OTN was established in 1997 with the vision that telemedicine will be a mainstream channel for healthcare delivery and education. There were several barriers initially including startup costs, a compelling business case, a process for scheduling events, paying doctors, and overcoming health care professionals’ (HCP) resistance to using the technologies. A business and operational strategy was developed, always keeping in mind the need to be as easy and convenient to use as face-to-face encounters.
OTN currently has four channels of virtual care:
- Elective Virtual Ambulatory Care: Last year OTN supported over 300,000 provider/patient real-time video consultations in over 40 specialty services. The top 5 therapeutic areas were mental health, internal medicine, primary care, oncology, and surgery. Store forward asynchronous consults were supported in dermatology and ophthalmology.
- Urgent/Emergent Virtual Acute Care: OTN supported telestroke (for tPA), acute burn, crisis psychiatry, trauma, critical care, and long-term care.
- Learning and Meetings: OTN supported 19,000 education events last year, reaching over 400,000 learners, using videoconferences, webcasts, and web conferences.
- Chronic Disease Management: OTN supported patients in their home with congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD). The program focuses on coaching patients and better enabling them to self-manage their illness. Substantial reductions in hospitalization and emergency room visits have been demonstrated.
Going forward, OTN's role includes supporting a single, harmonized collaboration model; catalyzing adoption by providers, organizations and clinical programs; and continuing to simplify the process of organizing and doing telemedicine. OTN offers online tools to find consultants, find appropriate patient sites, and book events. Video can now be done from PCs and laptops as well as traditional videoconferencing systems.
OTN will continue to expand the suite of virtual services for use by HCPs and patients. Some possible future ways virtual tools may be used in healthcare:
- E-referral tools will allow referring providers to send meaningful clinical information to consultants. Consultants can then choose to respond by email, request additional information or see the patient using video or face-to-face.
- Patients can send structured/managed emails to their HCP who can respond electronically or do a home video to the patient using their computer.
- Mobile devices will support one tool for care coordination and information sharing, with unique views for the patient, provider and care coordinator.
- Patients can self-monitor their health issues and share the information with their provider.
- Providers will prescribe apps as well as medications to assist in treating illness.
- Individualized, integrated patient care pathways will be technology enabled.
These new tools will become effective when they are fully integrated into a receptive health care system. There needs to be new processes that support collaborative care amongst all community health care agencies, community-wide technology solutions that support the process, and leadership to lead the change.
