Source: Florida Medical Business
E-Health
August 2000
Title: Hospitals, Physicians Both Benefit from Teleconferencing
Written by: H. Allen Benowitz

......Imagine cutting travel time from a small, rural hospital to major, urban hospital from an hour to zero. Picture the individual physician, who, from his or her own office, can consult with another professional thousands of miles away. Thanks to the advancements of modern telemedicine, this is now possible.
......Telemedicine, a rapidly growing facet of videoconferencing, utilizes a combination of computer databases and real-time video networks, saving time, space and money for today's health care professional.
......Florida's health care industry is booming, surpassing tourism as the state's biggest business. South Florida alone has more than 75,000 health care professionals, with its location and reputation creating a tremendous opportunity for the expansion of telemedicine into Central and South America.
Telemedicine has applications in almost every field; however, it is primarily used in dermatology, cardiology, consultative radiology, emergency medicine, neurology and oncology.
......While there are multiple telemedicine applications, three major ones form the backbone. Clinical applications are those that permit physicians to consult with each other from different locations, such as the transmissions of X-rays, or teleradiology. Medical education applications allow courses to be transmitted to other cities and, in some cases, other countries. Administrative applications are used to tie together health care systems, evident in interactive videoconferencing.

Attracting more patients
......Many hospitals are also using telemedicine as a way to attract patients and extend their coverage by connecting to smaller hospitals, resulting in stronger regional relationships with connecting satellite clinics. Hospitals can benefit from the re-selling of bandwidth and teleconferenced continuing medical education, resulting in increased revenue.
......Telemedicine allows remote managed care; second opinion medicine; consultation; remote diagnostics; distance learning, education and training; and remote robotic surgery.
......Several prominent South Florida-based hospitals have implemented telemedicine programs, including Baptist Health Systems of South Florida and Homestead Hospital. In 1997, Homestead established a system allowing it to send X-ray images to sister hospital Baptist.
......Baptist Health Systems has a similar arrangement with the Cayman Islands government in which X-ray images from hospitals in Cayman are sent to the hospital for consultation by a staff physician. Baptist has also ventured further into telemedicine with the deployment of a network called asynchronous transfer mode, more commonly called ATM, initially linking the system's hospitals together for videoconferencing purposes.
......For emergency service and remote consultations, a city hospital can also connect with a rural hospital without having to send physicians out in many cases.

Single docs benefit too
......There are considerable benefits for single practitioners as well. Because doctors are able to read X-rays from many different locations at one site, courier costs can be reduced and possibly eliminated. Doctors are able to save images to a patient's file and patient database records can interface with hospital database records, allowing doctors to improve efficiency and reduce internal expenses.
......What should the health care institution or professional consider before implementing a telemedicine program? The most successful programs have a narrow focus with clearly defined sources of funding that are fully reimbursed by Medicare and other insurers. Further, it is important to design a system so it fits smoothly with how personnel normally provide services. Equipment and communication make up a large portion of expenses and should be looked at carefully.

Source: Miami Today, May, 1997
Title: Medical institution finding increased uses for tele-medicine
Written by: Danielle Beck

......Tele-medicine has proved its worth in the health care delivery system as medical institutions are examining more ways to use it.
......It's a major trend that began emerging in the past year, said Ed Crowley, international marketing manager for the health care business unit of Austin, TX-based VTEL Corp., a video-conferencing manufacturer.
......"What we're really seeing is a pretty dramatic shift since a lot of the grant funding for these big projects for tele-medicine has run out. It's making companies look at how to invest in technology on their own," he said. "Tele-medicine has moved form formerly being a lot of private projects. Now the technology and its applications are being tested to really be a part of the health care delivery system."
......When predicting the effect of this in various cities across the country, it should be "interesting" in Miami, Mr. Crowley said.
......"There is a lot of interest in tele-medicine in Miami, not only between Miami and other US cities but between Miami and other countries, such as Latin America," he said. "I think we'll see that Miami is a logical gateway into Latin America for many of these projects. We're already seeing that many hospital systems have been pursuing things in that area."
......While there are multiple tele-medicine applications, three major ones form the backbone. Clinical applications are those that permit physicians to consult with each other from different locations, such as the transmissions of X-rays, or tele-radiology. Tele-medicine is also increasingly being applied in the medical education front in which medical education courses can be transmitted to other cities and, in some cases, even countries.
......Administratively, telemedicine is also used to tie together health care systems, evident in interactive video-conferencing.
......While video-conferencing has been around for years, the medical world has been somewhat slow to embrace it, Mr. Crowley said.
......"There was some resistance to it, but what's finally happened is there has been maturation of the technology that's made it friendlier, more cost-effective and easier to use," he said. "There's also more of a competitive pressure in health care these days. Many health care systems are looking for ways to streamline their operation to make them more cost-effective and efficient. Tele-medicine is ideal for that."
......Several local hospitals, such as Baptist Health Systems of South Florida, are enhancing their tele-medicine systems. Last month, a system was set up allowing Homestead Hospital to send X-ray images to sister hospital Baptist, said Kent Wreder, corporate director of object technology for the health system.
......"This gives the population of Homestead 24-hour coverage if someone there needs an X-ray read, because we have that capability at Baptist," he said. "It's a way to better help our patients."
......Baptist Health Systems also has a similar set-up with the Cayman Islands government in which X-rays images from hospitals in the Cayman Islands are sent to Baptist to be read by a Baptist Hospital physician.
......Within the next month, the health system will venture further into tele-medicine with the deployment of a new network called asynchronous transfer mode, more commonly called ATM.
......Initially, it will link the system's hospitals - Baptist, South Miami and Homestead - together for video-conferencing purposes, Mr. Wreder said.
......"For now, it will be for business meetings so people can attend without having to leave where they are," he said. "But over time, probably within a year, we see this technology as a way to do more tele-medicine across our enterprise."
Tele-medicine can save both hospitals and insurance companies money, savings that trickle down to the health care consumer, said Allen Benowitz, president of Worldwide Videoconferencing, a Miami-based company specializing in video-conference network design, equipment sales, consultation, and project management services.
......"For emergency service and remote consultations, a city hospital can connect with a rural hospital without having to send physicians out in many cases," he said. "Also, medical personnel can take continuing education courses in other cities without having to leave. Both are examples of how the technology can save travel expenses."
......Tele-medicine also dovetails with the new trend of satellite hospitals in which larger hospitals are setting up smaller outpatient health care facilities in suburban areas, said Mr. Benowitz, who presented a talk titled "Tele-medicine and Business Applications of Videoconferencing" at Intercom '97 held in Miami in March.
......"This is really an ideal application for tele-medicine," he said. "The facilities, although at different locations, are linked to each other."
......With the health industry replacing tourism as Florida's biggest business, Miami has the potential to become a global tele-medicine center, Mr. Benowitz said.
Dade County, the largest medical community in the state, has more than 34,000 health care professional, 32 hospitals and about 9,000 hospital beds, according to South Florida Hospital & Healthcare Association.
......"With Miami's location to Latin America and the Caribbean, a very competitive environment has been created," he said. "Miami has a very aggressive medical community. There is no reason why, with the proper marketing and implementation of this technology, we can't succeed in this arena."'
......Tele-medicine could help Miami receive the attention it deserves, Mr. Benowitz said.
....."With the medical talent we have here, we can bridge the gap between the patient, the health care facility and the doctor," he said. "The need for access to state-of-the-art health care provides an opportunity to not only improve the bottom line, but to compete with the Mayo Clinics up north for covered lives."
.....Tele-medicine also provides patients access to specialists they may otherwise never get, said Rey Brouard, conference chairman for Intercom '97.
With advances in technology being made every day, there's a lot more on the tele-medicine horizon, Mr. Brouard said.
....."It's still very much a work in progress," he said. "It will take a while until we benefit fully from the potential of tele-medicine."