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READ this article..According to Healthline.com and Investo-pedia, CareClix is ??the best telemedicine company in the USA in 2018. The range of what they do is truly amazing! This company managed to gather many doctors in the United States, bring them together with patients, and even connect Medicare, Medicaid and some other insurance services. It is not enough, but they have gone much further! From the existing doctors in the system, you can create a virtual clinic under your brand and start your own telemedicine business. You can buy a set of equipment from CareClix or a ready-made “medical office” of fourteen medical devices approved by the FDA, and install it, for example, at school so that children can receive medical care immediately at the time of treatment.

http://bit.samag.ru/archive/article/2113.


Remote connection established 1
Doctor_Aybolit> Remote connection establishedFree medicine of the USSR was a unique phenomenon, the value of which everyone realized only years later. Adapting in the capitalist world, we realized that health is a very expensive product, often simply unaffordable for the majority of the population. Will telemedicine be able to bring back the “bright past” times?

Telemedicine and everything connected with it, quite recently, was some kind of essence from the future, something absolutely useful, but at the same time complex and incomprehensible. To treat people through the Internet, using modern concepts of information and communication technologies, is an extremely tempting idea, which, despite its rather long existence, still raises many questions and doubts.

Despite the fact that universal coverage of telemedicine services seems to us somewhere in the distant future, in 2015 the international non-profit organization Cochrane 2 published an interesting document. This report assessed the effectiveness, acceptability and cost of interactive telemedicine, "provided in addition to conventional medical care or as an alternative to conventional medical care, compared to conventional medical care." The document states that in a sample of 93 studies conducted, the use of telemedicine led to either the same results as during personal visits to a doctor (for example, in treating heart failure), or better care (for example, in controlling blood glucose levels in people with diabetes) [1].

One of the main problems of telemedicine for a long time was the lack of understanding of how this thing should look like. There are at least five parties interested in the remote treatment of patients: patients, doctors, insurance companies, integrators of information and communication services and the government. It is quite natural that each participant has his own, well-founded views on what telemedicine should be. It is logical that these views absolutely do not coincide, because their carriers think in completely different planes. And now we are talking not so much about Russia, but about the rest of the world.

Taking a step to the side, let us ask ourselves an abstract question: how to invent something new? The easiest way is to adapt something that is already clear and known to the novelty. For example, the process of hanging an internal combustion engine on horse-drawn vehicles proceeded along the path of direct replacement of a horse with a motor. As it turned out, it is not as easy as you would like. It was necessary to invent not just a new design with a steering wheel, cardan and gearbox, but also to create an infrastructure unseen before, with special roads, road services, traffic lights, etc.

The introduction of telemedicine in the early stages also took place according to the principle “we will pull out the horse, and in its place we will insert the kerosene unit!”. Initially it was assumed that the doctor, as before, will begin to receive patients in the same clinic where he has been working for many years, with the only difference that this will happen by teleconference and the patients simply will not come to the appointment personally. However, as the experience of the past few years has shown, minimal changes in the work of doctors and the installation in their workplace, say, Skype as a working tool is indispensable.

First of all, telemedicine has generated a number of completely new problems that doctors have never had to face before. The most important of them can be called psychological. Patients want, as before, to see the doctor and talk with him live. Will the doctor be attentive to the visitor's illness if this is a virtual visit?

Americans would not be by themselves if they did not investigate the difference between “teletechnik and medicine simply and would not write a scientific article on this subject. The essence of the experiment was that from 2016 to 2017, a group of patients was selected consisting of 5,500 people, which were divided randomly into two parts. Patients in the first cohort received telemedicine services, and participants in the second were treated exclusively through personal visits by the doctor. The diagnoses, the material well-being of the patients, the regions of the country and many other factors were taken into account and appropriately correlated. The findings are interesting.

Within two weeks, patients from the telemedicine group were seen by doctors in emergency cases 1.3% and the usual 6.6%. In the group of personal emergency visits was 1.1%, and the usual 5.1%. That is, the frequency of requests was about the same. Doctors who examined patients remotely prescribed fewer antibiotics (36.1% of visits) than those who saw patients in the office (40.1%). The most interesting factor in this study is the cost of visits. Telemedicine consultations, taking into account the cost of working time of doctors, cost each patient $ 38 on average against $ 114 for the confrontation. That is, from the point of view of the quality of services, there is practically no difference, but the economic benefits of the “telecounter” are obvious.

Telemedicine and Globalization
Let's think about some more things that may seem fantastic now. Today, to get an appointment with certain medical professionals, we have to wait. Sometimes long. However, what if the required specialist accepts right now, say, in Sydney or Madrid? Suppose that a foreign language is also not a problem: the emergence of publicly available voice translators in real time is a matter of the next few years. Now we are all for some signs assigned to a specific medical institution and an insurance company. But assuming that there is no more centralization? What happens when anyone can make an appointment with a doctor anywhere? The competition among doctors is growing by an order of magnitude, plus to everything, it will become global. A young endocrinologist from the Volga region will compete with a professor from Moscow or Dusseldorf.

With such a level of globalization, the issue of payment for medical services, insurance and insurance companies will be very acute. It will be much more difficult to find out personally which clinic will agree to take your medical insurance card specifically. Probably, some kind of financial and insurance metastructure should arise, the main task of which will be accounting and coordination of insurance payments.

Everything looks so that today's familiar health structure is unlikely to harmoniously fit into the new reality of the near future. What will come in return? Apparently, these will be aggregators, like CareClix.

According to Healthline.com and Investo-pedia, CareClix is ??the best telemedicine company in the USA in 2018. The range of what they do is truly amazing! This company managed to gather many doctors in the United States, bring them together with patients, and even connect Medicare, Medicaid and some other insurance services. It is not enough, but they have gone much further! From the existing doctors in the system, you can create a virtual clinic under your brand and start your own telemedicine business. You can buy a set of equipment from CareClix or a ready-made “medical office” of fourteen medical devices approved by the FDA, and install it, for example, at school so that children can receive medical care immediately at the time of treatment. Convening

Unlike many other aggregators, CareClix is ??ready to provide assistance even to our compatriots. For the sake of interest, I registered on their website. If you want to experiment, you need a Clinic ID, it should be specified CC1216. I have no idea what this means, but without these "magic" numbers you cannot create an account.

Another unusual area in which CareClix is ??also trying to succeed is investment. Due to the transparency of the processes provided by the software platform, this company is a convenient tool where you can invest money and make a profit. The annual turnover of the company, by the standards of the United States, is small, only $ 8 million. Nevertheless, in terms of "the share of turnover per employee" (eng. Revenue per Employee, RPE), they take the first place with $ 400 thousand per person against $ 200 thousand from most competitors.

If you try to look into the near future, the use of telemedicine services aggregators can provide another advantage. Experimental modern medical systems of artificial intelligence used for diagnostics are now tied to certain locations. Somewhere the AI ??is engaged in pulmonology, elsewhere in psychiatry. The aggregated network of medical services makes it easy to connect and use AI systems, along with human doctors. It is likely that this will further reduce the cost of using and owning such a structure and is likely to increase the accuracy of diagnosis.

Telemedicine Information Security
Behind the scenes was only one issue - information security. At one time, Candidate of Medical Sciences, Professor E.V. Krivtsova noted that the success of the implementation of telemedicine solutions will depend on whether it is possible to create a simple and universal method that will uniquely identify the remote user [2]. And the conversation is not about traditional logins, passwords and even two-level authentication systems using OTP (eng. One Time Password).

If we are talking about the application of these tools to telemedicine solutions, then all of them do not allow for 100% guaranteed patient authentication, since a pair of login-password and OTP can be used without being tied to a specific person.

On the other hand, traditional biometric characteristics, such as fingerprints or retinal patterns, require special equipment and cannot be accurately obtained and processed without its help.

Why is the question of completely secure authentication so important? For many reasons. First of all, this will avoid medical errors in prescribing treatment. We are all unique. Even twins can react quite differently to the same drug. The physician must be sure that he prescribes the medicine for the person to whom this treatment is intended. The second important point is financial. Insurance companies are unlikely to be happy with the prospect of paying a doctor's appointment, even a virtual one, to a person without insurance, who simply ended up next to the patient and got access to his identification data.

An interesting solution called “The Unified Biometric System” (???) recently presented Rostelecom. Unlike Apple Face ID, which recognizes only a face image and Siri, which is currently used only to distinguish different users, the EBS is a ready-made solution for unique user authentication and provides an error level of 10-7, that is, one wrong solution for ten million Connection to the EBS system is carried out through the portal of state services.

Despite the fact that now this solution only allows opening an account in some banks and is positioned as an authentication platform for financial institutions, it obviously has great prospects! Two-factor authentication of the EBU provides a high probability of correct user identification, and integration with the State services in the future can be a great advantage in working with telemedicine projects.

Obviously, the future of telemedicine belongs to aggregators of medical and ICT services, which will unite doctors and patients, insurance companies and banking structures, training centers, hospitals and intensive care centers. New technologies have enormous potential and will allow access to medical services to such a broad segment of the population that the term “global health” will take on a completely different meaning.