The History of Desktop Telemedicine

The roots of desktop telemedicine date back to the birth of television. In the late 1920’s, engineers at AT&T Bell Laboratories were simultaneously inventing television and telephones that could see. Their work on the picture telephone culminated in April, 1930 with the first public demonstration of 2-way video telephony. The event linked the downtown New York headquarters building with a Bell Laboratories building at a different site. At each location, participants sat in sound-proof and light-proof booths containing the picture telephones. A neon lamp displayed the image of the person at the other end on a receiving disk. A blue light illuminated their faces while they looked into photo-electric cells, which captured their image for transmission. They spoke through a mounted microphone and listened through a loudspeaker. The demonstration received great press. An article in the April 10, 1930 New York Daily Mirror compared one-way commercial television to the laboratory-stage picture telephone, and concluded that the picture telephone was "more highly developed" and more user-friendly than television. Despite this, it would be more than thirty years before AT&T would release a product.

Telemedicine from the Desktop

The adoption of PC-based desktop medical teleconferencing is tracking closely after the more widespread use of desktop videoconferencing (DVC) for business and personal use. Recent monographs from International Data Corp. (508/935-4585) and the Int’l Teleconferencing Association (703/506-3271) project the growth of the worldwide PC-based videoconferencing market. Expect the market to increase from $604 million in 1996 to $1.29 billion in 2001. The reasons? Rapid development of enabling technologies such as multimedia PCs (with MMX video-enabled chipsets); improved data compression and bandwidth availability; adoption of standards for regular phone lines (H.324) and the Internet (H.323). Throughout the U.S., desktop telemedicine remains at the pilot stage. Soon, however, some programs may move towards more widespread deployment.

A Robot in the Living Room?

It’s become a truism that things are progressing today at a rate our grandparents, even our parents, could never have imagined. That being so, the next steps in tele-rehabilitation can’t be very far in the future. One of them, in fact, may be a robot developed by scientists at the Massachusetts Institute of Technology. Prof. Neville Hogan, director of MIT’s Newman Laboratory for Biomechanics and Human Rehabilitation, his MIT colleague, Hermano I. Krebs, a research scientist in mechanical engineering, and Drs. Mindy L. Aisen, Fletcher H. McDowell and Bruce T. Volpe of the Burke Rehabilitation Center in White Plains, NY, recently completed a 20-patient study of robot-assisted stroke rehabilitation therapy. A second, larger study is currently underway.

Video Publishing

Stored video is rapidly becoming critical to many telemedicine applications. The problem has been the lack of a way to catalogue and manipulate video information…until now. The solution comes from one of the 70 companies exhibiting at the DVC (Desktop Video Communications) '98 Spring conference and exhibition in Santa Clara, California. As I walked the aisles of the show, I ran into many of the usual suspects in the video communications marketplace, the companies whose names regularly fill these pages. Many of these firms are delivering exciting videoconferencing technology, but I was looking for something new that might have an order-of-magnitude impact on personal telemedicine

Cost Effectiveness of Telemedicine

Telemedicine is no longer just a playground for dreamers, enthusiasts and pilot programs. It has become a strategic tool for hard-eyed hospital administrators and entrepreneurial practitioners, whose first questions are: Does it make sense economically? Does it improve efficiency enough to justify its cost? Will it help the bottom line? This article presents an overview of peer-reviewed economic analyses of various telemedicine applications. Most of these are straight cost analyses, and include the following items in calculating costs: fixed costs, direct variable costs, indirect variable costs.

Distance Healthcare Education Technologies

Since its inception, telemedicine has been a natural partner to distance learning. After all, if you have technology in place that can connect rural and urban physicians for consultation or treatment purposes, why not use it to connect them for educational purposes? Why not use it to teach a surgical procedure to medical students in a classroom through live, real-time, interactive videoconferencing with a surgeon actually performing the operation…or to provide continuing education to physicians and other healthcare professionals…or to teach patients what they need to know about their medical conditions and treatment plans? For this issue of Telemedicine Today, we looked at a variety of technologies being used in a variety of locations to educate physicians, patients and students. From traditional videoconferencing to the Internet, there’s a lot going on out there.

A "WhatIf" Scenario for Telemedicine Reimbursement Based on ATSP/TT Survey Findings

In any business model for telemedicine, health care professionals must be paid for providing teleconsultations. Reimbursement has been a constant issue in recent years, with industry concerns focusing on the levels and types of payments that are appropriate for government programs, insurance coverage, and managed care plans. No one knows how much compensation physicians and specialists are currently receiving throughout the United States for their telemedicine-mediated services. Historically, there has been little, if any, documentation for claims processing. Even in California (where reimbursement legislation has been enacted for two years now), the first telemedicine claims processed by the Department of Health Services were only paid out in August 1998.

TechTalk: Internet Security

In the last TechTalk column we introduced some issues regarding Internet security and privacy. These are often overblown, particularly when compared to current practices. One reason for this is a dearth of information about the true risks and the available security measures. Nevertheless, there are real concerns that must be addressed before many individuals will be comfortable transporting patient data over networks, particularly the public Internet.