July 95

Level of Govt: State, city, county.

Function: Health care.

Problem/situation: Many rural and public hospitals lack financial and specialist resources available in city medical centers.

Solution: Telemedicine enables hospitals to share doctors and resources.

Jurisdiction: Denver Health and Hospitals, Georgia.Statewide Academic and Medical System.

Vendors: AT&T;, Compression Labs Inc., Personal Technology Research, Southern Bell/Bell South, Georgia Telephone Association and CAE Link.

Contact: Kirsten Hinsdale, Denver Health and Hospitals 303/436-5629; Andrew Todaro, AT&T; 303/290-2429

By David Aden

Contributing Writer

Telemedicine is a "hot topic" these days - everyone is talking about it. Many feel they ought to get into it, but some fundamental issues such as reimbursement, liability, national licensing, and standards are yet to be resolved. Nonetheless, market forces favor increased deployment of telemedicine systems. For many, the question is not "if" but "when" to adopt the technology.

In fact, despite the relative newness of the field, there are many projects in the works. Sarah Dickson, program director and senior analyst for Video Teleconferencing at Waltham, Mass.-based Personal Technology Research, estimates there are telemedicine projects, in at least the planning stages, in almost 40 states with as many as 2,000 already in use.

At the most basic level, "telemedicine entails sending compressed video images over phone lines," said Dickson. "You have the basic hardware for videoconferencing. You integrate into that certain other equipment for medical applications."

Kirsten Hinsdale, the director of product and program development for Denver Health and Hospitals, has plunged headlong into developing a telemedicine system because it should benefit Denver Health and Hospitals, hospitals in rural areas, as well as the quality of patient care.

Denver Health and Hospitals has 107,000 patients and one of the most successful trauma centers in the country, Hinsdale said. "But how's a public hospital going to survive? We need to capture more of the insured market so we can use some of that to help fund care for the indigent. We are positioning ourselves as emergency and trauma for the region."


Most rural hospitals cannot afford large emergency or trauma centers, including Denver Health and Hospital, but they still need to have access to the expertise of such a center. Hinsdale views telemedicine as a way to extend the reach of the large urban hospital, to leverage its expertise by making it available to multiple rural hospitals and clinics.

"If we have an expert, we can direct a medical provider in Cripple Creek using a telemedicine system," Hinsdale said. "We can save lives and limbs and we can also contain cost by preventing inappropriate referrals to trauma centers."

While Denver Health and Hospitals was looking into telemedicine for some time, it came into focus in connection with the Service to the Citizen Summit held in Denver last February. Hinsdale worked closely with AT&T; Data Networking Marketing Manager Andrew Todaro to put together a telemedicine demonstration for the summit. The project has sparked a great deal of interest.

The demonstration was based on AT&T;'s Vistium system which uses Integrated Services Digital Network (ISDN) lines. The hospital had already embraced ISDN, so the basic network requirements for a system were already in place.


Despite recent declines in hardware, software and network costs, implementing telemedicine involves a major commitment of time and resources and remains very much

David Aden  | 
David Aden DAden@webworldtech.com is a writer from Washington, D.C.