In respect of returning military personnel, John Liebert, MD and William JJ Birnes, PhD, JD published in 2013 a book called “Wounded Minds” where they highlighted the impact of results of the inefficiency of traditional treatment approaches ($32.2 billion annual expenditure for anxiety disorders alone).
These two authors state (page 254) in respect of the use of new suicide prevention initiatives that “Technology aimed at augmenting therapy is another strategy, one designed to overcome some access to care issues in remote areas. Virtual reality and telemedicine are examples”
Anxiety is just one area of medicine that can benefit from telehealth (i.e. substance abuse, depression, etc.)
It would, in my view, be a mistake to limit looking to telehealth to address the behavioral sub-set of conditions that patients can present with or to restrict telehealth to care access in remote areas.
It’s my view we have hardly begun to scratch the surface here.
We need to remind ourselves that the approach to medicine as currently practiced (i.e. fixing problems) is far less efficient than encouraging lifestyles that help to prevent problems from developing (i.e. wellness).
We can use telehealth in the area of treatment planning/monitoring as well as in the area of promoting wellness, with the caveat that no single approach/methodology/technique should replace all others.
Increasing availability of medical devices in the field bring us back to telemetry, a technology that is absolutely pervasive in industry, with origins back in the 19th century (data transmission between the Russian Tsar’s winter palace and army headquarters developed in 1845).
My area of interest in healthcare is in continuity of care (i.e. doing the right things, the right way, using the right resources, at the right places and times).
The foundation for this is twofold
a) there cannot be ten best ways to do something nor should there be only one.
b) healthcare resources are scarce so we need to make efficient use of these.
We can talk on and on about telehealth but it is an area that has many moving parts and these all have to fit together smoothly and seamlessly if we are to make effective and efficient use of this important technology.
Civerex has been a pioneer in providing infrastructure for telehealth.
We had in place in the early 2000’s telehealth Tx planning monitoring software for use in the treatment of anxiety disorders. The communication at the time was purely via telephone, but with call centers in one time zone, providers in another and patients in yet a third time zone, it was important in the appointment booking software module used by call center staff to make sure that providers and patients would “meet” at the right time.
Civerex’s current focus is to provide customers with efficient ways of recording 1:1 telehealth sessions and consolidating video/voice recordings at patient EHRs. We are looking to accommodate live video broadcasts of in-home sessions carried out by clinical staff so that senior staff back at clinics can tune into these broadcasts and provide real-time advice/assistance on the administration of treatment plan protocols.
The owners of Civerex developed in the late 1980’s a software product called RapidTox for the diagnosis of instances of poisoning. We were inspired by the work of Robert Driesbach, MD, who published the 1st edition of Handbook of Poisoning back in 1955.
The foundation of our work on RapidTox was a diagnostic algorithm that was able to identify candidate poisons on the basis of symptoms/signs. Selection of a poison gave the user a list of modalities (treatments that worked) with goals/objectives plus the ability to carry out differential diagnoses.
Our current suite of behavioral/medical software products continue to include the diagnostic algorithm in addition to putting a focus on encouraging consistent use of “best practices” protocols via background orchestration, with accommodation for deviating from these as and when deemed appropriate/necessary, subject to governance. The two core methodologies we use are BPM (business process management) and ACM (adaptive case management).
Another area of interest is promotion of the concept that discharge planning should start with the first incoming phone call.
We have spent a lot of time on providing seamless interoperability by and between our products and local and remote 3rd party systems and applications and we promote for general use, a product called CiverExchange that addresses this need.
Any groups interested in collaborating with Civerex should contact us at 450 458 5601 to highlight areas of interest and be prepared to apply for research grants to fund any proposed initiatives that Civerex may agree to in respect of collaborative undertakings.
We are happy to provide “private label” versions of our software for loading content subject to be of interest to different communities of prospective users.