UniDoc Shows How Telemedicine Can Meet Regulatory and Cost Requirements

Wouldn’t we all like to gather the fragmented elements of our life or work and put them all conveniently in a box, to have them all where we need them? UniDoc is doing that for telemedicine with their H3 Cube (Figure 1). Featuring an enclosed, modular design, it houses a collection of tools for standard medical examinations that lets a patient complete a telehealth visit in privacy. UniDoc is an impressive triumph of engineering, and equally of regulatory compliance.

The H3 Cube is a large module that can comfortably seat a patient along with diagnostic tools.
Figure 1: The H3 Cube is a large module that can comfortably seat a patient along with diagnostic tools.

I talked with CEO Tony Baldassarre about UniDoc’s vision and goals. They believe that everyone in the world should have access to basic medical care, which in many regions requires telehealth. Baldassarre says “We look at health care as a right, not a privilege.”

How H3 Cube Provides Broad Health Care Coverage

An H3 Cube can be set up anywhere, indoors or outdoors. A nurse or technician checks in the patient. The cube provides privacy, while the staff is available for assistance if needed.

The local health care partner can install whatever diagnostic tools they think their patients need, even an MRI machine. More than 300 routine diagnostic tools have been certified for use in an H3 Cube by more than 100 countries. Much of the work to certify the tools was done by UniDoc’s partner, AMD Global Telemedicine.

Physically, a standard H3 Cube is 8x8x8 feet, but a client can order a half size cube or expand the cube by adding panels. The resin-soaked panels are hard enough to stop a speeding bullet, discouraging vandalism. They also contain honeycomb inserts for soundproofing at an STC rating ranging from 45 to 52.

Naturally, UniDoc has to integrate its telemedicine solution with the broader health system. The H3 Cube can securely transmit data to an electronic health record (EHR) so that the doctor can record all information from the visit. Recent versions of the Hl7 protocol are used, and UniDoc doesn’t retain any information from the visit after the information is uploaded to the provider.

Baldassarre says that in addition to bringing sophisticated medical treatment to people who are remote from doctors, the H3 Cube gives the patient control over timing and place of visit. Many disabilities are accommodated. Thus, a ramp allows patients on wheelchairs to enter, and hard-of-hearing patients can communicate using a keyboard and captions for the clinician’s speech in the video console. Captioning supports 83 languages.

Can remote telemedicate provide comprehensive health care? Not completely, but Baldassarre says that 90% of health care visits are handled by a nurse or technician in a regular doctor’s office; UniDoc can do the same thing remotely.

The H3 Cube is attractive to payers because they can encourage patients to use it before going to the emergency room. A clinician can evaluate whether an ER visit is needed.

Business Models

Every health care technology has to surmount cost barriers, so UniDoc offers several different business models:

  • Shared revenue. Partnering with a doctor network, UniDoc brings patients to them and shares revenue from billing. In this model, UniDoc doesn’t bill the patient directly.
  • A subscription model. This is aimed governments, who choose which patients are served by the H3 Cube and pay a fixed monthly fee per patient. UniDoc helps with communications, but the government is responsible for encouraging visits.One example of this model in use comes from the Sirach wellness group Tucson, Arizona, which plans to offer the H3 Cube to the homeless, low-income residents, and veterans. One of the advantages of the arrangement is that they can register people who have fallen through the cracks by offering them a medical visit, and then register them for federal programs.
  • Purchase or lease: In this model, the client pays for the cubes and keeps all the revenue. The client just has to license the communication protocol and the software that certifies the product.

Some countries use H3 Cubes to allow people to hold visits with their own doctors while traveling.

Innovation and Regulation

The two terms in the previous heading seem to be connected by a “versus” more often than not, but I think that UniDoc and AMD Global Telemedicine have shown that regulation doesn’t have to be an opponent to innovation. Getting hundreds of devices approved in one hundred companies is proof that health IT companies can meet the needs of their legal environments.

UniDoc’s success also shows the innate appeal of telemedicine. After a decade or more of being dismissed for numerous superficial reasons, it is now embraced by clinicians, patients, and payers.

As far as I can see, the technologies employed in the H3 Cube are mainstream. UniDoc didn’t have to invent much technically. But a deft combination of proven, reliable technologies can create a radical change in the market and the patient experience.

About the author

Andy Oram

Andy is a writer and editor in the computer field. His editorial projects have ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. A correspondent for Healthcare IT Today, Andy also writes often on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM (Brussels), DebConf, and LibrePlanet. Andy participates in the Association for Computing Machinery's policy organization, named USTPC, and is on the editorial board of the Linux Professional Institute.

   

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