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Sherry Emery - Telemedicine in Hospitals: Issues in Implementation

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Book:
Telemedicine in Hospitals: Issues in Implementation
Author:
Sherry Emery
Publisher:
Routledge
Genre:
Books / Science
Year:
1998
City:
London
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HEALTH CARE POLICY IN THE UNITED STATES

edited by

JOHN G. BRUHN

PENNSYLVANIA STATE

UNIVERSITY-HARRISBURG

Health Care Policy in the United States

John G. Bruhn, editor

Physician Participation in Medicaid Managed Care

Sunday E. Ubokudom

Healing the Social Body: A Holistic Approach to Public Health Policy

Elizabeth R. Mackenzie

Directing Health Messages toward African Americans: Attitudes toward Health Care and the Mass Media

Judith L. Sylvester

Gender Justice and the Health Care System

Karen L. Baird

Who Cares for Poor People? Physicians, Medicaid, and Marginality

Margaret M. Hynes

Health Care Reform: Policy Innovations at the State Level in the United States

Larry E. Carter

Telemedicine in Hospitals: Issues in Implementation

Sherry Emery

TELEMEDICINE IN HOSPITALS

ISSUES IN IMPLEMENTATION

SHERRY EMERY

Telemedicine in Hospitals Issues in Implementation - image 2

First published 1998 by Garland Publishing, Inc.

This edition published 2015 by Routledge

711 Third Avenue, New York, NY 10017, USA

2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN

Routledge is an imprint of the Taylor & Francis Group, an informa business

Library of Congress Cataloging-in-Publication Data

Emery, Sherry.

Telemedicine in hospitals : issues in implementation / Sherry Emery.

p. cm. (Health care policy in the United States)

Includes bibliographical references and index.

ISBN 0-8153-3223-8 (alk. paper)

1. Rural health servicesUnited StatesCommunication systemsPlanning. 2. HospitalsUnited StatesCommunication systemsPlanning. 3. Telecommunication in medicineUnited StatesPlanning. I. Title. II. Series: Health care policy in the United States (New York, N.Y.)

RA771.5.E45 1998

362.1028dc21

98-29436

ISBN 13 : 978-0-8153-3223-7 (hbk)

Contents

I would like to acknowledge and thank the US Office of Rural Health Policy, Health Resources and Services Administration, Public Health Service, US Department of Health and Human Services, for funding this research, which was supported by Grant # CSR000002-03-0. This work benefited tremendously from the input of the many interview subjects. Without their candor and insight, the results of this study would lack meaning and depth. To each of the individuals who took the time to speak with me about this research, I am very grateful. I would like to acknowledge the Cecil G. Sheps Center for Health Services Research for the institutional support to conduct this research, and Tom Rickets for his guidance at every stage of this project. I also thank Linda Garcia, Ken Temkin, and Elizabeth McClelland for their friendship and intellectual support. Most importantly, I thank my parents and husband, Marc Garfinkel, for their confidence and unwavering emotional support. Finally, I alone am responsible for any errors or omissions contained in this document.

AHA	American Hospital Association
ANOVA	Analysis of Variance
ARF	Area Resource Files
CODEC	Coder-Decoder
COTH	Council of Teaching Hospitals
CT	Computerized Tomography
ECU	East Carolina University
GPA	Group Purchasing Alliance
GSAMS	Georgia State Academic and Medical System
HCFA	Health Care Finance Administration
HMO	Health Maintenance Organization
IDN	Integrated Delivery Network
IO	Investor Owned
MHS	Multi hospital system
MRI	Magnetic Resonance Image
MSA	Metropolitan Statistical Area
NFP	Not-for-profit
NIST	National Institute for Standards and Technology
NTIA	National Telecommunications and Information Administration
OMB	Office of Management and Budget
ORHP	Office of Rural Health Policy
OTA	Office of Technology Assessment
RUS	Rural Utilities Service
SMSA	Standard Metropolitan Statistical Area
UNC	University of North Carolina
UNC-CH	University of North Carolina-Chapel Hill

f	function of
summation
/	divided by
L	log-odds
probability
In	natural log

Telemedicine in Hospitals

telemedicine \tel-I-med-.-s.n\ n: technologies that allow for medical consultation between health care providers in geographically separate locations, ranging from telephone consultations to interactive video sessions using state-of-the-art technologies.

In 1968, Dr. Kenneth D. Bird solved a problem for Massachusetts General Hospital. The hospital had been responsible for staffing the medical station at Bostons Logan International Airport. Emergencies demanded an immediate, highly skilled response even though the expertise of a physician was rarely required. Therefore, during most of the staffed time at the medical station, the physicians time and labor were underutilizeda significant expense to the hospital and airport. In response to this problem, Dr. Bird developed a system for remote transmission of voice and images. Using this system, doctors working remotely from Massachusetts General Hospital performed physical examinations, made diagnoses, and even delivered limited treatments to ailing travelers using the airports medical station (New York Times, February 16, 1991).

Dr. Bird was not the first innovator of telemedicine, but in the 1960s and early 1970s, his project was among the few that used microwave television technologies to transmit medical images and educational materials. For rural areas, these new telemedicine technologies promised to change how health care and medical education were accessed and delivered. Some of the pioneering telemedicine projects were very successful in achieving such promises. Yet, in its early applications, telemedicine failed to diffuse widely or to change health care dramatically. Now, more than 25 years later, the original telemedicine innovations are being transformed by advances in medical and telecommunications technologies. Once again, telemedicine holds promise as a partial solution to the health care crisis in many urban centers and rural areas of the United States.

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