Can Telemedicine Help My Mother?

Mom turned 90 this year.  She is in relatively good health with no life-threatening illnesses.  She lives in a well-appointed independent living facility about 30 minutes from my home.  In the past few weeks I have taken Mom on several medical appointments and having been involved in telemedicine for close to 30 years, I ask the question, could telemedicine help?

Mom is not computer savvy, not that she doesn’t want to be.  Dad was the user of the family computer until he passed away ten years ago.  If he had taught Mom how to use his computer, we wouldn’t be in the situation we are in in today.  I have tried to get Mom on line with both the PC and a tablet.  Poor hand-eye coordination and a shrinking attention span have made this task impossible.    She uses a flip phone rather than a smart phone and likes the Jitterbug from Greatcall (https://www.greatcall.com/) because “it has big buttons and a big display”.

Mom has several medical conditions that need regular attention.  She has macular degeneration in her eyes, a severe hearing loss, and an increasing complex orthopedic condition with both feet.  Let’s see how telemedicine could help.

Mom gets regular injections to prevent her macular degeneration from getting worse.  No telemedicine there.  But tele-ophthalmology is now becoming an available service.  In New York City, Columbia Ophthalmology is taking the fight against the leading causes of blindness out of the traditional clinic and onto the streets. The Department’s new mobile tele-ophthalmology unit will be serving neighborhoods with populations at high-risk for eye disease.   https://www.columbiaeye.org/Tele-Ophthalmology.

Mom has been wearing hearing aids for the past two years and it’s been a struggle.  The biggest challenge has been learning how to properly put in the hearing aids.  An on-line video showing how to install the hearing aids is available (https://www.youtube.com/watch?v=XmlIJCIF-ys&list=PLAEwIo2bHQMwzpOQK–L6VbGFkAccRb4J&index=3) but this assumes one can get on line.  Another advance has been new technology for hearing testing.  dB Diagnostics (http://www.dbdsys.com/) is a startup that has developed a hardware/software system that enables medical providers to test their patients for hearing loss.  If hearing loss is caught early-on, learning the proper use of hearing aids would be most beneficial.

To help treat her orthopedic condition, she needed to go to a nearby imaging center for x-rays of her feet.  While the local radiologists were happy to send the podiatrist their report, they didn’t want to send the images.  I asked for a CD with the images and hand delivered it to the podiatrist.  An image sharing service like https://www.lifeimage.com/ would have made this much simpler, and I’m sure my friends at www.teleradiologyspecialists.com would have been happy to review the images and write the report.

Even though Mom is surrounded by many peers at the Independent Living facility, she still misses her family.  A telemedicine system should easily enable video visits, cut down on transportation for medical appointments and enable remote monitoring should a condition become chronic.

So, here’s my wish list for Mom, or for other mostly independent seniors who could use a technology boost:

• An easy to use system that perhaps uses her home television as the primary screen with a very easy to navigate user interface (touch screen?)
• Easy ability to include family members in on-line visits.
• Ability to schedule appointments with all her providers and the ability to speak to them on-line when needed.
• Appointment reminders.
• A list of her current medications which can be shared electronically with a new provider when an appointment is made.
• Medication reminders.
• No more clipboards!
• Ability to monitor her apartment and send an alert in case of a fall.
• An individual physically in her facility that is comfortable with the technology and can provide on-site assistance when necessary (not sure who pays for this)
• An on-line assistant who can guide her through any technical issues.
• A complete revision of out-of-date Medicare regulations regarding telemedicine reimbursement (because CMS will actually be saving money when systems like this are in full use.)

I am confident that this service will be in place within the next ten years.  Perhaps not is time to help my mother.  Surely in time to help me navigate an increasingly complex medical system as my own needs continue to change.