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Telehealth Best Practices: Stuart Long of InfoBionic On How To Best Care For Your Patients When They Are Not Physically In Front Of You

An Interview With Dave Philistin

Preparation is key. As a patient myself, the clearer the explanation of my ailment along with the healthcare providers instructions being explicitly clear on what is expected of the patient. (Often we just show up to the doctors office unprepared as to what is expected of us).

One of the consequences of the pandemic is the dramatic growth of telehealth and telemedicine. But how can doctors and providers best care for their patients when they are not physically in front of them? What do doctors wish patients knew in order to make sure they are getting the best results even though they are not actually in the office? How can telehealth approximate and even improve upon the healthcare that traditional doctors’ visits can provide?

In this interview series, called “Telehealth Best Practices; How To Best Care For Your Patients When They Are Not Physically In Front Of You”, we are talking to successful doctors, dentists, psychotherapists, counselors, and other medical and wellness professionals who share lessons and stories from their experience about the best practices in telehealth. As a part of this series, I had the pleasure of interviewing Stuart Long.

Stuart Long was appointed CEO of InfoBionic in March 2017. With more than 20 years of experience in the medical device market, Mr. Long brings a great deal of expertise in achieving rapid commercial growth. Prior to joining InfoBionic, he was CEO at Monarch Medical Systems, LLC, a Charlotte-based, artificial intelligence clinical decision support software provider for insulin dosing calculations, where he oversaw the organizational restructuring of the company.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to get to know you a bit better. Can you tell us a bit about your backstory and how you got started?

I got started in my very early youth going on home health visits with my mother who was a home health nurse for a big portion of her career. I got to see the joy, peace of mind and sense of security her patients felt when she arrived… especially with a youngster in tow. I later went to become a certified nurse’s aid in high school and volunteered in local nursing homes. There’s a high degree of influence from these early experiences on my understand and humility toward the human condition. This later led to my earning registries in both Radiology (X-ray & Cat scan) as well as Cardiology in echocardiography (ultrasound of the heart). I worked as a cardiology supervisor and later made the leap to the vendor side where I have worked almost exclusively with leading edge technologies that are first of kind introductions that have proven to vastly improve clinician workflow and ultimately better patient care. (From cardiac video tapes to floppy disk, then from film to digital screens, later from old school client/server IT systems to web-based only systems and then on to first of kind AI in calculating insulin dosing for in hospital patients and ultimately here at InfoBionic for the first cloud based near real-time streaming of remote cardiac ECG’s).

Can you share the most interesting story that happened to you since you began your career?

The most interesting stories are the one’s where a life has been saved or altered in such a positive way from the solution, I’ve been charged with delivering into the market. One that sticks out was during the middle of the pandemic. The largest independent cardiology practice closed all 30+ locations all at once. It was extremely challenging to see patient’s. Yet with some ingenuity and close work with this group, we were able to get our customer’s MoMe monitors out to any patient who needed it. Although the examples are ten fold now, it was the first story of our device working in concert with a telehealth video solution that allow the patient to be virtually monitored in near real-time. The physician’s we’re able to diagnose her symptoms they were having at home. They changed her medication doses and watched to see if her symptoms were relieved. They were initially but then returned. The physician received that alert and decided they needed to get to the hospital so they could implant a device to solve the issue for good. They were able bypass the emergency room and had the patient admitted directly into the hospital in an area not associated with the ER and provide the procedure and get them back home asap. The patient felt as though their life was saved and the physician(s) were very pleased at how they were able to identify, diagnose and ultimately intervene in a brand new care model that didn’t exist even 30 days prior.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

Actually I have two favorites… both linked to each other:

A mistake that makes you humble is much better than an achievement that makes you arrogant. — Anonymous

They may forget what you said — but they will never forget how you made them feel.
— Carl W. Buehner

Given my upbringing followed by both direct patient care and progressive leadership roles on the vendor side I’ve come to appreciate humility as one of the most singular & redeeming quality a person can live authentically in their lives.

No question, people will remember how you make them feel… treating people from a place of humility or arrogance leaves an indelible and nearly permanent impression

Ok wonderful. Let’s now shift to the main focus of our interview. The pandemic has changed so many things about the way we behave. One of them of course is how doctors treat their patients. Many doctors have started treating their patients remotely. Telehealth can of course be very different than working with a patient that is in front of you. This provides great opportunity because it allows more people access to medical professionals, but it can also create unique challenges. To begin, can you articulate for our readers a few of the main benefits of having a patient in front of you?

Being able to assess a patient physically is without question the gold standard. From emotional queues to body language to a sense of trust that would allow a patient to feel comfortable and safe discussing any health issue. Care in some cases can be expedited base on physically being able to assess a physical situation.

On the flip side, can you articulate for our readers a few of the main challenges that arise when a patient is not in the same space as the doctor?

Typically when you go to your doctor you get ‘triaged’. A clinician will take all your vitals and do an initial physical observation. Not being present requires the patient to either collect these on their own or simply not at all. Further the accuracy of in office devices vs what might be in the home can vary greatly as well as how the collection of data is administered. Furter, a clinician can’t look in your ears… or palpate a physical injury either.

Fantastic. Here is the main question of our interview. Based on your experience, what can one do to address or redress each of those challenges? What are your “5 Things You Need To Know To Best Care For Your Patients When They Are Not Physically In Front Of You? (Please share a story or example for each.)

  1. Preparation is key. As a patient myself, the clearer the explanation of my ailment along with the healthcare providers instructions being explicitly clear on what is expected of the patient. (Often we just show up to the doctors office unprepared as to what is expected of us).
  2. Invest in a high quality (doesn’t mean expensive) BP monitor/cuff, weight scale, thermometer and depending on your condition, and SpO2 (blood oxygen) monitor, all available at your local pharmacy.
  3. For the providers, make it clear what you expect your patients to do. For patients, be explicit about your condition. In most (not all) you will take your vitals just before your eVisit. A good example here is in a cardiology virtual visit, these vital signs are very important. Yet for dermatology assessment of say a mole you have a question about, vitals may not be required.
  4. As far as the virtual visit itself… be on-time, my personal experience is that I’ve never had to wait on the doctor (compared to siting in the office well past an appointment time.
  5. Make sure you have a good internet connection, especially if you’re using video and ideally be in a place that is well lit
  6. Lastly, trust your caregiver that the virtual visit is appropriate and valuable. They will know when you book your appointment if it should be in person or not.

Can you share a few ways that Telehealth can create opportunities or benefits that traditional in-office visits cannot provide? Can you please share a story or give an example?

I think the quality of care equals the care we get in our typical first encounter office visit as well as the many possible follow up visits.

Virtual care has proven to be very efficient. For the patient’s.. just the travel time alone. If you live in a rural area, this is especially valuable. The cost of travel and time of getting to and from the appointment, not to mention the time lost waiting in the doctor’s office. I’ve hear story after story about how much time is saved where I patient would take the day to get to their doctor, only to spend 10–15 minutes with them and then the rest of the day getting back home. Removing all the complexity and still getting the 10–15 minutes from the comfort of your home has very high value to any patient. The good news is patients can be both quality and convenience with telehealth visits.

Telehealth offers better access to care, especially for people in rural areas or areas

Telehealth saves healthcare entities a lot of money. A new study showed that using telehealth to access patients, rather than having them travel to an emergency department, saves as much as $1,500 per patient.

Patients using Telehealth also save money; the national median cost for a telehealth virtual visit is around $50, while in-person visits typically cost between $85 and $740, depending on the patient’s needs.

Telehealth utilization can actually strengthen the patient-provider relationship, since these technologies increase rates of communication and provide access to clinical data immediately, from any location.

Let’s zoom in a bit. Many tools have been developed to help facilitate Telehealth. In your personal experiences which tools have been most effective in helping to replicate the benefits of being together in the same space?

Video is a key asset in a telehealth. Being able to visually see your patient goes an exceptionally long way. Past this, any type of vital signs monitoring data that physician can review remotely is equal in value.

If you could design the perfect Telehealth feature or system to help your patients, what would it be?

A system that allows a patient to be monitored remotely with both video and connected devices in ‘periodic’ phases. Meaning one time per month, two times… or even weekly for conditions with low complexity. Yet the best system would have the ability to go to ‘always on’ with data streaming, smart clinical and physician notifications that could be ordered for immediate application to treat higher complexity or newly forming urgent conditions that a ‘periodic’ system would not be capable of managing. Just like in the hospital, you have an ER (triag), and ICU for very sick patients and step-down or med surg units for less severity… the best telehealth system would employ as facets similarly to a hospital.

Are there things that you wish patients knew in order to make sure they are getting the best results even though they are not actually in the office?

Physician and care provider transparency and quality measures are important for patients to consider, especially when they have a choice. Yet not everyone has a choice.

If you’re being treated expeditiously and your condition is being treated to expectations, then there’s little know more than your provider and your treatment plan are working.

Yet for those who might begin to form questions or concerns, a quick Google search for “second opinion” will reveal a growing segment where companies provide a qualified physician to give you a ‘second opinion’

The technology is rapidly evolving and new tools like VR, AR, and Mixed Reality are being developed to help bring people together in a shared virtual space. Is there any technology coming down the pipeline that excites you?

There is a long line of failed innovations in healthcare… its easy to get excited, yet to find healthcare just isn’t ready of it. Yet with the rapid adoption of telehealth, the technology to not just bring people into a shared space, yet the technology to provide in-hospital level care all the way to the home is what excites me the most. This has the largest ability to provide equitable care to all of us… to me that’s a game changer.

Is there a part of this future vision that concerns you? Can you explain?

Healthcare is notoriously slow to adopt… the pandemic has changed Telehealth and Virtual Care overnight in a very positive way… yet the dream of ubiquitous & equitable care for all is an uphill push:

There are still large variations in legal and regulatory rules, regulations, and guidelines for practice

Currently, a lack of multistate telehealth licensure means that physicians cannot provide medical services across certain geographic barriers.

Providers cannot perform comprehensive physician examinations via telehealth, making in-person office visits necessary. Remote patient monitoring devices can offer physicians information on the patient’s vital signs, but there is no comprehensive device nor one that goes subtantially beyond blood pressure, temperature, oxygen levels, glucose levels, cardiac rhythm, and pulse.

Technical difficulties may make using telehealth especially difficult for certain patients, such as the elderly.

Greater privacy and security risks may turn some patients away from these technologies.

The accuracy of data transmission may be compromised depending on factors such as Internet bandwidth.

Ok wonderful. We are nearly done. Here is our last “meaty” question. You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

As I’ve noted… equitable and affordable care for all. If there is a way to bring quality care to all those who need it… now’s the time to capitalize on the forces in play

How can our readers further follow your work online?

www.infobionic.com

Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.

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