Sunday, May 30, 2010

Observations of a Techno-Skeptic and Telemedicine-Advocate

It is plausible to be skeptical while advocating technological solutions to human health care problems.

It depends on what the problem is:

• If the problem is health endangered by an implacable enemy, like the Vietgong or Al-Queda or the Taliban, room for skepticism exists. Geurillas or terrorists can always hide in the bushes or among followers.

• If the problem is changing human behaviors leading to drug addiction, alcoholism, or obesity, I am skeptical one can alter human mindsets through technological social engineering.

• If the problem is cultural – like poverty, poor education, economic malaise, or disintegrating family conditions, crime or violence – it is important to remember most of these conditions or beyond the reach of medical technologies.

• If the problem is a natural disaster – like an underwater well gushing oil, an erupting volcano spewing ash, a hurricane, a tsunami, or a tornado wreaking havoc – technologies has limitations.

• If the problem is human aging , curing all cancers, and prolonging useful life beyond 100, medical technologies , no matter how sophisticated, are unlikely to succeed.

Yet we , as the New York Times reminds us “ Our Fix-It Faith, May 30, 2010), “Americans have long had an unswerving belief that technology will save us – it is the cavalry coming over the hill, just as we are about to lose the battle."

As Andrew Kohut, president of the Pew Research Center, remarks, “Americans have a lot of faith that over the long run technology will save everything that somehow we’re going to find a way to fix it.”

I believe this faith is well-founded when it comes to information technologies

• If the problem is educating patients to understand how to cope with diseases that afflict themselves or others with the same condition, I believe websites like or are useful and instructive.

• If the problem is using the Internet to empower consumers to take control of their health and spot value among providers, information technologies have a bright future.

• If the problem is lowering costs and gaining direct access to medical expertise, like rural regions, prisons, remote locations, worksite or offshore clinics, astronauts in space, travelers abroad, and the home, using videos to consult a doctor without leaving where you are will lower costs and improve care.

Interactive videos, and face-to-face telemedicine, is gaining market share, investors, and health plan payer support each day, as costs rise, technologies improve, reimbursement grows, video-quipped booths in retail clinics proliferate, audio video devices next to the bedsides of chronically ill, home bound patients become popular , patient and doctor satisfaction grows, and new physician-directed, venture backed companies like www. sprout..

Suddenly, as costs rise, the interactive telemedicine business has gone mainstream , growing 10 percent each year and garnering more than $500 million in annual revenues. TDistance may no longer hinder physician access.

1 comment:

Jeffrey Seguritan said...

Clinical telemedicine is an intriguing movement in healthcare delivery that addresses two key needs: (1) shortage in primary care, particularly in rural areas, and (2) lack of collaboration between physicians and specialists over the best course of care. Telemedicine is likely to reduce costs in the long run, but it's not immediately obvious to what extent it will improve quality of care, particular when you lose the intimate setting in which doctors examine patients. I discuss about telemedicine in my most recent blog ( and try to understand what it might mean for the future of the doctor-patient relationship.