecialists.
Melanie: So what functionality does it provide from a clinical perspective? Are you able to prescribe medication or, you know, help somebody with some of their symptoms? How does it really work?
Dr. Menon: Absolutely. It's difficult to tell a patient's symptom over the phone. Telemedicine allows you to see the patient, talk to the patient, examine the patient, and come up with a plan, and we send in prescriptions electronically. We order tests electronically, or we tell the nurse what tests we need. So, basically we are in the room with the patient whether it's in the office outpatient setting or an inpatient setting, such as we see consults, and these patients were they not to have telemedicine, would have to travel all the way to Cincinnati to see the doctor for a few minutes and come up with a plan, and that is a tremendous stressor for these patients.
Melanie: So what about specialists? How will this impact them, and they won't have to take time out to travel as you're speaking about to see patients?
Dr. Menon: Our specialists, such as for example, endocrinology, our diabetic specialist, and our lung specialist, they have a limited number of physicians that can travel, so traveling for them is difficult. This puts them virtually in the clinic -- in that area -- to see the patients that have lung and diabetic issues and take care of their problems without having them travel all the way to these clinics or have these patients come all the way to the big city to be seen by these specialists.
Melanie: So what about cost-effectiveness? Is it cost-effective and are you seeing that it's satisfying for patients and providers? Does it offer a lower cost for the hospitals in general?
Dr. Menon: It does. I think the benefits to the hospital is that their patients get seen locally, and, of course, they benefit from the patient being seen locally as well as the tests being ordered locally instead of them traveling and getting the tests done, such as, for example, in Cincinnati. It is very cost-effective for physicians. Travel time has always been a down time for us. We cannot do anything except drive to these places, and now you can without driving see patients, make a decision, and order the appropriate tests, and it reduces the drive and the fatigue from the driving for these physicians.
Melanie: And what about insurance? How is that relating telemedicine and how are the insurance companies -- are they appreciating this?
Dr. Menon: There's a big movement. It is a new way of thinking -- this telemedicine, but right now, Medicare reimburses for rural telehealth. That is -- I believe -- more than 50 miles from your original location. That is from let's say Christ's Hospital to Adams County. It's over 50 miles, and they are embracing it, and other insurance companies are following, and this will only grow. There's a movement within the government to increase accessibility for patients -- all about accessibility in these rural areas. Not just Adams County, but we have many other counties where they are just not being serviced by the correct amount of physicians and their subspecialties. So, I think it's going to grow, especially as the technology gets better, cheaper, and is more accurate.
Melanie: So elaborate on some of your treatments, like CardioMEMs that help providers better manage heart failure patients so using telemedicine technology for something like CardioMEMs?
Dr. Menon: CardioMEMs is an implantable device, a tiny one, that's put in the pulmonary artery in the lungs, and it monitors the pressures, such as what we call the filling pressures in our patients with congestive heart failure. That means that if they are getting short of breath, by the time they get short of breath, it's almost too late. They'll have to come to the hospital to get treated. Well, what we have found is that these pressures -- these filling pressures -- go up as they get short of breath even before they get short of breath. So, these patients are transmitting on a daily basis, and we see a rise in the filling pressures, maybe we can tackle that and prevent a hospitalization and keep them at home. So, it's -- the device transmits through Bluetooth through a pad that they lie on and that transmits to a secure website, and we get the data within parameters and when there's an alert -- when they go outside their filling pressures, that is their parameters -- it transmits to us, and we act accordingly.
Melanie: That's really great, and it certainly is -- would seem to be the wave of the future and certainly quite a diversion from the old days when a pacemaker would be checked remotely by plugging their phone into something. So, this is really great. Now where do you see this going in the future? Give us a little blueprint for the future research of telemedicine.
Dr. Menon: I think that telemedicine will continue to grow. As there's a shortage of physicians, especially in the underserved areas, but I also feel that people cannot take time off from their day to go see their physician for a routine visit. They can do it via a kiosk where they are examined, their blood pressure is checked, their questions are answered, and a prescription is given if necessary or a test is ordered. So, I think it's all about accessibility and especially the younger generation. They believe in the technology, and I think that telemedicine will continue to grow as it becomes more accessible.
Melanie: So, in summary, Dr. Menon, please, tell other physicians what you'd like them to know about telemedicine offered at The Christ Hospital Health Network.
Dr. Menon: The telemedicine program is growing, and we’re going to use it across service lines meaning that right now, we're doing cardiology, but like I said, we're going to do pulmonary and endocrine. We're also going to do orthopedics, spine, wound care and so on. So, every specialty within The Christ Hospital will have telemedicine for these rural areas as well as the rules change even to local hospitals that do not have these services.
Melanie: That's fantastic. Thank you so much for being with us today. You're listening to Expert Insights Physician Views and News with The Christ Hospital Health Network. To learn more about Dr. Menon or for information on other physicians with The Christ Hospital Health Network, please visit tchpconnect.org. That's tchpconnect.org. This is Melanie Cole. Thanks so much for listening.