Stories about: health care innovation

The 21st century home visit

An early prediction of telemedicine
The TeleDactyl, as depicted on the cover of Science and Invention magazine in 1925.
Shawn Farrell, MBA, is Telemedicine and Telehealth Program Manager at Boston Children’s Hospital.

Back in the 1920s, when medicine was more an art than a science and doctors made home visits, a publishing and radio pioneer named Hugo Gernsback predicted the future of telehealth. As described on Smithsonian.com, he wrote of a device called the TeleDactyl: “a future instrument by which it will be possible for us to ‘feel at a distance’”—dactyl, from the Greek, meaning finger.

Since that time, the practice of medicine has changed dramatically. Our understanding of the human body has advanced beyond our wildest dreams, producing drugs, devices and procedures that have made hospitals a place for healing and curing. At the same time, home visits were abandoned in favor of the office visit, making doctors more efficient. Almost 100 years later, several converging forces are making the home visit popular again, increasing the likelihood of seeing Gernsback’s vision become a reality.

The rollout of the Affordable Care Act, which will add millions of new patients to the health care system, comes at the same time that we have a shortage of primary care doctors, specialists and other care providers.

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Redesigning behavioral health care: The time is now

(TheReapersApprentice/deviantART)

Richard Antonelli, MD, is a primary care pediatrician and medical director of Integrated Care and Physician Relations and Outreach at Boston Children’s Hospital.  He also co-chairs the Task Force on Care Coordination for Children with Behavioral Health Needs, a group within the Massachusetts Child Health Quality Coalition. Laura Chandhok, MPH, Physician Partnership Liaison at Boston Children’s Hospital, contributed to this post.

The recent shootings in Newtown, Conn., have revived the long-standing debate about gun control in the United States and rightly put a spotlight on media and video-game violence. Importantly, this tragic event has also raised questions about the adequacy of our nation’s behavioral health system and whether troubled children, adolescents and their families have access to needed diagnostic and management services.

These questions aren’t new. And as care delivery models evolve in response to the demands for better care at lower costs, we have an opportunity to improve our behavioral health services.

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