Tuesday, January 10, 2012

The Time Has Come: Physician Productivity and Telemedicine

Time is totally irreplaceable. Moreover, time is totally perishable and cannot be stored. Yesterday’s time is gone forever and will never come back.
Peter F. Drucker (1909-2005)

January 10, 2012
- This blog’s genesis is three-fold: one, an article I read by Phillip Betbeze “Telemedicine as Talent Strategy” in today’s HealthLeadersmedia.com; 2) an interview I conducted in May, 2010 with Ron Pion, MD, chairman of Telemedicine Associates in Los Angeles , titled “The Internet Lifts All Boats”; and 3) frequent Skype conversations I’ve been having with my son, who lives in Madrid, Spain.

From these encounters, I predict: new sophisticated Internet technologies may be key to enhancing physician productivity.

For the physician, there may be no more “dead time” or “windshield” time sitting in one’s car travelling to remote locations to examine patients.

For the patient, there may be no more time needed to be physically present, travelling to a distant location, and spending time away from home or your home town.

Yes, I’m aware of the problems – the impersonal nature of it all, possibilities of overuse and abuse, how, when, and whom to reimburse , difficulties of electronically replacing the physician examination, and, above all, the “virtuality” of it all.

But I am persuaded from my own Skype experience – the intimate "feeling" of talking two-feet away to a loved one face-to-face; the exploding and frightening shortage of doctors and nurses; and the telemedicine tale as told by Betbeze that these obstacles can be overcome – in real time, by real physicians, by real patients, in real circumstances.

Betbeze describes the clinical experiences of Don Chomsky, MD. a cardiologist associated with Saint Thomas Heart in Nashville, which is part of Ascension Health, a multi-hospital system. Chomsky,backed by a technology system developed by Cisco, the Cisco HealthPresence System and supported by the American Hospital Association, has been experimenting with seeing and examining patients electronically.

The idea is to make real-time visits remotely in hospital outreach clinics. The difference between the Nashville approach and previous approaches is the sophistication and clarity of the Internet-transmitted images, via large High-Definition television screen, and in the physical presence of a nurse practitioner or other mid-level practitioner with the patient.

According to Dr.Chomsky , with the able help of a midlevel practitioner, he can listen to the heart and lungs, look for leg swelling, examine the neck vessels, peer into ears, and look for other tell-tale physical signs just as well as if he were actually there. It is, he says, “frightfully intimate,” and he adds, patients are just as satisfied with the new encounter of the Internet kind as he is.

Tweet: Cardiologists in Nashville and elsewhere are now conducting real-time visits remotely for hospitals via Cisco’s HealthPresence System.

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