5 Unexpected Uses of Telemedicine and How They May Help You

by Robyn Bolton | May 6, 2020 | Innovation, Stories & Examples

There is more to telemedicine – the exchange of medical information from one site to another through electronic communication to improve a patient’s health – than virtual visits with physicians.

Specialists like dentists, orthodontists, ophthalmologists, psychologists, and even veterinarians are using telemedicine solutions during the pandemic.

Like their physician counterparts, many resisted virtual visits until it became the only way to continue to care for patients and stay in business, as stay-at-home orders expanded from weeks to months.

Here’s a quick run-down of telemedicine’s use in other specialties and what the road ahead could look like for each.

DENTISTRY

Where we are now

According to the American Dental Association, since early March, 79% of dentistry practices closed except for emergency procedures, and another 18% closed completely.

This isn’t surprising given how COVID-19 is transmitted but, for patients in pain, it can be hard to know what constitutes a true emergency and what can be managed at home. Helping patients figure out what needs immediate attention and what can wait seems to be tele-dentistry’s sweet spot.

“Research indicates that 80% of acute dental concerns can be addressed at home without an in-person visit,” explains Chelsea Acosta Patel, Head of Wally Experience at Wally Health, a dental care start-up based in Boston. “Using technology, dentists can triage issues and care for patients while keeping them out of the chair.”

Where we go from here

The bigger, long-term opportunity, according to Patel, may be in preventative care by creating and monitoring at-home preventive care solutions across the patient dental journey.

“Most dentists don’t have the tools to keep an ongoing pulse with patients. They just assume that if a patient has an issue or a question, they’ll call the office. Teledentistry solutions enable dentists to develop customized, ongoing touchpoints to help patients remain healthy and catch potential issues early. This improves the patient’s experience, drives loyalty and word of mouth (pun intended) for the dentist, creating a virtuous oral health cycle.”

ORTHODONTICS

Where we are now

While Dentists need a way to answer questions, triage issues, and provide follow-up care, Orthodontists have a more pressing need – to make sure their patients’ jaws continue to develop and their teeth continue to move in the right way.

“We serve a vulnerable pediatric population whose jaws are developing. The adjustments we make as part of their treatment affect that growth and development,” explains Dr. Adam Welmerink of Welmerink Orthodontics in Reno Nevada. “When we realized this would be more than a 2-week shutdown, we needed a way to keep our patients safe, make sure their appliances weren’t doing any harm, and ensure their treatment was progressing as planned,”

Through services like Orthodontic Screening Kit (OSK), patients receive instructions on how to take photos and upload them to the OSK site for review by their orthodontists. Of course, the orthodontist’s ability to assess the patient’s need is determined by the quality of the photos, but, at a minimum, the service creates an opportunity for orthodontists to reconnect with their patients and give them guidance on signs that could trigger an in-office visit.

Where we go from here

Telemedicine in orthodontics, like many other specialties, will likely continue to be used to triage issues or to serve patients in remote rural areas.

“Many of our patients live in rural areas, with some driving 2 hours for a 10-minute appointment. We’ll probably continue to use (OSK) to see if they need to come in. And I could see using it in a limited capacity to triage patients who call with an emergency to assess if they can treat the issue at home or if they need to come in.” Dr. Welmerink mused. “Honestly, time-wise, it’s quicker to see a patient in the office. But this is great for right now.”

OPTHALMOLOGY & OPTOMETRTRY

Where we are now

Telemedicine’s use as a way to calm patients and triage concerns, deciding whether or not an in-office visit is required, continues with eye care.

“It is certainly a way to reassure patients that we are there for them, which is most important in these scary times,” NYC optometrist Dr. Susan Resnick told All About Vision.

While reassurance is important, most eye care professionals agree that telemedicine’s use is extremely limited. Proper eye care requires pupil dilation and specialized tools to accurately identify problems like glaucoma or assess the health of optic nerves and retinas.

Where we go from here

Despite its limitations, Dr. Resnick sees value in continuing to use telemedicine, “We will continue to utilize this platform whenever necessary. We do not view it as a disruptor or threat, but rather as a way to bolster our practice.”

Not everyone agrees.

“I’m not terribly enthusiastic (about remote eye exams),” Illinois ophthalmologist Dr. Benjamin Ticho told All About Vision. “There’s going to be too many mistakes. Plus, it diminishes the warmth and personality of the interaction. For many patients, a good doctor visit is a pleasant social occasion, and for many doctors, that’s part of why we went into medicine.”

MENTAL HEALTH

Where we are now

The data is staggering.

Before the crisis, 20% of US adults lived with mental illness but less than half received treatment according to federal statistics.

In the last two weeks of March, 45% of US adults felt that worry and stress related to COVID-19 were harming their mental health. It’s likely that number has increased as stay-at-home orders extend, and job losses and furloughs increase.

Yet the adoption of telemedicine to address mental health concerns has been slow. A phenomenon that is far from new. Case in point – over a decade ago, Congress excluded mental health providers from a $30M investment in digitizing patient health records. Even now, as CMS, private insurers, and state regulators are easing restrictions and increasing reimbursement for telemedicine to treat physical concerns, similar attention and flexibility have not been shown to mental health concerns.

As a result, “(providers) are kind of trying everything right now and seeing what can work,” John Torous, director of the digital psychiatry division at Beth Israel Deaconess Medical Center told Politico.

Where we go from here

More than other specialties, the jury is out on what happens next with regards to telemedicine for mental health.

On one hand, “so much of counseling has to do with body language, being physically present in the room, intonation,” Lynn Linde for the American Counseling Association told Politco. “Sometimes, that’s lost when you don’t have a good internet connection, or one of your starts getting garbled.”

On the other, this could be a “tipping point for the way we practice,” said Peter Yellowlees, a professor of clinical psychiatry at the University of California, Davis and former president of the American Telemedicine Association.

Optum, a division of UnitedHealth, seems to be betting on the latter. Last week it announced that it was in talks to acquire AbleTo, a New York-based virtual therapy provider for $470M, or 10x forward revenue.

VETERINARY CARE

Where we are now

If telemedicine is good enough for humans, it’s good enough for our animal companions.

A relatively new addition to the specialties offering telemedicine solutions, only a handful of companies are currently playing in this field. TeleVet, a “Texas-based, digitally optimized company focused on veterinary care,” is one.

Before the outbreak, TeleVet was in use in 1000 clinics across the US and even closed a $2M seed round in January.

“We can check for infections such as ear infections or drainage from either a still picture or a video, or even a live video conference with the owner,” Dr. Amy Garrou as Houston-area vet explained to Innovation Map. “The platform has been useful because we can do any of those consultations and get the information we need to manage the case without the pet owner having to come into the clinic.”

Where we go from here

Like dentistry, orthodontics, and eye care, telemedicine’s use in the Veterinary space is a boon for providers and patients at a time when it’s not safe to be in a crowded office. But as restrictions lift, like the other health care fields, it’s likely to be used primarily to answer questions, triage concerns, and perform post-surgery check-ups.

THE CLINICAL APPLICATIONS ARE DIFFERENT BUT THE ROAD AHEAD IS THE SAME.

Yes, telemedicine is an incredible tool to have in our collective healthcare toolkit. Its use across medical specialties is evidence that it fills a need for clinicians (provide care for my patients) and patients (address my concerns).

In “normal” times, those needs are well addressed by in-office visits, retail clinics, and urgent care. It is only in very specific circumstances, like when medical professionals cannot easily or safely see patients in-person, that existing solutions fall short and telemedicine becomes the most attractive option.

However, telemedicine only became an available option when regulators relaxed rules, insurers increased reimbursement, and patients accepted emails and video-chats as treatment.

It took a pandemic to create the confluence of circumstances required for physicians, dentists, orthodontists, eye care professionals, mental health caregivers, veterinarians, and other clinicians to begin or expand the use of telemedicine. It’s their experience, and the experiences and decisions of other players in the healthcare ecosystem, that will lead them back to the office and the hands-on care that is both desired and required.

10 Moments of Innovation Zen: Military

by Robyn Bolton | Apr 16, 2020 | Stories & Examples

Innovation is something different that creates value. Sometimes it’s big, new to the world, world-changing things. Sometimes it’s a slight tweak to make things easier, faster, cheaper or better.

Sometimes, it’s both.

It’s no secret that the military and NASA are birthplaces of incredible inventions (something new) and innovations (something different that creates value). Most people know that Velcro, nylon, and powdered drinks (Tang!) originated at Nasa, and that Jeep, GPS, and the internet come to us from the military.

But did you know that these 10 everyday innovations have their origin in the military?

Duct Tape

Invented in 1942 to seal ammo boxes with something that could resist water and dirt while also being fast and easy to remove so soldiers could quickly access ammunition when they needed it. Originally, it was made by applying a rubber-based adhesive to duck cloth, a plain and tightly woven cotton fabric, and has evolved over the years to be used for everything from repairing equipment on the moon to purses.

Synthetic Rubber Tires

Speaking of rubber, prior to WWII, most rubber was harvested from trees in South America and shipped to southern Asia where the majority of rubber products were produced. When the Axis powers cut-off access to Asia, the US military turned to Firestone, Goodyear, and Standard Oil to create a replacement substance. The recipe they created is still used today.

Silly Putty

Like most inventions, there were a lot of failed experiments before the right synthetic rubber recipe was found. Silly Putty is the result of one of those experiments. A scientist at GE developed the strange substance but quickly shelved it after it became clear that it had no useful military application. Years later, GER execs started showing off the novelty item at cocktail parties, an advertising exec in attendance saw its commercial potential and bought the manufacturing rights, packaged it into eggs and sold it as a toy. 350 million eggs later, we’re still playing with it.

Superglue

The result of another failed experiment, Superglue came onto the market in 1958 and has stuck around ever since (sorry, that pun was intended). Military scientists were testing materials to use as clear plastic rifle sights and created an incredibly durable but impossibly sticky substance called cyanoacrylate. Nine years later it was being sold commercially as Superglue and eventually did make its way into military use during the Vietnam War as a way to immediately stop bleeding from wounds.

Feminine Hygiene pads

Image Credit: Museum of American History

Before Superglue was used to stop bleeding, bandages woven with cellulose were used on the battlefields and hospitals. Seeing how effective the bandages were at holding blood and the convenience of having so many on hand, US and British WW1 nurses began using them as sanitary napkins and bandage makers adapted and expanded their post-War product lines to accommodate.

Undershirts

Image Credit: Foto-ianniello/Getty Images

While people have been wearing undergarments for centuries, the undershirt as we know it — a t-shaped, cotton, crewneck — didn’t come into being until the early twentieth century. Manufactured and sold by the Cooper Underwear Co., it caught the Navy’s eye as a more convenient and practical option than the current button-up shirts. In 1905, it became part of the official Navy uniform and the origin of the term “crewneck.”

Aerosol Big Spray

Soldiers fighting in the Pacific theater of WWII had a lot to worry about, so they were eager to cross mosquitos and malaria off that list. In response, the Department of Defense teamed up with the Department of Agriculture to find a way to deliver insecticide as a fine mist. The first aerosol “bug bomb” was patented in 1941 and, thanks to the development of a cheaper plastic aerosol valve, became commercially available to civilians in 1949.

Canned Food

Image Credit: Pacific Paratrooper — WordPress.com

While it’s not surprising that canned foods were originally created for the military, it may surprise you to learn that it was Napoleon’s armies that first used the concept. In response to the French Government’s offer of a large cash reward for anyone who could find a way to preserve large quantities of food, an inventor discovered that food cooked inside a jar wouldn’t spoil unless the seal leaked, or the container was broken. But glass jars are heavy and fragile, so innovation continued until WW1 when metal cans replaced the glass jars.

Microwave

RadaRange on the Nuclear Ship NS Savannah

This is another one that you probably would have guessed has its origins in the military but may be surprised by its actual origin story. The term “microwave” refers to an adaptation of radar technology that creates electromagnetic waves on a tiny scale and passes those micro-waves through food, vibrating it, and heating it quickly. The original microwaves made their debut in 1946 on ships but it took another 20 years to get the small and affordable enough to be commercially viable.

Wristwatches

Watches first appeared on the scene in the 15th century but they didn’t become reliable or accurate until the late 1700s. However, up until the early 20th century, wristwatches were primarily worn as jewelry by women and men used pocket watches. During its military campaigns in the late 1880s, the British Army began using wristwatches as a way to synchronize maneuvers without alerting the enemy to their plans. And the rest, as they say, is history.

So, there you have it. 10 everyday innovations brought to us civilians by the military. Some, like synthetic rubber, started as intentional inventions (something new) and quickly became innovations (something new that creates value). Some, like superglue and silly putty, are “failed” experiments that became innovations. And some, like undershorts and feminine products, are pure innovations (value-creating adaptations of pre-existing products to serve different users and users).

Sources: USA Today, Pocket-lint.com, and Mic.com

10 Moments of Innovation Zen: Travel

by Robyn Bolton | Apr 8, 2020 | Stories & Examples

Sunday was Read a Roadmap Day which is, naturally, one of MileZero’s favorite days.

For hundreds of years, maps were works of art. Available to only the rich and powerful, they described the full sum of our understanding of the land and sea, and told stories of the fantastical creatures that lived beyond our shores.

Even as maps became more accessible, reading a roadmap still felt like reading a treasure map. As a kid, I loved to study the different types and colors of lines signaled different types of roads. Dozens of symbols each translated to some wondrous place or service. And don’t get me started on the wonder and magic of AAA’s TripTiks!

As time goes on, fewer and fewer people know how to read road maps, which is understandable given that technology puts real-time custom location information at our fingertips. But there’s still magic in maps and in the discoveries that only occur through travel.

So, for this week’s 10 Moments of Innovation Zen, and in honor of Read a Roadmap Day, here i are 10 innovations in travel that you can enjoy from your own home (which is really your only option at the moment)

Savage Beauty by Kari Kola in Connemara, Galway County, Ireland

Savage Beauty, the largest site-specific light artwork ever created because art need not be constrained to pencil, paint, and canvas

Slow TV in which there is no story line, no script, no drama, no climax, just 9+ hours of Norwegian landscape as viewed from a train

Heritage on the Edge by Google showing how World Heritage Sites are affected by global climate change

Animal Cams so you can virtually visit the pandas at the Smithsonian National Zoo or the penguins, fish, seals, and other inhabitants of the New England Aquarium

Virtual Walking Tours of NYC, South Korea, Japan, the Philippines, LA, San Diego, and a few US college campuses

Virtual Museum Tours of the Louvre, Madrid’s Museo Nacional Thyssen-Bornemisza, and The Vatican Museum

Virtual Concerts performed by the Melbourne Symphony Orchestra or the Berlin Philharmonic

Virtual Operas from all over the world, including the Royal Swedish Opera’s Madama Butterfly and the Polish National Opera’s Tosca

Google Earth lets you visit anywhere on, well, earth and, with this link, you can visit any of the US National Parks

Royal Portuguese Reading Rooms, Rio de Janeiro, by Getty Images

Listicles of the best of anything, including the world’s most beautiful libraries (sorry, I just love books too much)

The 5 Why’s of Working From Home

by Robyn Bolton | Mar 25, 2020 | Stories & Examples

In middle school and high school my dad and I would have massive arguments about my math homework. And by “massive,” I mean arguments that make episodes of The Real Housewives look like polite differences of opinion over tea and crumpets.

The issue was not my struggles to understand the work (though I’m sure that played into things) but rather my insistence on knowing WHY I needed to learn the content in the first place.

My dad, a metallurgist before becoming a computer engineer, seemed to think the answers to “Why?” were (1) you will need to know this in the future and (2) because this is the assignment.

To which I would respond, (1) no I won’t because I’m going to be a lawyer or a writer and even if I’m not those two things I can say with 100% certainty I won’t be an engineer and (2) that is not an acceptable reason.

As you can imagine, things would escalate from there.

In the decades since, with the exception of some single-variable algebra and basic geometry, I have yet to use most of the math that I was forced to learn and I still insist that “because that’s the assignment/the rules/how things are done” is not an acceptable answer.

Usually I apply that same stubborn curiosity to help my clients find and capitalize on opportunities to do things differently and better, create value, and innovate.

But, in the last week as I, like most Americans, find myself largely confined to my home, my curiosity is extending to my own environment and habits and I’m not always prepared for the insights that emerge.

WHY am I trying to maintain all my pre-pandemic habits?

Initial Answer: Because the experts say I should
Insight: I have a choice and now is the perfect time to decide which habits to keep and which to change. So far, I’m keeping all habits related to basic personal hygiene, dressing, and eating, while also experimenting with other habits, like how I schedule my time
Real Answer: We’re in an unusual time of collective uncertainty which makes this the perfect time to examine, re-evaluate, and change the things we often take as given. Like our own habits

WHY am I watching non-stop news?

Initial Answer: Because information is empowering in uncertain times
Insight: A screen showing “Breaking News” AND the global and US COVID-19 diagnosis and death counts AND numerous experts AND a crawl with dozens of other stories is not information. It’s noise. If the “news” has been known for 4 hours, it’s not “breaking,” it’s broken, move on.
Real Answer: I need to schedule my information consumption and focus on facts.

**WHY am I not using this time to get feedback from my own customers, especially since this is the first thing I tell my clients to do?**

Initial Answers: (1) I don’t want to bother them, (2) They’re busy with more important things, (3) They never complained so I’m sure it’s all good (4) I need to focus on the future, not the past, (5) I have other things to do, (6) Oh look, another email/text/Facebook post/bird/distraction!
Insight: I don’t want to for the exact same reasons most of my clients don’t want to have open-ended EPIC (empathy, perspective, insightful, and connected) conversations with their customers — I’m afraid that even though they say they love me they also know that I’m not perfect and will have really great and helpful suggestions that will require me to change. (in all honesty, this is the nice version of what I say to myself)
Real Answer: Time to put on my big-girl pants, follow my own advice, and go ask for feedback. It’s the only way improvement, innovation, and most importantly, client delight will happen

WHY do I suddenly feel the need to go outside and spend all time with people?

Initial Answer: Because it’s Spring, the weather is nice, and I like people
Insight: I want to go outside and be with people because I have been specifically told NOT to do those things. Just as I’m an introvert who does not like bugs or pollen, I also have a rebellious (intrapreneurial?) streak which makes me want to do exactly what I have been told not to do.
Real Answer: I can go outside or open a window, stand in the backyard, or sit on the front porch. I can socialize, I just need to use technology and bring my own drinks and dinner to the FaceTime/Zoom/Skype/Google Hangout

WHY are there 6 dozen eggs in the refrigerator?

Initial Answer: My husband is losing his mind OR he forgot that he bought 2 dozen eggs in each of the last two trips to the grocery store.
Insight: These are strange and uncertain times and that rattles even the most stoic and level-headed of people. My husband was a submarine warfare officer in the nuclear navy and often tells stories of sleeping on the missiles because they were more comfortable than his bunk and unarmed. This is not a guy who reacts emotionally to events or who worries about the apocalypse. He is cautious and practical and, sometimes, annoyingly reasonable. But he also bought 6 dozen eggs in less than 7 days.
Real Answer: Be patient, have empathy, listen to, and support everyone. Especially they people who you think may least need it. Also, I need to get over my aversion to quiche and other egg-heavy dishes.

In conclusion

Stay curious, turn off the news, be open to feedback and change, be supportive of others, let me know if (1) you’ve ever had to use calculus in your personal life and/or (2) have a great egg-heavy recipe

Creative or Reactive: Which One Are You Right Now?

by Robyn Bolton | Mar 19, 2020 | Stories & Examples

Creative and Reactive

Same letters.

Different order.

Very different results.

These are strange times.

A relentless stream of news and updates are coming at us, warning us about COVID-19, a declining stock market, rising unemployment, and the financial crunch facing millions and millions of individuals and families.

On the other hand, we’re also getting daily notifications from companies about what they’re doing in the face of all of this news, tips for working from home and maintaining our mental health, and encouragement to support our friends, families, neighbors, and strangers in new ways.

Should we be scared or stoic? Isolated or connected? Hoarding or sharing?

Whatever you choose (and it is your choice), I encourage you to also be creative.

I’m not talking about being creative in the capital C way and take up painting, sculpting, composing, or any of the other activities we typically associate with the fine arts.

I’m talking about calmly assessing your situation, clearly acknowledging the constraints that are requiring change, and then exploring the “new normal” you can create.

This is what innovators do and you, yes YOU, are an innovator.

Innovators know that creativity thrives within constraints. If anything is possible and everything is permissible, you can do whatever you want! But that’s not how the world is. Not now and not before COVID-19.

We, people and businesses, have always faced constraints because we’ve never had infinite resources, money, or time. But we acknowledged the constraints and created within them. That’s what we have to do now.

Here’s some inspiration:

Businesses

Devil’s Food Catering: From event caterer to consortium offering takeout meals

Caterers have to order food well before events take place so when events are cancelled, caterers are left with a lot of food that they’ve already paid for and without the event income that was going to cover their costs.

Devil’s Food Catering in Portland OR faced exactly this situation. Instead of letting the food go to waste or trying to become a take-out shop on their own, they created Handbasket by teaming with other with other Portland area restaurants, breweries, distilleries, bakeries, and other providers to create “handmade menus for quality in-home dining experiences during this of social distancing.”

Gyms, Fitness Studios, and Personal Trainers: From in-person to on-line communities

Some people are gifted with the motivation to workout and some of us, well…aren’t.

In-person classes and personal training are often the solutions we rely on because we feel a sense of connection with our instructors, trainers, and classmates. As gyms close and social distancing becomes a way of life, the loss of live workouts can deepen our sense of isolation.

Recognizing this, local gyms, studios, and personal trainers in cities across the country are offering livestream classes so that we can continue to feel connected AND healthy AND active from the comfort of our own homes.

p.s. the link above is for the Boston area but I found similar articles for Philly, Washington, Houston, and even Wyoming

Speakers Who Dare: From Broadway event to Livestream to Movie

Spears Who Dare bills itself as TED meets Broadway, “a groundbreaking speaker series produced like a Broadway show, featuring speakers from around the world who want to ignite change and inspire new ways of thinking.”

Scheduled to take place on March 24, the organizers recognized that, like many other live events, their original plans for a live Broadway event needed to change. Last week, they shifted from live to livestream, planning a 6-camera shoot of each speaker and performer sharing their messages and art in an empty theater.

Then NYC closed the theaters. Within hours the organizers shifted again and asked each speaker to record a “mini-movie” that could be edited together to create “a full-blown Speakers Who Dare Film” to be shared with a global audience, viewing together on the original event date.

People

Seeing your coworkers when you can’t (or don’t want to) videoconference

Homemade games for when you’ve already played all the games you bought

More homemade games for when you really need to interact with people outside your own home

How and what will YOU create today?

Just in case you need a nudge…find the perfect gif starring the perfect celebrity expressing the perfect emotion and send it to someone who needs it

h/t to Kate Dixon and Megan Shea for sending their suggestions

10 Moments of Innovation Zen

by Robyn Bolton | Mar 8, 2020 | Stories & Examples

I don’t know about you, but I’m rather tired of the non-stop hysteria that seems to be occurring these days. Between COVID-19, politics, the economy, and the state of Tom Brady’s contract (sorry, I live in Boston), it seems that the world is having a panic attack.

Namaste, people. Namaste.

In an effort to not contribute to the panic, instead of writing something topical and relating it to innovation, I’m simply going to share images of something that makes me extremely happy and peaceful and relate them to innovation.

Books.

I love books. I love reading them, looking at them, talking about them, and just being amongst them. In the days before Amazon, I would go to bookstores and simply sit in the aisle because it was the most calming and energizing thing I could think of. Don’t even get me started on the sheer joy of going into The Stacks in a library.

But as Amazon grew and the big chain bookstores shrank or went out of business, my opportunities for moments of book-filled zen became fewer and far between.

That sometimes happens with innovation — when something new comes on the scene that creates value in a different way, the old solutions that can’t or won’t change fade away. Yes, I love Amazon because I can get any book I want delivered to my door in 2 days, but I also hate it because I lose the sense of discovery, joy, and peace that I got from being physically surrounded by books.

That’s why I love what independent bookstores are doing. They are innovating too, by changing the business they’re in. They’re no longer in the book-selling business (Amazon won that battle), they’re in the book experience business.

The Book Experience business is everything that Amazon.com can’t offer — discovery, community, an environment that stimulates all your 5 senses. Don’t believe me? Why do you think Amazon is opening physical book stores?

Yes, it takes time, money, risk, and resources to re-define the business you’re in but it’s worth it because it not only keeps you in business, it creates a competitive advantage that lasts.

And may even create moments of zen.