Telemedicine and its ability to shrink specialized medicine and education from miles to bytes, is one of the best kept publicity secrets for many hospitals. Often it is the software/hardware companies that are getting the word out about how this technology is turning doctors into techno-savvy heroes and hospitals into medical innovators.
Despite its promising future, (telemedicine equipment sales, which generated $77 million in 1995, is expected to leap to $283 million by the year 2000, according to the U.S. Telemedicine Report published by Feedback Research Services), telemedicine is still underutilized and under-marketed by hospitals. Similar to the Internet and intranets, many hospitals are in a quandary about telemedicine's most effective healthcare delivery services. This uncertainty hinders effective hospital communication about its uses and future direction. In addition, physician skepticism and operational problems like video quality and scheduling inconveniences continue to block its expansion, according to a 1996 market survey conducted by a top industry magazine, Telemedicine and Telehealth Networks.
Bridging The Gap During Emergency
It took Minneapolis-based Medvision, Inc., a telemedicine software company, to alert the media about its dramatic rescue mission for Red River flooding in North Dakota. When North Dakota and parts of Minnesota were being devastated by the Red River floods, United Hospital, in Grand Forks, N.D., sprung into action with its telemedicine program, which at the time was being beta-tested. "When the floods hit, we had to take a don't walk, run approach to the [telemedicine] equipment," said John Green, United's manager of physician services, who organized the telemedicine presentations to the hospital's physicians.
Within 24 hours of being evacuated, a rural emergency site in East Grand Forks, Minn. became host to United's first successful telemedicine application.
When Todd Benson, United's telemedicine coordinator contacted Medvision, Inc. to install the teleradiology software necessary to link physicians from Grand Forks, N.D., to East Grand Forks, Minn., Medvision technicians boarded a private plane to the sites and within six hours had the emergency system operational.
While East Grand Forks, a community of 9,000 was being evacuated, physicians there raced against time to become trained on the technology. In less than an hour the skeletal physician task force was able to transmit an EKG for a carbon monoxide poisoning case and an X-ray for a broken ankle to specialists at the Grand Forks trauma site.
"It was exciting to see how all these things came together under such extreme pressure: the quick response by Medvision made a lot of things happen in a short time frame," recalled Benson.
Still Suffering Low Hospital Visibility
Although the floods dramatically illustrated how useful telemedicine is to rural healthcare delivery, the technology still suffers low awareness and usage among the potential pool of physicians who could access it, according to Benson.
Currently about four physicians regularly use the store-and-forward system that is in place and being trialed, Benson would like to see expand to 170 once the program becomes fully operational.
Using 12 rural hospital sites (at $30,000/site), Benson is doing a needs assessment to determine which medical departments would be best served by telemedicine's store-and-forward systems and possibly some live interactive video software. Radiology is still a key area as well as pediatrics and dermatology.
Selling Physicians on Telemedicine
Prior to the floods, United, like many hospitals, test drove the technology in the radiology department. Using the latest store-and-forward applications to transmit images and patient data via phone lines and computer systems, the e-mail-like systems are most popular among radiology departments because the services will most likely reimbursable.
Spearheaded by Steve Sveningson, director of the radiology department, the first telemedicine discussions took place about two years ago for teleradiology systems.
To solicit wide-ranging medical support, Green organized a town meeting-like presentation that involved physicians, physician assistants and nurses from 21 surrounding counties in North Dakota and Minnesota.
"The draw for them was learning about how to find an efficient way to keep patients at home or in their town without having to travel, especially in inclement conditions," said Green, who highlighted three of the most compelling telemedicine benefits to this audience: patient care delivery at home, immediate access to specialists and higher productivity. Pursuing early input from healthcare providers was a key factor in earning their acceptance, said Green.
Admittedly, Benson says that more frequent meetings need to take place with Patty Lazarus in media relations and Audrey Lorenz in public affairs. Unfortunately, many of United's telemedicine success stories-including all the medical relief that was provided to flood victims-has not received the ink it deserved because of this lack of communication.
United's wait-and-see PR approach to telemedicine is typical. According to an industry expert, as telemedicine departments evolve, PR's coverage will increase, "In the next year, you can expect to hear a lot more about telemedicine success stories from hospitals, by then many of them will have been around for about three to five years and hospitals will have a better understanding of its particular benefits."
Since telemedicine penetration is still pretty low, 14 percent (according to a telemedicine evaluation study published in Telemedicine Today magazine), the most immediate focus will be increasing physician usage. (Feedback Research Services, 800/927-8071; United Hospital, 701/780-6561; Telemedicine Today, 800/386-8632)