Keynote for Telehealth Awareness Week, Geelong, VIC, Australia, 3/2014

1. 3/21/14
1
ì
TeleHealth:
It’s
Not
About
the
Technology
Daniel
Z.
Sands,
MD,
MPH
@DrDannySands
Society
for
Par=cipatory
Medicine
Beth
Israel
Deaconess
Medical
Center
Harvard
Medical
School
Boston,
MA
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands
Commercial
Disclosures
ì Best
Doctors,
Inc.
–
consultant
ì Kinergy
Health,
Inc.
–
consultant
ì SeniorLink,
Inc.
–
consultant
ì PostWire,
Inc.
–
consultant
(2013)
I
will
not
be
discussing
products
or
services
of
any
of
these
companies
in
my
presenta8on.
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands

2. 3/21/14
2
Disclosure:
I’m
Not
An
Early
Adopter
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands
Source:
G.
Moore
aUer
E.
Rogers
Hats
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands

3. 3/21/14
3
Source:
ReachMail.net
and
DZ
Sands
▶ 1969:
Internet
born as
ARPAnet
at UCLA.
◀ 1998:
First
guide-lines
for
e-mail w/
patients
(AMIA)
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands
History
Lesson
Boston’s Beth
Israel
introduces
e-mail
1991:
Danny
e-­‐mailing
pa=ents
Dr.
Sands
not
seeing
patients
“Sorry,
Dr.
Sands
no
longer
sees
people.
He
e-­‐mails
them.”
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands

4. 3/21/14
4
What
Have
We
Learned
About
e-­‐Messaging?
ì Includes
encrypted
e-­‐mail
or,
more
commonly,
secure
web
messaging
ì Enables
efficient
communica=on
because
it
is
asynchronous
ì Is
cost-­‐effec=ve
and
benefits
both
pa=ents
and
physicians
ì Enhances
rela=onships
ì Is
a
channel
for
care-­‐at-­‐a-­‐distance
Sources: Kane B, Sands DZ, JAMIA 1998. Delbanco T, Sands DZ, NEJM 2004.
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands
Care
Delivery
Costly
in
Traditional
Settings
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands

5. 3/21/14
5
There
Are
Many
Seductive
Cool
Tools
…
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands
Source:
Philips,
American
Well,
Cisco,
InTouch
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands

6. 3/21/14
6
…
Yet
Simpler
Tools
Can
Also
Work
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands

7. 3/21/14
7
But
It’s
Not
About
the
Technology!
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands
What
Is
It
About?
What
are
you
trying
to
achieve?
Who
will
be
using
it?
How
will
it
be
used?
How
will
you
fund/sustain
your
program?
How
will
you
measure
success?
Who
will
get
in
your
way?
What
technologies
will
you
employ?
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands
Save
This
For
Last

8. 3/21/14
8
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands
Workflow
Matters
New
Care
Models
ì Loca=ons
ì Distant
loca=ons
ì Underserved
areas
ì Physicians
unwilling
to
visit
ì Clinician
not
economical
(incl.
rural,
ships,
oil/gas
plaeorms)
ì Clinical
services
ì Primary
care
ì Augment
rela=onships
ì Specialty
care
ì Home
care
/
remote
monitoring
ì Extended
care
facili=es
ì Wellness
ì Reduce
need
for
nursing
homes
ì Business
models
ì Scale
exis=ng
resources
ì Extending
virtual
catchment
area
for
services
ì Medical
center
support
of
rural
areas
ì Community
hospital
network
support
(doc-­‐to-­‐doc)
ì Home
care
ì Extended
care
facili=es
ì Employee
health
ì Retail
clinics
ì School
clinics
ì Correc=onal
care
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands

9. 3/21/14
9
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands
Source:
hgp://www.shetlandamenity.org/,
hgp://globalmed.com,
hgp://wikischolars.columbia.edu
Issues
in
Telehealth
Programs
Technological
Social,
Poli=cal,
Organiza=onal,
Financial
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands

10. 3/21/14
10
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands
Source:
American
Psychological
Associa=on
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands

11. 3/21/14
11
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands
Questions
and
e-­‐mail
address
Questions?
Danny@DrDannySands.com
hBp://www.DrDannySands.com
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
-­‐
@DrDannySands
@DrDannySands

12. 3/21/14
12
Questions
and
e-­‐mail
address
Questions?
Danny@DrDannySands.com
hBp://www.DrDannySands.com
©
Copyright
2014
D.
Z.
Sands,
All
Rights
Reserved
@DrDannySands