Congressional Budget Office,Harvard Medical School,RAND Corporation,telemedicine

Use of telemedicine for mental health in rural areas on the rise but uneven

Newly published research by Harvard Medical School and the RAND Corporation reveals a dramatic growth in the use of telemedicine for the diagnosis and treatment of mental health disorders in rural areas, but strikingly uneven distribution of services across states.

The results, published in Health Affairs, stem from analysis of telemedicine use among Medicare beneficiaries nationwide over10 years.

The study shows an average 45 percent jump per year in telemedicine visits between 2004 and 2014, among rural patients, with striking variation across states. Four states had no such visits in 2014, while in nine states, there were more than 25 telemedicine visits per 100 patients with serious mental illness.

The reasons for the dramatically uneven distribution remain unclear, but the study investigators say state laws that regulate the provision and reimbursement of telemedicine services for mental health appear to play some role.

“Our results highlight the growing importance of telemedicine in the treatment of mental health disorders in rural settings where access to mental health care is often problematic,” said study lead investigator Ateev Mehrotra, associate professor in the Department of Health Care Policy at Harvard Medical School.

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mobile health,Primary Care Providers,Remote monitoring,Wearable devices

Can technology transform chronic disease management?

Implementing best practice care for patients with chronic diseases is one of the greatest challenges currently facing primary care providers. Although digital health technology is hailed for all its potential, could it improve the ability of primary care and internal medicine specialists to help these patients?
Doctor looking at ipad
Remote monitoring connects doctors and patients, but does it actually improve care?

In the United States, around half of all adults have at least one chronic health condition, such as heart disease, stroke, cancer, type 2 diabetes, obesity, or arthritis. Treatment for these conditions accounts for as much as 86 percent of national healthcare spending.

Cue digital health technology, which includes remote monitoring, mobile health (mHealth) apps, and wearables, such as activity trackers. There are myriad options on the market, but are any of these particularly beneficial for use by the healthcare professional?

Medical News Today asked primary care and internal medicine specialists how they use digital health technology in their daily practice and about their views on its potential for revolutionizing chronic disease management.

While they acknowledged that new technology has great potential to provide high-quality care, they did not hesitate to emphasize the barriers that prevent its widespread uptake by clinicians and patients.

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cystic fibrosis,Stanford University School of Medicine,sweat sensor,University of California-Berkeley,wearables

Wearable sweat sensor can diagnose cystic fibrosis, Stanford-led study finds

A wristband-type wearable sweat sensor could transform diagnostics and drug evaluation for cystic fibrosis, diabetes and other diseases.

The sensor collects sweat, measures its molecular constituents and then electronically transmits the results for analysis and diagnostics, according to a study led by researchers at the Stanford University School of Medicine, in collaboration with the University of California-Berkeley. Unlike old-fashioned sweat collectors, the new device does not require patients to sit still for a long time while sweat accumulates in the collectors.

“This is a huge step forward,” said Carlos Milla, MD, associate professor of pediatrics at Stanford.

The study has been published online in the Proceedings of the National Academy of Sciences. Milla shares senior authorship with Ronald Davis, PhD, professor of biochemistry and of genetics at Stanford. Former Stanford postdoctoral scholar Sam Emaminejad, PhD, and UC-Berkeley postdoctoral scholar Wei Gao, PhD, are co-lead authors.

How does it work?

The two-part system of flexible sensors and microprocessors sticks to the skin, stimulates the sweat glands and then detects the presence of different molecules and ions based on their electrical signals. The more chloride in the sweat, for example, the more electrical voltage is generated at the sensor’s surface. The team used the wearable sweat sensor in separate studies to detect chloride ion levels – high levels are an indicator of cystic fibrosis – and to compare levels of glucose in sweat to that in blood. High blood glucose levels can indicate diabetes.

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