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A Complete Guide For Offshore Software Development

a-complete-guide-for-offshore-software-development

To develop a software product is not an easy task; there are thousands of things you have to bear in mind all the time. Technical staff their team management, tech peculiarities, deadlines etc. Things become easy and less complicated after choosing the offshore software development. As you delegate a part of responsibilities to specialists, there is no need for a heavy focus on management and many other things.

This blog will guide you to show whether the offshore software development is a good option for you, as well as how to make less mistakes when you choose an offshore software development company and deal with it.

What is Offshore Software Development?

Offshore software development is outsourcing tasks to a third-party software company or developers. Such services may include software development, mobile app development, web development, web app development etc. Typically, a partner company providing development is from a foreign country.
If you don’t want to cooperate with a firm situated so far away, you may consider a variant of onshore and nearshore outsourcing. Let’s consider them in more details:
Offshore Outsourcing:
Offshore software development implies that headquarter of a company you cooperate with is placed somewhere far away from your native country. As a rule, there is a significant time zone difference.
offshore-outsourcing
Nearshore Outsourcing:
Nearshore outsourcing means that the company is pretty close to your native country. Respectively, the time zone difference is insignificant or absent at all.
nearshore-outsourcing
Onshore Outsourcing:
Onshore outsourcing implies that the company you work with is placed within your native country.
onshore-outsourcing

Steps to Offshore Software Development

It’s high time to consider what steps to take before the offshore software development process started and how to find a reliable company.
Get the Work Done on Your Side:
Even if you decided to delegate all tech responsibilities to the offshore software development company, there is still plenty of work for you as a stakeholder.
Decide on features for your target audience:
Analyze solutions from competitors and figure out what additional features you can provide your audience with to solve their pains. If your project implies offshore website development, you can track multiple parameters of your competitors. For instance, you can learn where their traffic comes from, what technologies they have used, how they scale and so on. It’s possible thanks to a myriad of web analytics tools and this data can help you to make informed decisions.
Take care of regulations:
If it’s required for your industry, you have to ensure that the product you want to create complies with the existing regulations. For instance, this can be applicable to apps using personal data or the ones connected with payments.
Define your objectives:
You should define your main goals to be able to set priorities throughout the project. Also, set metrics you want to reach as this will help you to measure your success.
Identify what you need:
We mean technologies to use, as well as specialists to hire (e.g. designer, developer, and marketer). If you’re not sure concerning all this, you can ask for consultation in your offshore software development company.
It’s a good idea to complete this list before contacting a company or at least take a break after consultation with its representatives to consider these points. This way, you’ll have a clear understanding of what you need and be able to define your goals.

Offshore Software Development Advantages

Cost cut down: It is known that you can reduce the expenses by hiring remote programmers. Their salaries will be lower than the in-house developers’. And at the same time, you don’t spend money on facilities, utilities, and equipment.
Talented and skilled specialists: Different countries have a wide talent pool of professionals. They are the graduates of tech universities that constantly improve their tech skills, take part in various IT conferences and competitions.
The balanced approach of management: The customer is in control of managing their project developers. You can always choose how many and what developers you need. However, it will not be time-consuming as the offshore software company is always there for you.
Know-how: The majority of offshore development companies specialize in particular technologies. They keep on improving employers’ skills. Regular training and gaining new experience are held on a regular basis. As long as you look for experts, offshore programming will definitely have the payoff.

Offshore Software Development Disadvantages

Communication issues: Sometimes communication may slow down due to time zone difference. Actually, it is about dealing with the issues timely, but in other cases, there are many modern ways of communication like video calls, email correspondence or even instant messaging. It will just require a little bit more organization and coordination
Cultural difference: It is recommended to consider this criterion because of the cultural barriers and different work ethics. The USA, Canada, Australia find the Eastern European mindset pretty similar whereas some companies have failed the communication establishment in Asia and the Middle East. Eastern mindset is quite different from the European one.

How to choose an outsourcing agency

how-to-choose-an-outsourcing-agency
There are hundreds of offshore software development companies. How to choose the most reliable one? Let’s try to find this out.
Check references:
What does this mean? Look through the company’s website to find some details about their previous projects or the overall expertise. Case studies, testimonials, blog posts and so on. All this can tell you a lot of things about the company and its experience.
Review references:
You can search for specialized rankings on resources like Clutch. Here you get the best outsourcing companies from the region you pick based on customers’ reviews and other factors that you can look through. For example, if you’re looking for offshore software development services in USA, you can filter companies by many parameters including development types (e.g. mobile development companies).
Protect your idea:
Contact a company to find out whether they sign a non-disclosure agreement (NDA) or not. It’s very important in case you have a unique app idea and you want to be completely sure it won’t leak anywhere.
Know your goals:
You should outline them first; make the choice of what technologies you are interested and what results your company expects.
Choose the right offshore development model:
As mentioned above you can choose among project-based contracts, dedicated teams, and development centers. It will just depend on your requirements.
Ensure regular connection:
Keep in touch with your provider, give guidance, and control the developing process. Communication is a fundamental element of success.
When you make a decision to apply for offshore software outsourcing and look for the company with extensive experience, you are welcome to contact Dreamsoft4u. Our company will be glad to find the best solution for you. Check our website for references and expertise we deal with. If you have a question or need the expert consultation send us an email, fill in the form at our contact page, or start the discussion right now in the chat widget.

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How To Become A Professional IOS Developer

how-to-become-a-professional-ios-developer
If you have dream to pursuing a career as a mobile app developer and finding the way to a professional iOS developer, here’s your guide for skills you need, salaries you desire, and the best programming languages to learn.
Here we have compiled the most important details and resources to help understand how to make career in mobile app development industry.

What does an iOS developer do?

An iOS app developer builds and tests applications for mobile devices for Apple’s operating system iOS that are consistent with the goals and standards of their company. They need to have a deep knowledge of iOS and how it works with various Apple devices like the iPhone, iPad, Apple Watch, and Apple TV, and be able to adapt their applications to their firm’s or client’s requirements.
Let’s discuss what you need to do to become an iOS developer?
  1. Buy a Mac or iPhone:

buy-a-mac-or-iphone
As an iOS developer, Mac should be your main working tool. I am not saying to spend so much money to spend before you earn, just buy a Mac, you may consider Mac Mini.
  1. Install Xcode:

install-xcode
The second step after you bought a mac, now you need to install the most important software for iPhone app developer-Xcode.
Xcode is the integrated development environment (IDE) for iPhone app development. It’s free and it can be downloaded from the Mac App Store. In Xcode is used to writing and editing the code, debugging, “drawing” your app in storyboards, unit test your app and many several things. Xcode is also used to upload ios application to App Store.  As soon as, you get familiar with it will be best for you as an iOS developer.
  1. Learn Basics Of Programming Language:

learn-basics-of-programming-language
If you already have programming background, pick the Objective-C (harder to learn) or Swift (easier to learn), they are mostly standard object oriented programming languages. But if you never had programming background don’t worry, there’s another way to go.
Two great resources for true beginners:
  • Ry’s Objective-C tutorial: This is the basic programming language for newbie app developers. You don’t have to truly master Objective-C, may be it is the old past language but it’s good to know the basics and understand the code.
  • Swift language guide by Apple: Swift language reference you want to use and learn from. Official Apple documentation, great as always. You need to fully immerse yourself into all this variables, pointers, classes, data types and loops. Very necessary context for a further learning.
  1. Create a few apps from tutorials.

create-a-few-different-apps-from-step-by-step-tutorials
Try this step when you are finally starting to do something useful. Get reference from these sites:
  • AppCoda: The best starting step for newbie app developers. You will get many tutorials, and step by step description.
  • Ray Wenderlich: Another useful site with a giant database of iOS development tutorials. Learn step by step.
Don’t stop here! Create a calculator app, after that create a weather app and then a currency converter app, Music app etc. with the help of the tutorials.
  1. Build your own custom app

build-your-own-custom-app
Now, you are going to next level.
At this step, start to build your own custom app. You don’t have to build second Facebook. Learn things to go ahead during the custom app development. So stay calm and analyze the areas of iOS development, you are going well. During the iPhone app development you may face some new criteria such as-
Maybe you need to build an application that uses networking a lot?
Maybe you have so much learned UIKit and that makes you create complex user interfaces?
Just Focus on clean and working code.
  1. Learn about software development

learn-about-software-development
Start learning to software development and for this you don’t need to go anywhere. Yes you can lear4n it at your own. Make Google your friend and try to be friendly with it. There are so many experts online who provide amazing session. Try to learn from them.
  1. Finish your app development

finish-your-app
Finish you app development after facing so many techniques during the process. That app will be going to play key role in your resume. Here’s a list of suggestions of what employers will be looking for in your app:
  • Working experience on app development
  • Clean code structure
  • Code organizing- how did you manage that code such as small classes, selected names for variables, file grouping inside the Xcode etc.
  • Usage of CocoaPods
  • Usage of storyboards
  • Some simple unit tests
  • usage of external libraries
  1. Publish application to App Store

This step can be optional, because to publish your app, you need an iOS developer account, which costs $99 yearly and there is a big chance that your app won’t break even that cost. It’s up to you that you want to or not to have an app in the App Store, but a lot companies evaluate this as a big plus in your resume.
  1. Upload app to GitHub.

publish-your-app-to-the-app-store
GitHub is a social platform which is used for sharing code.
You can upload your code here, you can watch other people’s code, you can also contribute to open source projects. It’s widely used and you can benefit from GitHub even if you are a solo-only developer — by better organizing your code and having the best possible backup.
  10. Apply for the Company!
contact-the-company
Now you are prepared to get your first job as an iOS developer! Intern or junior probably, but it’s not important — the important thing is now you have the skills to get first job, and when you achieve this, the rest will take care of itself.

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Challenges Of Software Development Startups In IT Industry

challenges-of-software-development-startups-in-it-industry
Startups whether it’s big or small, always adopt the latest software development industry trends and dedicatedly follow them to survive the competition.
Advanced Technologies and software development process automation to improve work, offer quality and deliver better services and products to their clients/customers. The software development industry is highly volatile and rapidly adapt to changes in the working environment.
However, to keep growing a web development company in USA should manage the technology correctly and face the software development challenges with proper strategies.
Often people think that software development is not a big game! Yeah, they might be true, but the software development challenges of startups are at different levels.
Projects involving cloud computing, product enhancement and upgrades, in-house products and services development, web-based solutionsmobile application development, etc. using the latest tech are the biggest challenges in the software development industry, especially for the startups.
Going further, let’s take a look at some challenges every software product developer or company faces. The software development problems and solutions are as follows:

Globalization: A Biggest Software Development Challenge

globalization-a-biggest-software-development-challenge
If your business relates to the software industry, then you are either building software solutions or offering software services. Global competitions often force businesses to redefine their product’s design by integrating new feature functionalities for retaining their position in the market.
Correct project management plays an important role in any new software company; otherwise, it might affect the client-company relationship. Finally, you might lose the project!
SaaS: Not a Software Development Problem, But a Solution
SaaS (Software-as-a-Service) platform helps small and mid-sized businesses to avail extensive enterprise level capabilities. Companies are shifting their gears to SaaS application development due to its reliability in building robust, flexible, scalable and user-friendly applications.
Thus, with an excellent team of developers and designers in USA, a software development startup can redirect a large chunk of investment on SaaS which in return give more value to your business strategies.
“SaaS is a business’s-friendly technology that works for practical innovation, cloud development services and gives real-life benefits to customers and users.”
Software Testing: Quality control
A product or service has value only when it’s tested thoroughly for errors, bugs, and defects. Being, reliable is an important criterion for a company in the software development industry.
A Project manager, therefore, focuses upon implementing powerful quality tests to ensure the project deliverables. Several types of tests ensure the quality of the software. Some of them are as follows:
  • Unit Testing
  • Functional Testing
  • Integration Testing
  • System Testing
  • Performance Testing
  • Stress Testing
  • Usability Testing
  • Regression Testing
  • Acceptance Testing
  • Beta Testing
Testing is among those challenges every software product developer faces to produce bug-free software. A Project manager must know every testing method of development platforms like web-based apps, mobile applications, and cloud services based apps, etc.
Project Reporting: A Common Offshore Software Development Challenge
If project reports are not appropriately conveyed to the clients, then a sudden rise in tension between a software development company in USA and client might put a project to halt.
Thus, as a startup focuses on keeping reports daily with these:
  • Project Status Report: A report containing the project’s overall health.
  • Time-sheet Report: Monitor resource availability for the tasks in development.
  • Resource Workload Report: It schedule resource across different projects and measure budget impacts.
  • Expense Report: It provides insights to the client about their investments.
  • Portfolio Report: To capture clients, give your samples as a portfolio to them.
  • Risk Reports: Detailing all the involved risks in a project along with their solutions.
  • Board/Executive Reports: A weekly status updates which directly goes to your project team and important business stakeholders.
Third-Part Integration Challenges Affecting Software Project Management
Technologies keep on updating, and software development companies tap their potentials to build third-party integration modules that offer pre-defined functionality. These modules reduce the development time and safely integrate into the existing systems. This can increase all the stress levels because managers are forced to invest a particular time in understanding how the modules work.
Custom software development project must be regularly monitored by the startups to avoid all the biggest challenges in software development projects as discussed above. The monitoring process consumes a lot of time, but interaction with various individuals in the team of your software development company.

Top 10 Challenges in Software Development

top-10-challenges-in-software-development
Software Development is the instruments of administration, management, and planning for an enterprise. The expectations are sky-high. An Application should function smoothly, cater to each need of a company, integrate multiple systems of the company, be secure and give back a considerable return on investment (ROI).
Challenges on the road of Enterprise Application Development
Developing an Enterprise Application is a scrupulous job. It requires precision, vision, and expertise. The challenges can be many but it’s important to be aware of them to get the right product.
Here is a list of probable challenges in the way of Enterprise Application Development-
Changing Business Requirements and Environments
  • The landscape of a business might change, sometimes completely. There can be technological transformation taking place. Or there can be economic disruptions.
  • The path that a company follows might change owing to feedback and analysis. This simply means new workflows and requirements have to be implemented.
  • Or in special cases, there can be a merger or acquisition. In that case, it all becomes a mammoth task integrating the two systems into a common Enterprise Application.
  • Enterprise Applications are complicated and changing.
Shifting to the mobile platform
  • More Enterprise Applications want to go mobile. The global market for enterprise mobility is projected to reach US$218 billion this year.
  • Mobility and cloud-computing accelerate faster than the desktop counterparts and your company might lose relevance if you aren’t going mobile with your applications.
  • Mobility increases productivity and leads to faster decision-making. This is because information can be captured fast using mobile and can be shared instantaneously.
  • Employees and customers enjoy mobility and it’s surely more of a necessity now than empowerment. Such a requirement will most definitely reach your business, if not already. The challenge is to make the transition to mobile easy by including the essential functions on the mobile platform, without creating a heavy mobile-application. A lot of testing is required to get the layouts and fields right so that everything fits the mobile format easily.
Security
Security for your software development begins with controlling user access and securing the resources of the application. There are various services in a software development like user-interface services, Operating System services, Business Process Services, etc. Controlling user access simply means restricting the usage of these services to authorized users.
  • A strong defense system is a primary requirement that includes encryption and firewalls at application, host and network level.
  • Enterprise Data is of utmost importance to a company. Use competent security software to install and maintain security. Make sure the privacy of sensitive user information is protected.
  • Web applications like a mobile application or cloud-based software are prone to cyber-attacks and breaches. This is because an increased number of networks lead to more vulnerability like unknown users, cookies, etc. Make sure your security software is competent to protect all aspects of the web application.
  • The software must be updated with the latest security patches. The same security levels must be implemented across all platforms.
Interoperability
  • It is required that systems in an Enterprise are well-linked with each other. For example, Leave Management System and Payroll System must be linked for consistency across all functions. Similarly, a Customer Management System will be using data from the Sales System.
  • Enterprise Applications is a web of neatly linked functions across different sub-systems.
  • There should be a smart link between applications that use the same set of data to achieve optimization in an Enterprise Application.
  • Interoperability standards should be followed to achieve effortless sharing and usage of data.
  • Careful design is necessary especially for heterogeneous environments that involve disparate systems
User Interface and Experience
Is functionality everything? No. If an Enterprise Application has a basic user interface, employees might not enjoy using the software. If consumer apps can have sleek interfaces, why not an Enterprise Application?
The importance of beautifully designed, comfortable user-interface should not be underestimated as it can result in greater and impactful engagement, ultimately extracting more value from the same software.
Adding small details to the application to make navigation and accessibility easier can have big results in terms of employee satisfaction and productivity.
Low ROI
Enterprise Application Development, as mentioned before, needs expertise and detailed planning. It’s a costly affair and the expenses don’t stop there. There are high maintenance costs and expenditures like in creating and sending regular updates. But, a feeling of disdain comes when the costly development and maintenance doesn’t bring in the expected results.
The aim of an Enterprise Application can be to improve the sales cycle, increase the productivity of the employees or to smoothen and optimize internal processes.
The goal should be clear and it should be reflected in the design and development of the Enterprise Application.
Regular measurements and comparisons need to be done to know the real value of your Enterprise Application.
Time and Cost
Software and Web Application Development can be a time taking process if the approach isn’t clear. It can take months to develop an Application, sometimes 5-6 months.
Incorporating and integrating various systems of a company takes time. Half-a-year, on an average, is a long time period, especially when you want to get started with an Enterprise Application quickly. But, is the solution?
A Modular architecture is an answer to this problem. Modular Architecture uses pre-made blocks of code (ready-made functionalities) that are customized according to the needs of an organization and linked together accordingly. This can cut short time by one-third; thereby you can save a lot of time and thus money.
Maintainability
Maintainability is as crucial as developing an Application. It is not just limited to operating the product but also detecting defects and correcting them quickly.
Maintainability should not be a cumbersome job. The adaptability to new environments and future-requirement should not be a stressful process.
Also, maintenance should be a fast process. You don’t want to be in a situation where you are spending US$ 3000 per year on maintenance and yet it is a time-taking process.
Modular architecture again makes life much easier. For example, if you wish to make changes or correct a fault in ERP system, Modular Architecture makes sure that the Content Management System, that is independent of the ERP system, is not at all affected. This all leads to easy maintainability.

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Case Study of Remote Patient Monitoring Applications

Remote Patient Monitoring (RPM) is a kind of healthcare system that helps patients and doctors who use mobile devices to track vitals analyze data in real-time.RPM used as monitoring devices such as blood pressure trackers, heart rates trackers for patients getting care in the hospital or clinics. The data (recorded/live) is sent to doctors by using the cloud-connected system with the help of an application on the doctor’s phone.
Remote patient monitoring systems are designed to obtain a number of physiological data from patients. Most common data are Electrocardiogram (ECG), Electroencephalogram (EEG), heart beats and respiration rate, oxygen volume in blood or pulse oximetry, signals from the nervous system, blood pressure, body/skin temperature and blood glucose level. In addition to these, sometimes, weight of the patient, level of activity of the patient and sleep data is collected. A number of researches have been done for wound management and sleep monitoring applications.

Features of Remote Patient Monitoring

  • Hospital dashboard
  • Analytical, Reporting & Charting
  • Performance dashboard
  • Patient Portal for Accessing
  • Readmission rates dashboard
  • Multi-platform Support
  • Compatible For Wearables Integration
  • Real-time Video & Audio Interaction Functionality

Chania

Key Benefits of Remote Patient Monitoring System

Saves Money

Save money with this technology as this reduces official physician visits to the parients. This way, physicians are more efficient during their consultation hours without having to physically visit the patients every few hours. You can meet them rhjough the RPM.

Makes Healthcare Accessible

Remote monitoring enables patients to get consultation without having to visit a medical practitioner. The technology ensures timely communication, quick counseling, and time to make preventive measured if deemed necessary.

Makes Healthcare Efficient

We placed a Categorization System on the website for the Doctors to categorize their patients according to the severity of their conditions. Artificial Intelligence-powered remote patient monitoring technologies automate process redundancies.

Makes Healthcare Consumer-Centric

Incorporating cloud-connected monitoring systems in the recovery can significantly improve the patient experience. Patients recovering under remote monitoring systems report patient satisfaction and increased gratitude towards the hospital.

Follow-up Notifications

Every patient called for a different follow-up schedule, which made it impossible for the doctors to set a common schedule. We gave them a platform to feed in case wise follow-up instructions which were then sent to the patients.

Saving Patients’ Medical Record Filing Time

 To save your precisious time,We added the option for the patients to scan their medical data on the app. That helps patients to fill the medical information onlinewhich so far better than manually on the app.

Case Study of Remote Patient Monitoring Applications

Project Highlights
  • Refined workflows for doctor-nurse interactions, trends, and testing schedules
  • Integrated BizTalk orchestrations
  • Added functionality to support in-home data collection including a Bluetooth modem, glucose meter, pulse oximeter, blood pressure cuff, and scale
  • Added functionality to support a custom handheld application for caregivers in a medical facility to enter medical data for their patients
(I) What We Did:
  • Automated Testing
  • Web Development
  • Regulated Environment
(II) Tech Stack:
  • C# / Microsoft BizTalk
  • VB.NET / .NET Compact Framework
  • SQL Server
(III) Opportunity:
A medical device manufacturer needed to add features to its existing healthcare data system in order to support remote patient monitoring for long-term care. The new features needed to allow hand entry of blood glucose readings for home healthcare and elder care facilities.
Challenges of RPM
However, RPM is challenging because you remove the support of medical staff to ensure proper usage. A situation where it is the patient’s responsibility to adhere to any component of a treatment plan introduces challenges with patient compliance.
(I) Achieving Comfort and Usability:
Wearability is not only the most subjective issue, but perhaps the biggest issue to RPM device adoption, especially in longer term or continuous applications. Simply put, if the patient doesn’t wear it, it won’t work. Wearability has to do with comfort and convenience.  A comfortable device that is difficult to operate will not succeed. Conversely, a simple device that is uncomfortable to wear will fail.
(II) Form Factor and Sensor Upgrades to Improve Data Accuracy:
Data accuracy is the next important factor in RPM devices. The devices field is crowded with consumer style wearables, and some FDA-cleared medical devices. The challenge has been the convergence of the two into a form factor that offers wearability and medical accuracy. Consumer style wearables are user friendly, but often lack the accuracy and validation for medical use. Not only may the sensors and technologies in consumer wearables be lacking, but the position on the body, such as the wrist, can limit data accuracy.
(III) Connecting Patient Data to Providers:
The final piece for RPM’s fullest potential is timely access to data. In the case of infection monitoring, time is of the essence. Or if a patient is being treated for heart conditions, it is important to know as soon as certain problem indicators are happening. A key challenge with data access is network availability.
(IV) Integrate Third-Party RPM Data in to the EHR:
Once decisions have been made on how to integrate third-party RPM data into the EHR, leaders must next decide to which device manufactures to connect assuming the EHR vendor allows custom development to ingest external data. Typical device integration can take weeks or months for an experienced software developer to code and test, which means that organizations need to be very thoughtful about which device types and manufacturers to focus on. Developing integration with a device that won’t be well-adopted, isn’t accurate, or has unstable or unreliable interfaces are all risks.
In summary, a successful RPM program will ensure that you’re getting the right data from the right people, making sense of that data to make the right interpretation, and bringing it to the attention of the right care team to take the right action.
If you have faced challenges in doing this, or are just starting out on your RPM journey, drop us a note. We’d love to share more with you, as well as look at how Dreamsoft4u might be able to help your organization create a scalable, sustainable RPM strategy. Our new remote patient monitoring platform, Impact, is designed with all of these principles in mind and is designed to extend your existing investment in your EHR and care management solutions.
Result
The web app allows patients to remotely share data with trusted caregivers. The new added measurements and reports help those doctors better capture and understand their patients’ status. The new handheld app helps doctors and caregivers manage their patients by quickly and easily entering key medical information.

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Case Study of VCDoctor Telehealth App

Dreamsoft4u already has developed VCDoctor; a HIPAA compliant web portal that will bring patients and doctors together that could execute business transactions for their consultation and providing better and instant care for patients.

Features of VCDoctor

  • Video Consultation
  • HIPAA Compliant Solutions
  • Appointment Booking and Scheduling System
  • Alerts Reminder and Notifications
  • Online Payments
  • Payment History
  • User Membership Plans
  • Extensive Doctor’s using Various Criteria
  • Manage Users and view Complete Details of Users

Illustration for article titled VCDoctor Telehealth App

Case Study of VCDoctor Telehealth App

WHAT IS TELEHEALTH?
Telehealth is a means of delivering medical information and health care through the use of telecommunication technologies.
Telehealth does not typically create new or different health care services. It simply provides a new way to deliver existing services. On the clinical side, telehealth bridges the distance between patient and health care provider by allowing patients to remain in their communities, while being seen by a health care provider at a distant site. This enables those living in northern communities or areas that are underserved to have improved access to health care. Telehealth also saves time and money by reducing the amount of travel time and expenses, as well as reducing the time patients are off work or away from family responsibilities.
Defining and Overcoming Telehealth Challenges
The goal of this large grantor was to fund IT projects “to support planning, implementation, and evaluation of various information technologies that were intended to improve the quality, safety, and efficiency of healthcare delivery.” AHRQ grantees implement telehealth programs all over the United States. Typically these programs sought to connect rural clinics and facilities with larger urban hospital counterparts in order to provide access to specialty care in rural communities. The programs used telehealth in a variety of ways, including:

  • Provider-to-provider communication with the patient present.
  • Provider-to-provider communication without the patient present.
  • Telemonitoring or remote monitoring of patients.
  • Healthcare education.

Visit Our Product: Digital Imaging and Communications in Medicine (DICOM)

While the way they used telehealth was diverse, they all experienced implementation challenges over the past decade but found ways to overcome them. Some of the challenges, solutions, and lessons learned they reported included:
(I) Security and Interoperability:
Security and Interoperability presented challenges for these providers, because disparate healthcare organizations were required to communicate information. To overcome these issues, grantees coordinated common security technologies, including firewalls and encryption, while sharing and maintaining security protocols. This required cooperation between different healthcare providers and the coordination of departments beyond IT. The report pointed out, “Changing organizational policies requires buy-in from organization leaders who understand the value of telehealth for providers and patients.
(II) Image Resolution:
Image resolution and video quality requires significant bandwidth. Providers reported low-resolution video was less-than-adequate for healthcare applications. The providers recommend introducing telehealth in pilot projects in order to work out these kinks.
Visit Our Product: VCDoctor Telehealth App
(III) Technical Support:
Technical support that is efficient and cost-effective is a requisite for these programs. For the academic facilities, internal technology departments provided technical support. Rural healthcare programs had fewer resources and many times technical support was provided by a consultant our third-party vendor. This was an expensive undertaking several years ago, that has been mitigated over time with more user-friendly applications.
(IV) Organizational Culture:
Organizational Culture changes as part of any telehealth services offering. Gaining the buy-in of stakeholders is imperative in any new service line. Yet the grantees found that because patients saw many different providers within a healthcare organization, telehealth helped facilitate a team-centric approach that lent itself to coordinated care. The challenge of coordinating care improves with telehealth, because it eliminates geographic distances that stymie communication between providers and the providers and their patients. The study said, “Telehealth supports and enhances team-based care by connecting providers remotely to foster collaboration and health information exchange.
(V) Provider Retention in Rural Areas:
Provider Retention in Rural Areas is often a significant challenge. Rural doctors can feel isolated and may seek a more urban practice. Interestingly, the study found that telehealth had a side benefit of connecting rural providers with their peers from other hospitals in both urban and rural settings. One project funded by AHRQ developed a telehealth-driven learning network for doctors and other clinicians. The project surveyed network participants and found that the clinicians felt more confidence when treating complex and chronic diseases. They also reported higher job satisfaction.

Prior to implementing telehealth, some of these providers had to drive up to 100 miles to participate in healthcare learning events and networking activities. After implementing the telehealth learning network, grantees reported lower turnover among doctors, nurses, and other clinical providers.

(VI) Payment:
Payment parity reimbursement and coverage for telemedicine services comparable to those of in-person services — is a big challenge for telehealth. There is no guarantee of payment parity between telemedicine and in-person health care. Even in the 28 states in which payment parity laws have been passed, no apparatus exists to enforce it. This could potentially defeat the point of telemedicine to reduce health care costs and expand access to services, and could also discourage providers from offering telehealth because there is no guarantee of comparable payment.
(VII) Misdiagnosis:
Misdiagnosis happens often in in-person health care, but the risks increase with telehealth. Add to this the fact that there is no clear standard of care established by state legislatures, and quality may be uneven between one provider and the next.
Misdiagnosis has the potential to drive up overall costs to the general health care system as well, because misdiagnoses leads to wrong prescriptions and treatments. According to the CDC, one third of antibiotics prescriptions are already unnecessary. Additionally, if a telehealth service cannot determine a diagnosis, the patient may be counseled to go to an ER or an urgent care service. If these visits are unnecessary, they may result in a large cost to both the patient and the system as a whole.
(VIII) Widespread Implementation:
The government has been attempting to address patient demand for telehealth by passing legislation like CONNECT (Creating Opportunities Now for Necessary and Effective Care Technologies), which expands the availability of services provided through telehealth under Medicare.
The challenges of widespread implementation of telemedicine encompass many different areas, because “telehealth” can refer to so many different things — from robotics to telephone consultations. Some of the responsibility of implementation resides with the legal system, and rests with the government. Some is institutional, and rests with local hospitals and health care institutions. Also, some of the challenges are financial, and require the effective utilization of business strategy and human resources.
(X) Telehealth Vendors:
One unique challenge of utilizing telemedicine technologies on an extended scale is how to account for the vendors. Vendors are integral to the process, but they are not held responsible nor are they compensated for individual cases. Additionally, the line between provider and care platform is sometimes blurred when it comes to telehealth vendors.
VCDoctor works every day with clinicians utilizing telemedicine service lines to improve patient care. Talk to us about the challenges you’re experiencing with an existing service line, or about implementing a new virtual service for your patients.
Get in Touch, if you are having an idea of Telehealth App, we would like to hear from you.

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