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Digital doctors


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POSTED: Monday, March 30, 2009

Telemedicine, which connects medical specialists online with patients in other locations, is a growing trend with great advantages for rural hospitals and isolated patients, says Dr. Jay H. Sanders, one of the pioneers in the industry.

“;In essence it affords the ability to electronically transport the physician to the patient instead of the patient to the physician,”; said Sanders, who has been called the “;father of telemedicine,”; in an interview. “;It's really a life-or-death situation in many areas.”;

Sanders, president and chief executive officer of the Global Telemedicine Group, based in McLean, Va., was among the speakers at an Online Care Symposium sponsored last week by the Hawaii Chapter of Health 2.0 at the Kahala Hotel & Resort.

About 100 online-care pioneers, users and policymakers from Hawaii and the mainland attended the first event of its kind in Hawaii. It was co-sponsored by the Hawaii Medical Service Association, Kaiser Permanente Hawaii and American Well Inc.

Matthew Holt, co-founder of Health 2.0 and author of the Health Care Blog, said every person at the conference “;played an active role in discussing online care and helping shape its future.”;

Sanders developed the first statewide telemedicine system in the United States, the first correctional telemedicine program and the first “;tele-homecare”; technology, called “;The Electronic House Call.”;

He said telemedicine is used in many ways—for instance, to connect rural hospitals with academic medical centers and to address geographically isolated patients with no access to a trauma surgeon.

“;Telemedicine is the ability to bring expertise in a timely fashion to a patient,”; he said, predicting it will be used increasingly in the area of stroke care because it is critical to make a diagnosis and initiate therapy within three or four hours.

Many rural hospitals do not have the expertise in neurology to do an effective exam or read a CAT scan or MRI (magnetic resonance imaging) X-ray, he said.

With telemedicine, he said, a neurologist at a medical school or secondary-care community hospital is transported electronically to a rural emergency room to literally examine a patient by CAT scan or MRI.

The specialist can inform the ER physician how to treat the patient appropriately and “;basically clear that clot and have the patient literally walk out of the hospital,”; Sanders said.

He said he thinks the biggest value of telemedicine will be to examine a patient in the home, determine whether the disease is getting worse and begin treatment without hospitalization.

“;There is a huge cost savings,”; he said.

One problem with telemedicine development is that the physician is not reimbursed for care in many instances because of some “;archaic rules,”; he said, such as requiring face-to-face patient-physician care for Medicaid coverage.

He said Hawaii is “;way ahead of the game”; in how reimbursement is provided for Medicaid care. “;I believe the other 49 states soon will be looking at Hawaii as a model to follow.”;

Some other “;ridiculous handicaps”; also exist, such as legal and regulatory restrictions related to licensure, he added.

Sanders is looking to the Obama administration to push access to care with online interaction between physicians and patients: “;Very shortly you will be able to see me on the cell phone. It will be major technology for telemedicine.”;

He said Dell Computer and Microsoft are going to put the computing power of a laptop into a cell phone, which will have huge health applications. “;I can read an MRI or CAT scan on my iPhone,”; he said. Triage capability recently was added so a patient can enter symptoms and get a diagnosis from the software, he said.

“;You and I will probably view this as something new, but our kids will be using this every single day,”; Sanders said.