Specialists use telemedicine for pregnancy consultations FEATURES

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Specialists use telemedicine
for pregnancy consultations
July 2010
July 2010
Vol. 16Vol.
No.17No.
7 11
FEATURES
New on the ‘net
by Cynthia Johnson
5
■■ iPhone
4 contains
helpful features
for healthcare
professionals
■■ CMS
updates
telemedicine guidelines
■■ AHRQ
releases software
to build hospital quality
website
Healthcare guide
to the Internet
■■ Obstetrics
10
■■ Telemedicine
17
Site of the month
24
■■ The American Pregnancy
Association is a national
organization that
promotes reproductive
and pregnancy wellness
through education,
research, advocacy, and
community awareness.
It was founded in
1995 by a couple in the
adoption process who
recognized the need for
access to information
on reproductive and
pregnancy health.
A HealthLeaders
Media publication
While some companies give birth to new
ideas, like Apple® releasing of the iPad™,
Chattanooga-based BlueCross BlueShield of
Tennessee Health Foundation has an idea that
helps women give birth. In January 2009, the
nonprofit organization funded a $1.8 million,
three-year pilot project to determine whether
telemedicine technology could provide effective
perinatal consulting services to women who have
high-risk pregnancies and live in rural areas of
Eastern Tennessee.
Maternal fetal medicine specialists and healthcare professionals at Regional Obstetric Consultants (ROC) of Chattanooga and Knoxville offer
care to women with high-risk pregnancies. However, women living in the valleys and mountains
of Eastern Tennessee would frequently miss appointments because of the travel and time required
to get to the offices. These missed appointments
sometimes resulted in increased health-related
problems in both mother and child.
To improve patient outcomes and access
to care, ROC collaborated with the nonprofit
Community Health Network to form Solutions
to Obstetrics in Rural Counties (STORC).
The goal of the BlueCross BlueShield–funded
project is to use videoconferencing technology
by New York City–based TANDBERG (www.
tandberg.com) to connect rural patients with ROC
specialists.
“It’s about bringing an individual with
highly specialized knowledge and being able
Main Image
PLEASE BE AWARE
Color scheme will
change depending on
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to access them in a very timely fashion,” says
Joe D’Lorio, manager of healthcare services for
TANDBERG.
Have specialist, don’t travel
An obstetrician may refer a patient to STORC
because she has a high-risk condition, such
as multiple gestation, diabetes, or a suspected
anomaly with the fetus. Even though BlueCross
Blue Shield of Tennessee Health Foundation
funds the project, it is open to any patient referred by any doctor regardless of the patient’s
insurance situation.
“We’re so grateful to the BlueCross BlueShield
of Tennessee Health Foundation for ­providing
continued on p. 2
A HealthLeaders Media publication
Telemedicine
continued from p. 1
funds for programs like this,” says Debbie Lance, director of
the STORC project. “There are organizations out there that
are looking to be able to help.”
ROC uses a computer-based system to schedule appointments just as other offices do, but with the added variable of
different locations. It blocks time for the remote locations,
and nurse practitioners can make adjustments depending on
patient volume and need.
On the day of the appointment, a nurse practitioner and a
sonographer from ROC meet with the patient at his or her
local hospital or physician’s office.
“We can be in a hospital setting where they give us an
exam area to set up the equipment, or we can be in a physician’s office,” says Lance. The equipment at the remote
location consists of videoconferencing technology, a display
monitor, and a laptop.
During a typical visit, the nurse practitioner takes the patient’s history and the sonographer performs the ultrasound.
Then they transmit the ultrasound images to one of the hub
sites, where the consulting physician views the images on an
oversized screen in an exam room.
The consulting physician can look at the patient, the nurse
practitioner, and the sonographer on a videoconferencing
screen and review the ultrasound images with them. It’s also
Editorial Board
Group Publisher: Matt Cann
Senior Editor: Carrie Vaughan
[email protected]
Editor: Cynthia Johnson
possible for the specialist to guide the sonographer to take
additional views of the fetus with the ultrasound.
Bringing specialty services to the patient’s location has
made a huge difference in reducing the number of appointments missed. “Patients are compliant with actually keeping
that appointment,” Lance says. Since the launch of the project, STORC has logged a mere five missed appointments by
mothers who had already delivered their babies at their hometown hospitals.
Providing accessibility to specialist care so patients can deliver at their local hospital is one of the goals of the program,
and, according to Lance, the project has had “tremendous
success” in this area. “Normally, the outcome would be that
they wouldn’t necessarily get the care they needed,” she says.
“Most of these babies would probably have to be transported for delivery. The fact that they’re able to stay with their
support system in their local hospital is amazing.”
Thinking beyond telemedicine
In addition to consults with specialists, the telemedicine
tools also allow genetic counselors and diabetic educators to
connect with patients. This eliminates the wait time between
appointments with the counselor or educator, the specialist,
and the referring obstetrician. It also eliminates the use of
letters and phone calls to communicate a patient’s status.
“It’s the immediacy of bringing that genetic counselor in
and having the doctor, the specialist, the patient, and the
MICHAEL J. ACKERMAN, PhD
National Library of Medicine, Bethesda, MD
DOUGLAS E. GOLDSTEIN
President
JOHN S. LUO
Assistant Professor
ACE ALLEN, MD
CEO
Medical Alliance, Inc., EHealthcare.net,
Alexandria, VA
University of California, Los Angeles
Today Communications, Inc., Shawnee Mission, KS
THADDEUS GRIMES-GRUCZKA
Independent Pharmaceutical and e-Health
Strategist
NAOMI BROERING
Library Director
President
American Association for Technology in
Psychiatry
New York, NY
DALE O’BRIEN, MD, MPH
Medical Director
JANE A. JACOBS
Managing Editor
Lorenzen Cancer Foundation,
Pacific Grove, CA
AHA Resource Center, American Hospital
Association, Chicago, IL
Mayoclinic.org, Mayo Clinic,
Rochester, MN
AHMAD RISK
eHealth and Health Informatics Consultant
WILLIAM M. DETMER, MD, MSc
President & CEO
DONNA L. KURKUL, MLS
Information Specialist, Author, and Consultant
W.C. Herrick Community Health Care Library,
La Mesa, CA
DIANA CULBERTSON
Unbound Medicine
Hadley, MA
Clinical Assistant Professor
University of Virginia, Charlottesville, VA
MARK LEAVITT, MD, PhD
Chair
ROSALIND F. DUDDEN, MLS, DM/AHIP, FMLA
MedicaLogic, Hillsboro, OR
Gerald Tucker Memorial Medical Library,
National Jewish Medical and Research Center,
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Brighton, England
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University of Oklahoma Health Science
Center, Oklahoma City, OK
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Basil Strategies, Paris, France
Katherine Stemmer Frumento
Director of Library Services
Greenwich Hospital, Greenwich, CT
Medicine on the Net® (ISSN: 1085-3502 [print]; 1937-7606 [online]) is published monthly by HCPro, Inc., 200 Hoods Lane, Marblehead, MA 01945. Subscription rate: $229/year; back issues are available at $25 each. • Copyright © 2010 HCPro, Inc. All rights
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A HealthLeaders Media publication
genetic counselor all talking about patient-centric issues
wherever they may be,” says D’Lorio, who describes it as a
“tremendous value proposition.”
Hometown obstetricians are also beginning to attend
events and earn continuing medical education (CME) credits
using the technology. “If you consider a physician in a little
town, there may only be two obstetricians there,” says Lance.
“This means they have to share calls for each other. It would
be very difficult for them to get out to a conference in San
Francisco to get the CMEs they need.”
STORC, recognizing the need for such education services,
recently completed its first grand rounds across the network.
It brought a speaker to the ROC Chattanooga location and
had both live and remote event participants.
“We had about 11 different locations which were linked via
the telemedicine connectivity,” says Lance. “They were watching real time. They were able to ask questions. They were able
to get CME credit for it and it’s right there in their local area.”
Over the next year and a half, Lance says STORC will
expand this program and hold events more frequently to
help further relationships between specialists and physicians
involved in the project.
Nurse practitioners have identified another possible application for the technology. They have suggested networking
patients from several locations for an evening event where
they could talk with one another about their common concerns. Lance says it would allow patients who share diagnoses to realize that they’re not alone.
According to Lance, some of the facilities may not have had
any telemedicine services prior to the project. “It has opened
a door for them to explore other ways they could apply this
technology, and we’re helping them with that,” she says. For
example, the Tullahoma site recently used its videoconferencing tools to connect an overseas military father with his wife’s
hometown hospital so he could “attend” the birth of his child.
“We see video communications really streamlining and changing the way a number of businesses do work,” says D’Lorio.
“We see that telemedicine is having an impact in changing the
way that healthcare is delivered in just a very positive way.”
A virtual handshake
When patients learn that their specialist will be using telemedicine services for their appointment, the typical reaction
is, “What is it going to cost me?” For example, one patient’s
spouse commented that the services made it possible for him
to be present for his wife’s ultrasound without taking time off
work; however, in the middle of the visit, he asked whether the
services were going to cost him more, says Lance.
“We were able to say no,” she says. Then the clinicians
pointed out that the appointment would be less expensive
for the couple because it eliminated their travel expenses.
“It’s about bringing an individual with highly
specialized knowledge and being able to
access them in a very timely fashion.”
—Joe D’Lorio
Satisfaction surveys reveal that patients are pleased with
the improved access to care, says Lance. One may think that
the experience would be anything but intimate, but patients
supported the use of videoconferencing tools, she says.
In fact, one nurse practitioner reported that at the end of
an appointment, a patient stood to shake the hand of a specialist with whom she was “meeting.”
“You’re that connected and it’s that real to them,” says
Lance.
Hometown hospitals and referring physicians have been
equally pleased and appreciative of the services, she says.
The referring physicians have built relationships with ROC
specialists, and they feel comfortable reaching out to them
should they need to discuss a patient’s case further.
From credentialing to reimbursement
Lance is responsible for building the relationship between
the specialists and local obstetricians—discussing their needs
and describing how the program will work. She also works
on credentialing ROC clinicians who provide care and make
decisions for patients at the remote hospitals. (Credentialing
is not necessary if the appointment occurs in a physician’s
office or a clinic.)
“The business of healthcare mandates that medical professionals be licensed in the state in which they’re delivering
medical care and that they are credentialed and verified with
medical centers,” says D’Lorio, adding that telehealth must
conform to those rules as well.
continued on p. 4
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July 2010 Medicine on the Net® 3
A HealthLeaders Media publication
Telemedicine
Adding services and onboarding others
continued from p. 3
“We see a lot of programs emerging that really illustrate
bringing the right talent to the right place at the right time
and the value proposition behind that,” says D’Lorio.
For example, STORC recently added neonatology to its
offerings because of the success it has experienced delivering
perinatal services. Now, a neonatologist can look at a baby
born at a rural hospital and determine whether the hospital
needs to transport the baby for care or whether the baby can
continue to receive care at the hospital.
“Neonatology is one of the medical specialties that might
be prevalent in the academic university, but in the rural hospitals and even in the suburban hospitals, it’s a hard specialty
to maintain,” says D’Lorio. “Video has become a wonderful
mechanism to provide it.”
STORC is also sharing its best practices with other communities interested in developing similar programs in places
such as North Carolina and Georgia.
“It’s something that we’re pioneering along with other
areas around the country, and we’re certainly willing to
help any areas who have questions,” says Lance. “We’re
happy to network and share all of the information that
we’re learning. It is the way of the future, and it seems to
make a difference.” H
On May 26, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule in the Federal Register—
and opened it to public comment—that could simplify this
credentialing process for hospitals. The rule states that hospitals, including critical access hospitals (CAH), will soon be
able to use credentialing and privileging information about
telemedicine providers from the remote location. Previously,
CMS allowed hospitals and CAHs to accept credentialing
information about telemedicine providers from the distant
site, but not privileging information.
Under current CMS regulations, hospitals receiving telemedicine services must privilege each physician or practitioner
providing services to their patients as if the practitioners were
on-site. This process had been simplified: Hospitals that were
accredited by The Joint Commission (formerly JCAHO)
were deemed to also have met Medicare’s Conditions of Participation—including credentialing and privileging requirements—
under the Commission’s statutory deeming authority.
But with the passage of the Medicare Improvements for
Patients and Providers Act of 2008, the statutory recognition of The Joint Commission’s hospital accreditation
program is ending effective July 15. With this change, small
hospitals and CAHs using telemedicine services could face
the burden of privileging specialty physicians that academic
medical centers make available to them.
“We’re glad to hear that there is a change because that will
help us and many other telemedicine providers,” says Lance.
“There used to be reciprocity for different Joint Commission–
accredited hospitals. Medicare was saying as of July 15 this
year they weren’t going to allow that. They’re sort of putting
it back in place for the purpose of telemedicine.”
In terms of reimbursement, the STORC program receives
payment for services from all but one carrier, which may be
experiencing a paperwork glitch. Lance states that all of the
other patient insurers are paying and that they are not experiencing any problems.
D’Lorio describes reimbursement as an “emerging issue.”
Twelve states currently mandate that private insurers reimburse for telemedicine services, he says. Medicare and Medicaid programs work on a national level, so they create their
own reimbursement rules.
Long-term goals
At the end of the STORC project’s first year, the specialists
at the two hub sites had served nearly 150 patients at five
remote sites in Cookeville, Tullahoma, McMinnville, Newport,
and Winchester, TN. In the first quarter of this year, patient
volume increased by 229%. STORC has already set up connections at two more locations in Jellico, TN, and Dalton, GA,
and will start providing patient care in those locations soon.
The long-term goals of the project are to:
»» Connect 11 rural sites in Tennessee
»» Reduce cost of care
»» Reduce unnecessary patient transportation
»» Reduce unnecessary hospitalizations
»» Reduce days of neonatal ICU stays
»» Lower infant and maternal mortality rates
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A HealthLeaders Media publication
New
on the’net
Joint Commission pushes back
telemedicine requirements
The Joint Commission has pushed
back its plan to implement CMS
telemedicine standards for hospitals
(both acute and critical access) until
March 2011, according to an official
announcement from the accrediting
body.
Originally slated for implementation July 15, The Joint Commission
(formerly JCAHO) had intended to
add new elements of performance
that would bring the organization’s
requirements more in line with CMS
standards for telemedicine services,
specifically for the credentialing and
privileging of telehealth providers.
CMS issued an extension to The
Joint Commission because CMS has
proposed changes to telemedicine
requirements that will affect the
organization’s own standards and
change the requirements The Joint
Commission intends to implement,
according to a HealthLeaders Media
article.
The accrediting body has maintained a belief that CMS’ telemedicine requirements did not provide
sufficient improvement of quality
or safety to warrant the amount of
work they placed upon hospitals for
­compliance.
Hospitals can comment on the
proposed CMS rule changes until
July 26.
Three Philadelphia-area awards
for electronic patient records
Three Philadelphia-area healthcare
groups were awarded federal money
to adopt electronic patient records.
The recipients were the Health Federation of Philadelphia, $327,169;
Southern New Jersey Family Medical Centers, Inc., Hammonton, $3
iPhone 4 contains helpful features for healthcare professionals
The recent unveiling of the
iPhone® 4 is good news for those
in healthcare. According to a
HealthLeaders Media article, the
latest version of the smartphone
contains high-definition video and
four times as many pixels. These
advances may help drive medical apps for things such as:
»» Viewing high-resolution surgical procedure training
»» Listening to digital heart sound recordings
»» Analyzing 3-D scientific images
»» Researching clinical trials applications
million; and Southbridge Medical
Advisory Council, Inc., Wilmington,
$558,114, reports The Philadelphia
­Inquirer.
They are among 45 groups nationally that will receive a total of $83.9
million from the 2009 economic stimulus package.
Should doctors be exempt from
the FTC’s Red Flags Rule?
The Federal Trade Commission’s
(FTC) Red Flags Rule requires businesses offering credit to come up with
a written policy for finding, preventing,
and dealing with identity theft.
According to The Wall Street Journal’s
Health Blog, the law is controversial
and has been delayed several times, including when the FTC pushed off the
implementation originally scheduled
for June 1 until December 31.
The American Bar Association sued
last year, saying that the law shouldn’t
apply to lawyers, and a judge agreed.
Now, the AMA is making a case
for exemption. The group and two
others—the American Osteopathic
Association and the Medical Society
of the District of Columbia—sued
the FTC, arguing that physicians
should not be subject to the rule, the
blog reports.
CMS updates telemedicine guidelines
Hospitals and critical access hospitals (CAH) will soon be able to use
credentialing and privileging information about telemedicine providers
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July 2010 Medicine on the Net® 5
A HealthLeaders Media publication
New on the ’net
GE invests $5 million in heart disease test maker
General Electric Co.’s
healthcare unit has announced a partnership with
CardioDx, which develops genetic tests that are
used in diagnosing heart
disease. According to an
Associated Press article,
GE Healthcare, which
makes diagnostic and medical imaging products, said it invested $5 million in
­CardioDx through an equity fund that invests in healthcare technology companies. ­CardioDx makes genetic tests that can be used in treatment of people with
conditions including heart failure and coronary artery disease.
from the remote location, according to
proposed CMS changes to the Conditions of Participation.
According to a HealthLeaders
Media article, CMS had previously
allowed hospitals and CAHs to accept credentialing information about
telemedicine providers from the
distant site, but not privileging
information.
In its proposed rule, the agency
states:
CMS has become increasingly aware,
through outreach efforts and communication
with various stakeholders in the telemedicine
community ... of the urgent need to revise
the CoPs in this area so that access to these
vital services may continue in a manner that
is both safe and beneficial for patients and is
free of unnecessary and duplicative regulatory
impediments.
Additionally, CMS cites smaller
hospitals’ lack of clinical expertise
to evaluate a variety of privileges as
one of the reasons why a change was
needed.
The proposed rule was published
May 26 in the Federal Register for public
comment. The public can submit comments to www.regulations.gov during a
60-day comment period.
Healthcare IT providers to merge
AllscriptsMisys Healthcare Solutions, Inc., and Eclipsys Corp. have
agreed to merge in an all-stock deal
valued at about $1.3 billion.
According to a Wall Street Journal
article, the move creates an entity
whose combined technology will
make it easier for hospitals, nursing homes, and doctors’ offices to
share patients’ health information
­electronically.
Under the terms of the deal,
­Eclipsys shareholders will receive
1.2 AllscriptsMisys shares for each
Eclipsys share.
Work group suggests mandating
encryption for provider
information exchanges
During its May 19 meeting, a privacy/security work group for the Office
of the National Coordinator for Health
Information Technology reported that
encryption should be mandatory for
one-on-one exchanges between providers regarding treatments.
According to a HealthLeaders
Media article, the work group from
the monthly HIT Policy Committee suggested that those exchanges
include:
»» Encryption (no ability for facilitator to access content). Encryption
ideally should be required when
there is potential for ­transmitted
data to be exposed (mandated
through meaningful use/certification criteria or HIPAA Security
Rule ­modification).
»» Limits on identifiable (or potentially identifiable) information in
the message.
»» Identification and authentication.
Using the Web to curb waiting
room times
A new Web-based tool seeks to help
patients spend less time in the waiting
room before seeing their doctor. The
application, called MedWaitTime,
allows patients to check before their
appointment to see whether their
doctor is running late, according to
The Wall Street Journal.
Patients can access the site up to two
hours ahead of their appointment. If
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6
Medicine on the Net®
July 2010
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New on the ’net
the doctor is running late, patients can
be instructed to arrive later than their
scheduled appointment time. Patients
can also enter their cell phone number
into the system to receive text message
alerts.
MGMA tells HHS new EMR
disclosure requirements ‘onerous’
The Medical Group Management
Association (MGMA) told the U.S.
Department of Health and Human
Services (HHS) that the new HIPAA
disclosure requirements for electronic
medical records (EMR) are burdensome, unnecessary, costly, and may
discourage physicians from adopting
the new technology.
According to a HealthLeaders
Media article, the 2003 HIPAA Privacy Rule permits patients to request an
accounting of disclosures of their protected health information. However, a
new provision expands the type of information required in this accounting,
and medical groups using EMRs are
now required to track all disclosures
of patient information, including disclosures for treatment, payment, and
healthcare operations.
MGMA highlighted five critical
concerns:
»» Administrative burden on physician
practices
»» Low volume of patient requests for
accounting reports
»» Burdensome and unnecessary accounting for treatment disclosures
»» Burdensome and unnecessary accounting for payment and healthcare operations disclosures
»» The rule’s discouraging effect on
physician adoption of EMRs
Pairing high-tech, healthcare
The University of California–San
Francisco is collaborating with the
University of California, Berkeley to
offer a two-year master’s degree in
“translational medicine,” the discipline
of transferring lab breakthroughs to
the marketplace.
According to The Wall Street Journal,
the MBA-style program will target
students from both medical and
high-tech fields. The program will
begin this fall.
‘Private practices’ will be unmasked
on large breaches website
Names of healthcare entities masked
as “private practice” on the government website that lists organizations
reporting large breaches of unsecured
protected health information will soon
be revealed.
The Office for Civil Rights (OCR),
the enforcer of the HIPAA Privacy
and Security Rules, tells ­HealthLeaders
AHRQ releases software to build hospital quality website
The Agency for Healthcare
Research and Quality (AHRQ)
has released its MONAHRQ
(My Own Network Powered by
AHRQ) software. Hospitals can
use the software without charge
to compile, analyze, and post
data on the quality and cost of
their healthcare, according to a HealthLeaders Media article.
The Windows-based software is designed to permit hospitals and other
users to create customized websites with data that can be used for either internal quality improvement or public reporting of quality information. The
average time to set up the software is about one to two days, says an AHRQ
research scientist.
The use of the software is open to other entities as well, such as state governments, health insurers, health information technology vendors, and other providers.
Before the introduction of MONAHRQ, costs to create a website with quality
data from scratch have run as high as $300,000 and could take a year to set up,
based on the experiences of some users.
Hospitals that download the software can customize it by entering hospital
administrative data, including elements such as patient characteristics, diagnoses, procedures, health insurance type, and charges. MONAHRQ processes
that information and creates a website that can be customized.
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July 2010 Medicine on the Net® 7
A HealthLeaders Media publication
New on the ’net
Media in an e-mail it will lift the “private practice” tag on its website once
the 40-day comment period is up on
its April 13 Federal Register notice that
modifies its existing “System of Records” practices.
After the comment period ends
May 23, OCR anticipates beginning to publish the names of covered
entities currently listed as “private
practice” sometime after that. OCR
intends to apply the new routine use
retroactively, so names of all covered
entities currently listed as “private
practice” would be published.
Resisting the push to digitize
The federal government has boosted
the electronic health record (EHR)
industry with $19 billion for health information technology from the American Recovery and Reinvestment Act
of 2009.
According to a Politico article, it has
also bolstered that support with provisions in the healthcare reform law.
But as a new and particularly stringent regulation nears, numerous
medical groups say the aggressive
­government push to digitize is too
much too soon.
The American Recovery and Reinvestment Act authorizes grants to
hospitals and doctors serving Medicare
and Medicaid patients that could demonstrate “meaningful use” of EHRs.
Both the AMA and the American
Hospital Association, along with at
least 50 other, smaller professional
associations, have filed public comment protesting the definition. They
see the definition as untenable and
aggressive.
HHS seeks patient feedback about health IT
The U.S. Department of Health and
Human Services (HHS) is preparing
two surveys that aim to gather information about patients’ preferences
and satisfaction with electronic health
records (EHR) and personal health
Microsoft in venture for health database in Canada
Microsoft® is creating an
online database in Canada
with the Telus Corporation,
a large wireless carrier. The
Internet-based service will
be available to Canadian
consumers and their healthcare providers. The New York
Times reports that it will
be based on Microsoft’s
HealthVault™ software. Telus did not disclose financial terms of the deal.
records (PHR) in order to improve
nationwide health information technology (IT) adoption efforts. According to a HealthLeaders Media article,
both surveys were announced in the
May 14 Federal Register.
HHS plans to survey about 500
Medicare beneficiaries who are enrolled in the Medicare PHR Choice
Pilot, which launched in January 2009
in Arizona and Utah. The program encouraged fee-for-service beneficiaries to
enroll in one of several available PHR
services to track their own health and
healthcare services.
HHS hasn’t yet indicated whether
it plans to expand the pilot project,
but the results of the survey could
determine whether Medicare adopts a
national PHR program.
The second survey will be designed
to assess the gap between patients’
and providers’ perceptions about how
EHR systems affect the delivery of
care. It will focus particularly on primary care practices, and the goal is to
understand how having an EHR in a
primary care office affects consumers’
satisfaction with their care, their communication with their doctor, and the
coordination of care.
Both survey proposals are open for
comments and suggestions for 30 days.
New defibrillator avoids wires in heart
Researchers announced that they
have developed a new type of implantable defibrillator that avoids the need
to connect the device directly to the
heart with wires called leads, which are
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8
Medicine on the Net®
July 2010
© 2010 HCPro, Inc.
A HealthLeaders Media publication
New on the ’net
associated with complications of the
traditional technique. According to The
Wall Street Journal, the researchers said
a study showed the new defibrillator
successfully detected and corrected
potentially life-threatening irregular
heartbeats after a lead from the device
was placed under the skin adjacent to
the heart.
Wireless health institute gets $20 million
A pair of San
Diego philanthropists gave $20 million to the West
Wireless Health
Institute to jumpstart product development at the La
Jolla, CA, facility,
which could emerge
as a leading player
in the international movement to improve medical care with cell phones and
other devices.
The latest donation from Gary and Mary West will help the institute recruit more engineers, reports The San Diego Union-Tribune. Those workers will
create equipment that relies on wireless networks to track patients’ health
conditions, remind them about medications, or alert their doctors when a
problem surfaces.
Company plans to sell genetic
testing kit at drugstores
Beginning May 14, shoppers at more
than 6,000 drugstores across the nation will be able to pick up a test to
scan their genes for a propensity for
Alzheimer’s disease, breast cancer, diabetes, and other ailments.
The move is being welcomed by
those who hope that deciphering the
genetic code will launch a new era
in biomedical science, reports The
Washington Post. But it’s being feared
by those who worry it will open a
Pandora’s box of confusion, privacy
violations, genetic discrimination,
and other issues.
Hospital uses cell phone texting to
announce ER waiting time
To make the emergency room (ER)
more patient-friendly, Reston (VA)
Hospital Center has devised a text
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July 2010 Medicine on the Net® 9
A HealthLeaders Media publication
H EA LT H CA R E G U I D E TO T H E I N T E R N E T
Focus: Obstetrics resources
According to the American Pregnancy Association (our
site of the month), 11,018 women give birth in America
every day. There are also nearly 4,780 women who experience pregnancy loss and 5,479 couples who struggle with
infertility issues. The Internet has a number of excellent
obstetrics websites to supply these patients with resources
and information.
The American Congress of Obstetricians and Gynecologists (ACOG) site (www.acog.org) is a great source for
reliable information. The membership organization’s site
contains educational offerings, news articles, and information on women’s issues such as adolescent healthcare, HIV,
and ­violence.
The Parents section of KidsHealth.org is another superior
obstetrics site. It contains online tools, answers to FAQs,
and articles on a wide range of conditions.
Lastly, the Pregnancy.org website provides information on
topics such as preconception and preparing for parenthood.
OUR SITE-RATING SYSTEM
*****
Excellent
****
Very good
***
Good
**
Fair
*
Adequate
The site’s online tool lineup is also impressive, containing
tools such as a basal body temperature chart, due date calculator, quizzes, lists, and guides. Users can also receive free
text messages timed to the due date or birth of a baby.
Several obstetrics resources are described and reviewed in
the following pages, as listed in the index below, using the
five-star system to rate each on content, interface, and style.
American Congress of Obstetricians and
Gynecologists
www.acog.org
Ratings: Content: ***** Interface: ***** Style: ****
Index: Obstetrics resources
American Congress of Obstetricians & Gynecologists . . 10
Association of Women’s Health, Obstetric, and
Neonatal Nurses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
KidsHealth.org. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
March of Dimes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
OBGYN.net. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Obstetric Ultrasound. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Pregnancy.com . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Pregnancy.org. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Pregnancy-Info.net. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
What to Expect. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
WomensHealth.gov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
The ACOG represents more than 52,000 members who
provide healthcare for women. It is a private, voluntary,
nonprofit membership organization. The ACOG advocates
for quality healthcare for women, maintains high standards
of clinical practice and continuing education, promotes patient education, and increases awareness of issues in women’s
healthcare.
You can navigate this site using the top-level navigation
links. Some of the links expand to display additional menus.
You’ll also find a set of quick links to frequently accessed
content. You’ll find these on the left-hand side of the site’s
home page. You can also click on links on the site’s home
page to access featured content, such as news releases and
­announcements.
Key features of this site include:
»» Advocacy information, such as ACOG legislative priorities
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10
Medicine on the Net®
July 2010
© 2010 HCPro, Inc.
A HealthLeaders Media publication
»» A Health Reform Center that contains information on
how health reform will affect physicians and patients, including a Microsoft® PowerPoint® presentation, answers
to FAQs, and material about the ACOG’s work on reform
»» Educational offerings
»» News articles and releases
»» Advice on building a practice
»» Historical information about obstetrics and gynecology
»» A career center
»» An online discussion forum
»» Access to ACOG publications, such as bulletins, clinical
reviews, and committee opinions
»» Research information, including surveys, citations, and
abstracts
»» Links to additional resources
»» Meeting information
»» An events calendar
»» Practice management information on topics such as coding, health information technology, and HIPAA
»» Guidelines and policy statements
Unique elements: The Women’s Issues section contains
information on topics such as adolescent healthcare, HIV,
and violence.
Comments: The site contains information in Spanish and
English.
Cost: The majority of content on the site is free, with certain areas restricted to registered members only.
RSS XML link: Visit www.acog.org/rss/acogrss.cfm for a
complete list of feeds. Keywords: obstetrics, obstetricians, women, women’s
healthcare, pregnancy, conception, American Congress of
Obstetricians and Gynecologists, ACOG.
Association of Women’s Health, Obstetric, and
Neonatal Nurses
www.awhonn.org
Ratings: Content: **** Interface: **** Style: ****
The Association of Women’s Health, Obstetric, and
Neonatal Nurses (AWHONN) is a nonprofit membership
organization that promotes the health of women and newborns. The group’s mission is to improve and promote
the health of women and newborns and to strengthen the
nursing profession through advocacy, research, education,
and resources.
You can navigate this site using the link in the upper lefthand side of the home page. You can also click on links on
the site’s home page to access featured content, such as event
information.
Key features of this site include:
»» Journals
»» Publications
»» Research, including priorities, grants, and research-based
projects to advance evidence-based clinical practices
»» Links to additional resources
»» Perinatal risk assessment information
»» Perinatal staffing surveys
»» Evidence-based practice workshop information
»» Webinars on topics such as “The Professional’s Role in
Perinatal Bereavement” and “The Truths About Cervical
Cancer”
»» Legislative news and views
»» Information about the association’s coalitions
»» Position statements
»» Internship and fellowship information
»» Event information
»» News articles
»» Information about AWHONN public health campaigns
Unique elements: The association has a presence on Facebook and YouTube. You can click on these links from the
right-hand side of the page.
Comments: The site contains an online store.
Cost: The majority of the information on the site is free,
with certain areas restricted to members only.
RSS XML link: None.
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© 2010 HCPro, Inc.
July 2010 Medicine on the Net® 11
A HealthLeaders Media publication
»» Information about birthing centers and hospital
Keywords: obstetrics, obstetricians, women, women’s
healthcare, pregnancy, conception, Association of Women’s
Health, Obstetric, and Neonatal Nurses, AWHONN.
­ aternity wards
m
»» Information about birthing classes
»» A guide to eating during pregnancy
»» Exercise advice for pregnant women
»» Birth stories
»» Breast-feeding information
KidsHealth.org
www.kidshealth.org
Ratings: Content: ***** Interface: ***** Style: *****
KidsHealth is a website about children’s health and development. It is part of The Nemours Foundation’s Center for
Children’s Health Media. The site contains health facts as
well as information on a wide range of physical, emotional,
and behavioral issues affecting kids and teens.
Click on the Parents link to enter the site. This is where the
majority of the obstetrics-related information resides. From
there, you can navigate using the left-hand navigation links.
Clicking on a topic will display additional subtopics. You can
also click on links within the parent section to access featured
content, such as information on positive parenting, a body mass
index calculator, and summer safety advice. To access the obstetrics information on the site, click Pregnancy & Newborns.
Key features of this site include:
»» Answers to FAQs
»» Recipes
»» First aid and safety information
»» Information about doctors and hospitals
»» Articles on a wide range of conditions
»» News articles
»» Basic information about caring for a newborn
»» A guide for first-time parents
»» Information about genetics
»» Information about cord blood banking
»» Birth plans
Unique elements: The Pregnancy & Newborns section
contains many online tools, such as a pregnancy calendar,
recipes, and an immunization chart.
Comments: The site contains information in Spanish.
Cost: Free.
RSS XML link: None.
Keywords: obstetrics, obstetricians, women, women’s
healthcare, pregnancy, conception, The Nemours Foundation, KidsHealth.org.
March of Dimes
www.marchofdimes.com
Ratings: Content: ***** Interface: ***** Style: *****
The March of Dimes® is a nonprofit organization for
pregnancy and baby health. The group’s mission is “to improve the health of babies by preventing birth defects, premature birth, and infant mortality.” The organization carries
out this mission through research, community services, education, and advocacy.
You can navigate this site using the top-level navigation
links. You can also click on links on the site’s home page to
access featured content, such as news articles, the site’s blog,
and online tools.
Key features of this site include:
»» Information for healthcare professionals and researchers
»» Event information
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12
Medicine on the Net®
July 2010
© 2010 HCPro, Inc.
A HealthLeaders Media publication
»» Fact sheets on a wide range of perinatal and genetic
topics
»» Continuing education for healthcare professionals
»» Access to Peristats®, an interactive perinatal data resource
»» An online product catalog
»» Ask the Expert features
»» Videos (subscribe via iTunes®)
»» Audio files (subscribe via iTunes)
»» Pregnancy articles
»» Information on how to support the March of Dimes
»» Pregnancy-related information
»» Advice on caring for your baby
»» Information about birth defects
»» Information about premature birth
»» Links to social networking tools, such as Facebook,
­Twitter™, YouTube, and Flickr®
»» A tool that lets you locate your local March of Dimes
chapter
Unique elements: The site contains an interactive Flash
program that lets parents learn how newborns signal what
they feel and what they need. The program includes information about sleeping, crying, and feeding.
Comments: Users can opt to sign up for the site’s newsletter. It contains articles for parents, news, personal stories,
and much more. Click on the subscribe link on the home
page to learn more.
Cost: Free.
RSS XML link: None.
Keywords: obstetrics, obstetricians, women, women’s
healthcare, pregnancy, conception, birth defects, March
of Dimes.
OBGYN.net
www.obgyn.net
Ratings: Content: ***** Interface: **** Style: ****
OBGYN.net is an online community of OB/GYN medical professionals, pharmaceutical and medical device companies, and their patients. The group’s mission is “to share
knowledge to advance women’s healthcare globally.”
You can navigate this site using the following links that
will present content to best fit your individual needs: Medical Professionals, Medical Industry, and For Women. You
can also click on quick links on the site’s home page to access frequently requested content, such as discussion forums,
infertility, and weight management.
Key features of this site include:
»» An Ask the Expert feature
»» Conference presentations
»» Information on OB/GYN health topics, such as adhesions, breast health, contraception, and menopause
»» A calendar of events
»» Continuing medical education and training webinars
»» Information about a first trip to a gynecologist
»» Information about the future of reproductive medicine
»» Information about medical societies and associations
»» An acronym decoder for some of the frequently used
­acronyms in the field
»» A jobs database
»» Vendor information
»» Webcasts
»» Educational tutorials
»» Videos
»» Advice for younger women
»» News articles
Unique elements: The site contains online discussion
­forums that cover a variety of topics, such as women’s
health, endometriosis, fibroids, pregnancy and birth, and
many others.
Comments: Healthcare professionals are encouraged to
submit content for inclusion on the site.
Cost: The majority of content on the site is free, with
certain areas restricted to registered members only; however,
registration is free.
RSS XML link: None. Keywords: obstetrics, obstetricians, women, women’s
healthcare, pregnancy, conception, OBGYN.net.
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© 2010 HCPro, Inc.
July 2010 Medicine on the Net® 13
A HealthLeaders Media publication
Pregnancy.com
www.pregnancy.com
Ratings: Content: ***** Interface: **** Style: *****
Obstetric Ultrasound
www.ob-ultrasound.net
Ratings: Content: ***** Interface: *** Style: **
The Obstetric Ultrasound website is a comprehensive collection of information regarding obstetric ultrasound. Dr.
Joseph S.K. Woo of Hong Kong maintains the site.
You can navigate this site using the links within the text
on the home page. You’ll need to scroll down to find the
content that interests you. If you scroll to the bottom of the
page, you’ll find a collection of links to specific content on
the site.
Key features of this site include:
»» Information about obstetric ultrasound scans, including
its history
»» How obstetric ultrasound is used in pregnancy
»» How physicians use obstetric ultrasound to determine
­gestational age and assess fetal size
»» How physicians use obstetric ultrasound to diagnose fetal
malformation
»» Information about how practitioners use ultrasound to
determine placental localization
»» How ultrasound is used to gather information regarding
multiple pregnancies
»» Information about the different types of scans, such as
transvaginal and Doppler ultrasound
»» Information about the safety of obstetric ultrasounds
»» Links to additional resources
Unique elements: The site contains a gallery of ultrasound
images depicting various obstetric conditions.
Comments: The site contains a helpful FAQs page.
Cost: Free.
RSS XML link: None.
Keywords: obstetrics, obstetricians, women, women’s
healthcare, pregnancy, conception, Dr. Joseph S.K. Woo,
Obstetric Ultrasound.
Pregnancy.com is owned and operated by BabyCenter, a
global interactive parenting network that launched in 1997.
The site contains information on popular pregnancy topics
of interest to expecting parents.
You can navigate this site using the left-hand navigation
links. You can also click on links on the site’s home page
to access featured content, such as health tools, articles, and
product information.
Key features of this site include:
»» Advice on selecting a baby name
»» Labor and delivery information
»» A list of pregnancy signs and symptoms
»» Fertility information
»» Due date calculators
»» Ovulation calculators
»» An online store containing products related to maternity,
nursery, car seats, infant clothing, and many other categories
»» A week-by-week tool that lets users learn more about their
child’s development
»» A downloadable pregnancy planner
Unique elements: The site contains an online community
of groups. You can peruse them by topic by clicking on the
BabyCenter talk section’s Find Your Birth Club link. Community topics include adoption, birth clubs, getting pregnant,
fertility issues and concerns, and pregnancy.
Comments: The site contains information in Spanish and
English.
Cost: Free.
RSS XML link: None.
Keywords: obstetrics, obstetricians, women, women’s healthcare, pregnancy, conception, BabyCenter, pregnancy.com.
Pregnancy.org
www.pregnancy.org
Ratings: Content: ***** Interface: ***** Style: *****
Pregnancy.org is a newcomer to the field of obstetrics websites. The site is described as “built by parents for parents.”
You can navigate this site using top-level navigation links.
You can also click on links on the site’s home page to access
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14
Medicine on the Net®
July 2010
© 2010 HCPro, Inc.
A HealthLeaders Media publication
featured content on topics such as getting pregnant, pregnancy, labor and delivery, and baby and beyond.
Key features of this site include:
»» Information on getting pregnant
»» Preconception checklist, including tests that may be
required before getting pregnant
»» Pregnancy tools, such as a baby name database and pregnancy calendar
»» Information on labor and delivery
»» Advice for new mothers and fathers to help them get
ready for parenthood, including tips on choosing a pediatrician and what baby stuff you need
»» Advice for after the baby arrives on topics such as siblings,
juggling work and family, kids’ activities, and self-esteem
»» Ask the Expert section featuring advice from a child psychologist, doula, and lactation consultant, among others
»» Links to news articles on a variety of pregnancy and parenting topics
»» Social networking tools and blogs
»» Videos on topics including “Taking the newborn outside”
and “Introducing the concept of money to your child”
»» Reviews of products and services from books to strollers
to fertility monitors
Unique elements: The site contains many social networking tools, including links to common social networking sites
such as Facebook and Twitter. You can also click the Join
the Community link on the left-hand side of the site to use
the Ask the Community feature, the live chat feature, or post
comments on the bulletin board.
Comments: The site contains an online store.
Cost: Free.
RSS XML link: Visit www.pregnancy.org/taxonomy/term/1/
all/feed for a complete list of feeds.
Keywords: obstetrics, obstetricians, women, women’s
healthcare, pregnancy, conception, Pregnancy.org.
Pregnancy-Info.net
www.pregnancy-info.net
Ratings: Content: ***** Interface: ***** Style: *****
Pregnancy-Info.net is maintained by parents to offer information to users who are pregnant or who are planning a
future pregnancy.
You can navigate this site using the top-level or left-hand
navigation links. Some of the links expand to reveal additional menu options. You can also click on links on the site’s
home page to access featured content, such as articles, newsletter information, and forums.
Key features of this site include:
»» Advice on becoming pregnant, including pregnancy symptoms, conception, preconception care, and adoption
»» Pregnancy health information, such as diet and exercise
»» Information regarding pregnancy, including medical tests,
prenatal care, stages of pregnancy, teen pregnancy, and
discomfort
»» Information regarding labor and birth, including topics
such as birth plans and cesarean section
»» Postpartum content, including breast-feeding, depression,
body changes
»» Information regarding the problems that may occur during pregnancy, including risk factors, complications,
STDs, and cancer
»» Advice for those coping with pregnancy loss
»» Baby naming advice
Unique elements: The site contains many videos on topics
such as the use of chiropractic care during pregnancy, working during pregnancy, exercise, and reducing stress. You’ll
find them listed at the bottom of individual topic pages.
Comments: Users can sign up to receive a free newsletter from the site. From the left-hand side of the page, check
the newsletter(s) you are most interested in, then enter your
­e-mail address.
Cost: Free.
RSS XML link: None.
Keywords: obstetrics, obstetricians, women, women’s
healthcare, pregnancy, conception, Pregnancy-Info.net.
What to Expect
www.whattoexpect.com
Ratings: Content: ***** Interface: ***** Style: *****
What to Expect is a website from the author of the book
What to Expect When You’re Expecting, which has been the go-to
book for expecting moms for many years now. The website
is part of the Everyday Health Pregnancy and Parenting
Network.
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© 2010 HCPro, Inc.
July 2010 Medicine on the Net® 15
A HealthLeaders Media publication
You can navigate this site using the top-level navigation
links, which allow you to select information about preconception and pregnancy as well as information about child
rearing. You can also click on links on the site’s home page
to access health guides, online tools, and articles. Click on
Preconception or Pregnancy to access the obstetrics-related
information on the site.
Key features of this site include:
»» Information about pregnancy symptoms, such as backache, bloody show, and appetite
»» A free, customized newsletter (enter your due date or
baby’s birth date and e-mail address in the field on the
home page)
»» Blogs
»» An Ask the Expert feature
»» News articles
»» Online polls
»» A presence on social networking sites such as Facebook
and Twitter
Unique elements: The site contains a message board that
includes groups on many topics, such as birthing options,
breast-feeding, complications, blended families, and multiples and twins.
Comments: The site has many helpful online tools, including a due date calculator, an ovulation calculator, and a
pregnancy calendar.
Cost: Free.
RSS XML link: None.
Keywords: obstetrics, obstetricians, women, women’s
healthcare, pregnancy, conception, What to Expect.
WomensHealth.gov
www.womenshealth.gov
Ratings: Content: ***** Interface: **** Style: ****
The National Women’s Health Information Center
(NWHIC) is a service of the Office on Women’s Health
(OWH) in the U.S. Department of Health and Human
Services (HHS). The OWH was established in 1991 to
“provide leadership to promote healthy equity for women
and girls through sex/gender-specific approaches.” The
NWHIC offers free women’s health information on more
than 800 topics through its call center and this website.
You can navigate this site using the left-hand navigation
links. Some of the links expand to display additional menus.
You can also click on links on the site’s home page to access
featured content, such as health tools, statistics, and news.
To access the obstetric information on the site, click Health
Topics and then click Pregnancy. This displays the healthy
pregnancy page on the site.
Key features of this site include:
»» Preconception advice, including tips to help you conceive
and what to do if you have problems
»» Statistics
»» Campaign information
»» Information for healthcare professionals
»» Social networking tools
»» Information about prenatal care, food, fitness, and
how to deal with discomfort and problems that may
arise
»» Advice to help new mothers get ready for parenthood,
including tips on choosing a pediatrician, purchasing a
car seat, and how to baby-proof your home
»» How to spot the signs of labor
»» Information about the screenings and tests that newborns
receive after birth
»» Links to additional resources
»» Pregnancy-related news articles
»» A guide to pregnancy rights
»» Tips for recovering from the birthing process
Unique elements: The site contains many health
tools, such as a basal body temperature chart, due date
calculator, quizzes, lists, and guides. Click on Mom-toBe Tools to access them. Users can also sign up to receive free text messages timed to the due date or birth
of a baby.
Comments: The site contains information in Spanish
and English.
Cost: Free.
RSS XML link: None.
Keywords: obstetrics, obstetricians, women, women’s
healthcare, pregnancy, conception, National Women’s Health
Information Center, NWHIC, Office on Women’s Health,
OWH, U.S. Department of Health & Human Services, HHS,
WomensHealth.gov. H
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16
Medicine on the Net®
July 2010
© 2010 HCPro, Inc.
A HealthLeaders Media publication
H EA LT H CA R E G U I D E TO T H E I N T E R N E T
Focus: Telemedicine resources
According to the American Telemedicine Association
(ATA) site (www.americantelemed.org), telemedicine is “the use
of medical information exchanged from one site to another via
electronic communications to improve patients’ health status.”
A few years ago, Medicine on the ‘Net would have been
hard-pressed to locate telemedicine resources on the Web;
however, the field has become quite significant given its
many recent applications in specialty areas such as obstetrics,
neurology, and mental health.
The telemedicine websites we’ve selected are created by
organizations, regional groups, legal experts, the government,
and the military. You’ll find that they contain information
about telemedicine as well as their specific usage of it.
The Telemedicine Information Exchange site (www.tie.
telemed.org) contains information for healthcare providers who
have an interest in telemedicine. Sample content includes
articles, a glossary of terms, issue overviews, and training
information.
The California Telemedicine and eHealth Center (CTEC)
site (www.cteconline.org) is also a great source of information.
For example, the telehealth resource center contains a guide
to help users through defining, planning, and implementing
a telemedicine program.
The International Society for Telemedicine and eHealth
site (www.isft.net) contains information about the important
role that telemedicine plays in helping patients worldwide.
The site contains podcasts, best practice models, and
­presentations.
Several telemedicine resources are described and reviewed
in the following pages, as listed in the index below, using the
five-star system to rate each on content, interface, and style.
OUR SITE-RATING SYSTEM
*****
Excellent
****
Very good
***
Good
**
Fair
*
Adequate
Index: Telemedicine resources
American Telemedicine Association . . . . . . . . . . . . . . . . . . 17
California Telemedicine and eHealth Center . . . . . . . . . . . 18
Center for Telehealth and E-Health Law . . . . . . . . . . . . . . 19
Health Resources and Services Administration . . . . . . . . 19
International Society for Mental Health Online . . . . . . . 20
International Society for Telemedicine and
eHealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Telehealth.net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Telemedicine & Advanced Technology
Research Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Telemedicine Information Exchange . . . . . . . . . . . . . . . . . . 22
Telemedicine Technical Assistance Documents . . . . . . . . 23
American Telemedicine Association
www.americantelemed.org
Ratings: Content: ***** Interface: ***** Style: ****
The ATA works to promote access to medical care for
consumers and healthcare professionals through the use of
telecommunications technology. The ATA was established
in 1993 as a nonprofit organization. It is open to individuals, healthcare institutions, companies, and other organizations with an interest in deploying telemedicine.
You can navigate this website using the top-level navigation structure. The links expand to reveal additional dropdown menu options. You can also access featured content
on the site’s home page, such as event information, news
articles, and links to social networking tools. The home page
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A HealthLeaders Media publication
also contains a list of quick links along the left-hand side of
the page. Clicking on these links will display frequently accessed content.
Key features of this site include:
»» Information about the association
»» A description of telemedicine
»» A telemedicine overview
»» Telemedicine network maps
»» Terminology
»» Guidelines and technical standards that affect the practice
of telemedicine
»» Information about medical reimbursement
»» News articles
»» Membership information
»» Public policy information, including white papers, answers
to FAQs, and state policy
»» Meeting information
»» Education opportunities
»» A product and service directory
Unique elements: The site contains a video library containing clips on telemedicine-related topics. You’ll find it
under the About Telemedicine heading in the top-level
navigation.
Comments: The site has a social networking presence.
You’ll find links on the home page to Facebook, LinkedIn,
Twitter, and others.
Cost: The majority of the information on the site is free,
with certain areas restricted to members only.
RSS XML link: You must be a member to take advantage
of this feature.
Keywords: telemedicine, telehealth, e-health, American
Telemedicine Association, ATA.
California Telemedicine and eHealth Center
www.cteconline.org
telehealth systems to improve the delivery and availability of
health programs.”
You can navigate this website using the navigation links
on the left-hand side of the page. You can also access
featured content on the site’s home page, such as surveys,
­videos, and news articles.
Key features of this site include:
»» Information about the center
»» A description of the difference between telemedicine and
telehealth
»» Examples of telehealth applications
»» The importance of telemedicine and telehealth services in
the healthcare system
»» Information about telemedicine in the state of California,
including legislation
»» Information about the CTEC telehealth optimization
initiative, including reports, an overview, a summary of
recommendations, and action steps
»» Success stories that discuss how telemedicine has changed
the lives of patients
»» Online training videos to help lead users through the
­important elements of telemedicine
»» Forms
»» Tools
»» Links to additional resources
Ratings: Content: **** Interface: ***** Style: *****
CTEC is a source of information on the development
and operation of telemedicine and telehealth programs. It
is nationally recognized as one of six federally designated
Telehealth Resource Centers in the United States. The center’s mission is “to provide leadership and direction in the
development and application of innovative telemedicine and
Unique elements: The site contains a guide to help users
through defining, planning, and implementing a telemedicine
program. Click on the CTEC Program Developer & Guides
link in the right-hand column of the home page.
Comments: The site contains a blog. Click on the CTEC
Blog link in the left-hand column to access it.
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18
Medicine on the Net®
July 2010
© 2010 HCPro, Inc.
A HealthLeaders Media publication
»» A list of licensure requirements by state for nurses, doc-
Cost: Free.
RSS XML link: None.
Keywords: telemedicine, telehealth, e-health, telehealth resource centers, California Telemedicine and eHealth Center,
CTEC.
Center for Telehealth and E-Health Law
www.telehealthlawcenter.org
Ratings: Content: ***** Interface: ***** Style: ****
The Center for Telehealth and e-Health Law was created
in 1995. Its mission is “to overcome the legal and regulatory
barriers to the utilization of telehealth and related e-health
services.” The organization compiles, analyzes, and disseminates legal, regulatory, and public policy information associated with telehealth and its underlying issues. It provides
analysis and information on topics such as reimbursement,
licensure, telecommunications, FDA regulations, privacy,
and accreditation.
You can navigate this website using the top-level navigation structure. You can also access information about key
topics, such as licensure, by clicking the quick links on the
left-hand side of the home page. The home page also contains news articles and survey results.
tors, and other health professionals
»» FDA regulations
»» Legal and regulatory issues surrounding telecommunications
»» Reimbursement information—how Medicare, Medicaid,
and private payers treat telemedicine claims
»» Credentialing and accreditation information, including a
glossary of credentialing terms, a credentialing timeline,
Conditions of Participation, and legal precedents
»» Information about telepharmacy
»» HIPAA privacy and confidentiality information
Unique elements: The site contains information on how
telemedicine is treated by individual state laws.
Comments: The site contains answers to FAQs regarding
telehealth.
Cost: Free.
RSS XML link: None.
Keywords: telemedicine, telehealth, e-health, Center for
Telehealth and E-Health Law.
Health Resources and Services Administration
www.hrsa.gov/telehealth
Ratings: Content: **** Interface: **** Style: ****
The Health Resources and Services Administration
(HRSA) is an agency of the U.S. Department of Health
and Human Services (HHS). It is the primary federal agency
for improving access to healthcare services for people who
are uninsured, isolated, or medically vulnerable. The administration’s mission is “to improve and achieve health equity
through access to quality services, a skilled health workforce,
and innovative programs.”
Key features of this site include:
»» A directory of telehealth resources
»» A description of telehealth
»» Information about the center
»» News articles
»» Licensure information for those who want to practice
telehealth
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© 2010 HCPro, Inc.
July 2010 Medicine on the Net® 19
A HealthLeaders Media publication
You can navigate this website using the top-level navigation
structures. Some links expand to display additional menu options. You can also access featured content on the site’s home
page, such as online tools, news articles, and grant information.
Key features of this site include:
»» Information about telehealth
»» A description of how HRSA is involved in telehealth
»» Telehealth grant and funding information
»» Reports to Congress and legislative updates
»» Information about the joint working group on telehealth
Unique elements: The site contains articles on a variety
of telemedicine topics. Click on the Publications link within
the Telehealth section to learn more.
Comments: The site contains links to additional telemedicine resources.
Cost: Free.
RSS XML link: http://ask.hrsa.gov/HIL.xml
Keywords: telemedicine, telehealth, e-health, U.S. Department of Health and Human Services, HHS, Health Resources and Services Administration, HRSA.
International Society for Mental Health Online
www.ismho.org
Ratings: Content: **** Interface: **** Style: ***
The International Society for Mental Health Online
(ISMHO) is an international community of students, teachers, researchers, clinical practitioners, and others interested
in using Internet technologies to sustain positive mental
health. The members meet online to discuss issues and collaborate on projects that further their mission, which is “to
promote the understanding, use, and development of online
c­ ommunication, ­information, and technology for the international mental health community.”
You can navigate this website using the top-level navigation structure. The links expand to reveal additional dropdown menu options. You can also access featured content
on the site’s home page, such as news articles, information
about the society, and forums.
Key features of this site include:
»» Information about the society
»» Membership benefits and how to join
»» Suggested principles for the online provision of mental
health services
»» Clinical case studies
»» Reports
»» How to assess a person’s suitability for online therapy
»» The myths and realities of online clinical work
»» A bibliography
»» White papers on topics such as “Potential Risks and
Benefits of Online Psychotherapeutic Interventions”
»» Links to additional resources
»» News articles
»» Event information
Unique elements: The site contains forums where members can engage in discussions concerning online mental
health. The forums encompass a wide range of topics.
Comments: The society formed in 1997.
Cost: The majority of the information on the site is free,
with certain areas restricted to members only.
RSS XML link: None.
Keywords: telemedicine, telehealth, e-health, mental
health, International Society for Mental Health Online,
ISMHO.
International Society for Telemedicine and eHealth
www.isft.net
Ratings: Content: **** Interface: **** Style: ***
Founded in 1997, the International Society for Telemedicine and eHealth (ISfTeH) helps disseminate information
about telemedicine and e-health in order to provide access to
experts throughout the world. The site describes the organization as an umbrella for national telemedicine and e-health
organizations, which they also help establish.
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20
Medicine on the Net®
July 2010
© 2010 HCPro, Inc.
A HealthLeaders Media publication
You can navigate this website using the left-hand navigation structure. The links expand to reveal additional
menu options. You can access featured content on the
site’s home page as well, such as event information and
brochures.
Keywords: telemedicine, telehealth, e-health, International
Society for Telemedicine and eHealth, ISfTeH.
Telehealth.net
www.telehealth.net
Ratings: Content: **** Interface: **** Style: ****
Key features of this site include:
»» Information about the society
»» Conference and event information
»» Membership and member information
»» Information about the society’s working groups: e-health
information technology, education, students, telenursing,
and others
»» Best practice models
»» Publications
»» Presentations
»» Reports
»» A telemedicine directory
»» An online forum (registration required)
»» Links to additional resources, such as search engines,
­publications, and other organizations
»» Survey results
Unique elements: The site recently added podcasts
to its online offerings. To access them, go to the home
page, scroll down, then select the link within the podcasts
­section.
Comments: Users can access the site’s online newsletter.
You can find the newsletter under the Working Groups
link.
Cost: Free.
RSS XML link: None.
Telehealth.net describes itself as “your trusted information
and networking source for ehealth, telehealth, home health,
and telemedicine.” Much of the information on the site pertains to the delivery of mental healthcare using telemedicine.
You can navigate this website using the top-level navigation structures. You can also access featured content on the
site’s home page, such as event information, articles, and
recent comment posts.
Key features of this site include:
»» Articles on topics such as confidentiality, delivering behavioral telehealth, distance technology, and emerging
opportunities
»» A blog
»» A suggested reading list
»» A glossary of terms
»» Interviews with experts in the field
Unique elements: The site contains a free e-mail discussion community for healthcare professionals on topics such
as health, distance learning, and telehealth news. Click on the
discussion link to access this content.
Comments: The site contains links to additional resources
worldwide.
Cost: Free.
RSS XML link: None.
Keywords: telemedicine, telehealth, e-health, Telehealth.net.
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© 2010 HCPro, Inc.
July 2010 Medicine on the Net® 21
A HealthLeaders Media publication
Comments: The site contains links to additional military,
government, and telemedicine resources.
Cost: Free.
RSS XML link: None.
Keywords: telemedicine, telehealth, e-health, Telemedicine
& Advanced Technology Research Center, TATRC.
Telemedicine Information Exchange
www.tie.telemed.org
Ratings: Content: ***** Interface: **** Style: ****
Telemedicine & Advanced Technology Research
Center
www.tatrc.org
Ratings: Content: **** Interface: **** Style: ****
The Telemedicine & Advanced Technology Research
Center (TATRC) performs medical reconnaissance and
special operations to address gaps in Department of Defense medical research programs. We have included this site
since many innovations in the field of telemedicine begin
with solutions created to address medical problems on
battlefields.
You can navigate this website using the top-level navigation structures. Some of the links expand to reveal additional menu options. You can also access featured content
on the site’s home page, such as announcements and event
information.
Key features of this site include:
»» Descriptions of featured projects, including the
Electronic Information Carrier and Transcranial
Doppler
»» Information about funding opportunities
»» Online tools for investigators
»» Telemedicine and advanced technology news articles
related to TATRC programs and partners
»» A calendar of events
»» An archive of past meeting information
»» Information about the organization
The Telemedicine Information Exchange (TIE) describes
itself as “an unbiased and all-inclusive platform for information on telemedicine and telehealth.” The site, which is
supported and maintained by the Association of Telehealth
Service Providers, is aimed at healthcare professionals and
others who are directly or indirectly involved in healthcare
delivery services and have an interest in the practice of
telemedicine.
You can navigate this website using the top-level or righthand navigation structures. Some of the links expand to
reveal additional menu options. You can also access featured
content on the site’s home page, such as news articles, publications, and event information.
If you are a healthcare professional, you will want to click
the Professional link on the right-hand side of the page. If
you are a consumer, click the Consumer link. These links
display specific content for each audience.
Key features of this site include:
Unique elements: The Portfolios section contains information about the organization’s work in a variety of areas,
including psychiatric health, international health, trauma,
­vision, and infectious disease.
»» Access to telemedicine and telehealth articles
»» News articles
»» Access to the TIE Europe blog
»» Information about telemedicine programs
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22
Medicine on the Net®
July 2010
© 2010 HCPro, Inc.
A HealthLeaders Media publication
»» An index of journals
»» Vendor news and information
»» Event information
»» Telemedicine funding news and links
»» Links to additional resources
»» Job listings
»» Information about home telehealth, including articles,
c­ itations, programs, vendors, news, and online resources
»» Legal and policy information, such as articles, legislation
updates, issue overviews, news articles, and links to other
resources
»» A Telemedicine 101 section that contains articles, issue
overviews, training information, citations, links, and access
to publications
»» A glossary of terms
»» Information about practicing telemedicine in each state,
including the status of licensure and reimbursement and
lists of active programs and relevant organizations
Unique elements: Site users are invited to contribute
information using their online submission form. Topics include programs, vendors, meetings, bibliographic citations,
and jobs.
Comments: Users can sign up to receive news headlines
by e-mail. Click the Services link in the top-level navigation
structure, then select E-mail News Headlines.
Cost: Free.
RSS XML link: http://tie.telemed.org/xmlData/TIEnews1.xml.
Keywords: telemedicine, telehealth, e-health, Telemedicine
Information Exchange, TIE.
Telemedicine Technical Assistance Documents
www.telehealth.muhealth.org
Ratings: Content: **** Interface: **** Style: ***
This website contains technical assistance documents for
individuals or organizations interested in beginning to use
telemedicine. The documents provide an understanding of
the steps necessary to develop a sustainable network. They
also provide information on specialty-specific areas such as
cardiology, dermatology, mental health, home care, trauma,
and pharmacy.
You can also click on the links on the home page to
download the documents, which are more than 400 pages
long and contain information on the following telemedicine topics:
»» First steps in creating a successful telehealth program
»» Disease management
»» Electronic medical records for rural health systems
»» School-based services
»» Telehealth technology
»» Specialty-specific information
»» A definition of terms
Unique elements: The site was supported by grants from
the federal Office for the Advancement of Telehealth, the
Health Resources and Services Administration (HRSA), and
the U.S. Department of Health and Human Services (HHS).
Comments: You will need to download Adobe® Reader®
to view the files.
Cost: Free.
RSS XML link: None.
Keywords: telemedicine, telehealth, e-health, U.S. Department of Health and Human Services, HHS, Health Resources and Services Administration, HRSA, University of
Missouri-Columbia, Telemedicine Technical Assistance
Documents. H
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envelope for your renewal notice or call customer service at
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© 2010 HCPro, Inc.
July 2010 Medicine on the Net® 23
A HealthLeaders Media publication
SI T E O F T H E M O N T H
American Pregnancy Association
www.americanpregnancy.org
The American Pregnancy Association (APA) is a national health organization that promotes reproductive and
pregnancy wellness through education, research, advocacy,
and community awareness. A nonprofit organization incorporated in the state of Texas, it was founded in 1995
by a couple in the adoption process who recognized the
need for access to information related to reproductive
and pregnancy health.
You can navigate this
free site using the top or
left-hand navigation links.
Some of the links expand to
display additional menus.
You can also click on links
on the site’s home page to
access particular sections
and featured content, such
as online tools, articles,
and pregnancy news. The
site also contains a list of quick links to popular content
on the right-hand side of the page under the title “Most
Popular Articles.”
The site’s video library is unique and impressive. You
can access it by clicking Video Library on the left-hand
side of the home page. Video topics include the pill, endometriosis, reducing stress during pregnancy, infertility,
and miscarriages.
Key features of this site include:
»» Information to help women attempting to get pregnant, including topics such as preconception health,
conception after age 35, nutrition, pregnancy symptoms, genetic counseling, pregnancy testing, and understanding ovulation
»» Information about infertility, including medications,
emotions, infertility terms, alternative treatments,
­reproductive technologies, and donor insemination
»» Advice for those planning to become pregnant, including birthing choices, preconception health, maternity
leave, and birth plans
»» Advice for those preparing for the birth of a child,
including how to choose a pediatrician and information on breast-feeding, lactation consultants, circumcision, wills, and
life insurance
»» Content for women
who are pregnant with
multiples
»» Labor and birth information, including how
to choose a childbirth
education class, birthing
types, cesarean delivery,
and complications
»» Information about
common pregnancy
discomforts, such as
back pain, headaches, skin changes, leg cramps, swelling, sciatic nerve pain, and morning sickness
»» Information about fetal development during the three
trimesters
»» Content on birth defects and disorders, including tips
for preventing birth defects
»» Advice for those suffering from a pregnancy loss
»» Complications associated with pregnancy, such as
bleeding, cervical cerclage, ectopic pregnancy, and gestational diabetes
»» Discussion forums (registration required)
»» Blogs
The site contains many online tools, including an ovulation calculator, a pregnancy calculator, and tools to locate a
healthcare provider. Users can also sign up to receive the
association’s free journal and newsletter. H
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Medicine on the Net®
July 2010
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