Virtual Doctor

THE VIRTUAL DOCTOR HOW DATA NETWORKS ARE EXTENDING THE REACH OF MEDICAL CARE IN THE DIGITAL AGE IN ASSOCIATION WITH: CONTENTSCONTENTS The Virtual Doctor ................................................................................. 2 CASE STUDY: Ontario Telemedicine Network ........................................... 6 CASE STUDY: InTouch Health Systems ...................................................... 7 CASE STUDY: C3O Telemedicine .............................................................. 8 CASE STUDY: Telepsychiatry ..................................................................... 9 CASE STUDY: Boston Children’s Hospital ................................................ 10 Acknowledgments ..................................................................................11 T H E VIRT UAL DOCTOR HOW DATA NETWORKS ARE EXTENDING THE REACH OF MEDICAL CARE IN THE DIGITAL AGE Thirteen years ago, a surgical robot named Zeus We are not that far away from a future in which see- made history when a team of physicians in New York ing a doctor does not require being in the same room performed surgery on a patient in Strasbourg, France. or even the same building, says Yulun Wang, founder The Lindbergh Operation, as it came to be called, of InTouch Health and president of the American represented a con!uence of technical achievements, Telemedicine Association. “I think telemedicine will namely the dexterity of the digital Zeus Robotic become the core methodology of healthcare delivery Surgical System and a broadband transmission capa- in the future,” he says. “It has to, because that is where bility with optimized compression that limited the we are going to get the e"ciencies we need to meet time delay between the doctors’ commands in New rising needs created by an aging population and pro- York and the resulting action in France. vide a#ordable care.” Since that breakthrough in 2001, the idea of treat- One of the original imperatives for telemedicine ing patients remotely has touched almost every aspect was to bring better care to underserved and remote of healthcare. Neurologists can now “beam in” on areas with few medical facilities or where there were stroke victims to provide instant assessments that can long distances between patients and doctors. But even save lives. Patients recovering from surgery at home in well-served areas, there are compelling reasons to can have the equivalent of an electronic house call incorporate telemedicine into many practices. There with a video link to their surgeon for follow-up are not enough specialists—neurologists, cardiologists, appointments. And, in one of the newest applications dermatologists and psychiatrists, to name a few—to of telemedicine, psychiatrists can create avatars to meet rising demand. Someone su#ers a stroke every meet patients in virtual worlds where they can act out 40 seconds on average in the United States, but there di"cult scenarios. is not always a neurologist available in the $rst few 2 | THE VIRTUAL DOCTOR crucial minutes to provide a diagnosis. Telemedicine it,” says Yanez. “The network is behind the scenes, it’s can also reduce costs and improve outcomes. For not in the lights where people are clapping. But the example, home health monitoring for people with connection is real, and critical to the performance of chronic conditions, such as diabetes, can mean any telemedicine application.” fewer missed appointments and hospital stays, not to mention reduced travel time for patients. Comcast Business Ethernet services dovetail well with the needs of most healthcare providers. Ethernet These imperatives are driving unprecedented is a protocol that can run on both $ber and coaxial innovation and entrepreneurial energy in the $eld of cables, and it can be expanded with a single phone telemedicine today. However, none of this innova- call. So if a new imaging system starts producing $les tion would work without a reliable network capable that are choking the circuits, an existing Ethernet of carrying a detailed image from one location to service can be expanded exponentially without another, or to control a robot miles away, or simply to digging new holes or laying new $ber. access an electronic record safely and securely. Most hospital systems need to connect multiple New imaging systems, for example, save lives, but locations, from the main facility to outpatient clinics, they also create massive digital $les. “The hospital has physician’s o"ces, imaging facilities and record to have a really strong network to take advantage of archives—all of which may be miles from one this brilliant machinery,” says Tomas Yanez, director of another. Any hospital system that relies on digital enterprise marketing at Comcast. “Everything may medical records needs to ensure constant access to work great at the main hospital facility, but at the edge those records, and that requires a reliable network “The hospital has to have a really strong network to take TOMAS YANEZ, Director of Enterprise Marketing, advantage of this brilliant machinery.” Comcast of the network, at the radiologist’s o"ce a few blocks across all locations with multiple paths and multiple away, it might not work very well at all if the network redundancies. isn’t robust enough,” he explains. Sending video $les takes even more bandwidth. At Inspira Health Network, which was formed in 2012 after the merger of South Jersey Healthcare “Everyone gets excited about the performance and and Underwood-Memorial Hospital, a Wide Area the glory of a new application that promises to make Network (WAN) connects three medical centers, two the patient experience better or make a hospital health centers and dozens of outpatient sites with a more competitive, but it won’t work unless there is combination of several di#erent Comcast Business a solid network foundation underneath to support Ethernet services. Physicians at any of Inspira’s facili- COPYRIGHT © 2015 FORBES INSIGHTS | 3 ties can access test results, surgery notes, home health Much of telemedicine takes place over the public visits, diagnostics and other data as they move from Internet. “The Internet is inexpensive, it’s nearly one patient to the next. Instead of juggling paper ubiquitous, and you don’t need to program anything,” $les, doctors can spend more time with their patients. explains Yanez. Those qualities have laid the ground- Patients are also bene$ting from the network via a work for the growing ubiquity of telemedicine. For a dedicated portal where they can review test results, doctor answering an emergency call by logging on to pay their bill, schedule classes and access a library of a mobile device or paying a virtual visit to a patient health care information. in a remote location, the public Internet is the only option that makes sense. “The more services we run over the network, the more we can reduce the cost of those services,” says But security is still a real concern. “What could Thomas Pacek, vice president and CIO of Inspira happen when you pass medical records around over “The more services we run over the network, THOMAS PACEK, Vice President and CIO, the more we can reduce the cost of those services.” Inspira Health Network Health Network. Inspira is “collapsing everything the Internet?” asks Yanez. Data is handed o# from onto the network,” he explains, from cardiology one network to another, exposing the sender to the equipment to the medical records of physicians’ possibility of an embarrassing security breach. o"ces associated with the hospital. With so much of the daily workload moving over the network, reliability That is why many hospital systems use private is key. “The more we become electronic with our networks that don’t traverse the public Internet. With records—and everything we do related to patient care the explosion of mobile devices and the growing use is becoming digital—the more we can’t a#ord to have of telemedicine, some of them are able to extend any downtime,” says Pacek. their networks to include the homes of their healthcare providers through such services as “Ethernet at Security and privacy matter as well. Healthcare pro- HomeSM.” This service, o#ered by Comcast Business, viders have to meet HIPAA requirements to protect provisions o# the healthcare facility’s existing infra- patient privacy. A psychiatrist speaking with a client, structure without going over the Internet, just as it for example, can’t use standard free videoconferencing does at the other locations on a hospital network. It applications to hold a session. Instead, they must use is one more way that telemedicine is breaking down an application with HIPAA-compliant architecture the boundaries of distance and time to provide better that comes with a host of security features. Patients, outcomes for patients and healthcare providers. for example, might enter a virtual waiting room and then be invited into a virtual exam room that can be opened only by the room’s owner. 4 | THE VIRTUAL DOCTOR COPYRIGHT © 2015 FORBES INSIGHTS | 5 CASE STUDY: ONTARIO TELEMEDICINE NETWORK CANADIAN PIONEER Edward Brown, chief executive o!cer of the “Last year, because of telemedicine, patients Ontario Telemedicine Network, connects doctors avoided about 260 million kilometers of travel,” and patients across a province that is bigger says Brown. “That’s the equivalent of going than Texas and California combined. Because to the moon and back 330 times.” The private of the network’s size, there is great potential for network is particularly important for reaching collaboration and experimentation. And because remote places where there are no doctors—and of the network’s long history, Ontario has been no Internet. “We deal with a lot of rural areas ahead of the curve at every stage of telemedi- that may never have good Internet access.” cine’s evolution. But the bold new frontier for Ontario is con- The buildout started in the late 1990s as a necting directly with consumers via their device private network, before the public Internet was of choice. One example: people with chronic equipped to handle either the kinds of telemedi- diseases can stay healthier and avoid crises cine applications Ontario wanted to use or the by learning to self-manage their conditions.

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