Sunday, October 11, 2009

A Report on the Status of Telemedicine from the Three C’s

Over the past ten days I have been on the road speaking and participating in a number of completely different telemedicine-related meetings including the Canadian Society of Telehealth in Vancouver, Canada, a cellular industry conference in California and the Cartagena Telemedicine Conference in Colombia. Talking with these three groups in the three “C’s” (Canada, California and Colombia) provided an interesting opportunity to get a bigger view of where telemedicine is going. Despite the global recession, the diversity of applications continues to grow and the enthusiasm is bigger than ever.


Overall, telehealth continues to grow in Canada, but there are noteworthy differences among the regions. The economic downturn has significantly affected the support of the Canadian government for Provincial telehealth programs. Consequently, some programs, especially those in the more rural provinces, have been forced to cut back. Alberta, facing the double issue of a reduction in federal funds and a decline in oil prices has reduced funding and postponed other proposed telehealth projects. On the other hand, the Ontario Telehealth Network (OTN) has grown despite the economic downturn. OTN, now operating with a staff of 200, runs a province-wide health call center for the citizens of Ontario and has significantly expanded its remote clinical services programs providing services to 660 sites across the province. A couple of the provinces have also made significant investments in home telehealth over the past two years. The meeting in Vancouver was filled with discussions and presentations about amazing number of sophisticated telehealth programs extending health care to the remote tribal and First Nation communities.

The meeting was the last official meeting of the Canadian Society of Telehealth (CST). The group has decided to merge into COACH, a Canadian health informatics organization where they will remain an identified group within the larger organization.

ATA has had a great relationship with many of the Canadian telehealth programs as well as CST. About 150 members of ATA are Canadians and I have had the pleasure of attending many of the past CST annual meetings. Dr. Ed Brown, the director of OTN, is on ATA’s Board of Directors and Dr. Mo Watanabe from Calgary is a past board member.


The Cellular Telecommunications Industry Association represents the operators, transmission companies, cell phone makers and application providers in the wireless market. The CTIA meeting in San Diego was focused on business and related applications. It was not the primary annual meeting of the association but was attended by at least 5,000 attendees. Wireless health care, mHealth, was a new focus at the meeting and was clearly a hot topic for attendees. I spoke on a panel sponsored by Mobihealthnews and ATA had a booth on the exhibit floor in an area sponsored by Qualcomm, under the direction of Qualcomm Vice President, and ATA Board Member, Don Jones. The area also included the participation of several wireless health companies.

An important highlight from the meeting was news that CTIA teamed up with Harris Interactive to conduct a nationwide survey that found 78 percent of the U.S. is interested in mobile health solutions and 15 percent of the U.S. is extremely or very interested in learning more about mHealth. About 19 percent of the people surveyed said that they would upgrade their current mobile phone plan to gain access to mHealth services, while some 11 percent admitted that they would even switch their wireless service provider to receive mobile healthcare services.

It was definitely a crazy time for ATA, even with three staff on site. Alice Watland, Del Tillman and I were overwhelmed with attendees crowding around the ATA booth asking for information about telemedicine. Many developers and technology companies are getting into the market with exciting new applications. A group of state legislators also were in attendance and ATA took the opportunity to have conversations about Medicaid, licensure and other regulations with several of them.

Two relatively new organizations interested in wireless health were also present at the meeting. The Wireless Life Sciences Alliance (WLSA) is a trade association that is described as an international think tank, although it has become much more in recent years. The WLSA is chaired by Rob McCray, who comes from major positions in the healthcare industry. Also, David Aylward, the Executive Director of the new mHealth Alliance, was also at the meeting. The Alliance is a partnership recently formed by the UN Foundation, The Vodafone Foundation and Rockefeller Foundation to support and advance mobile health initiatives in the developing world. ATA has had discussions with both organizations about possibly partnering on a variety of activities.

There are two take-away messages from the meeting:
  1. The wireless industry clearly sees healthcare applications as an important new area for investment. Speakers at the meeting, from the Chairman of the FCC to the head of Verizon Wireless to the CEO of CTIA, mentioned the importance of health applications in their speeches.
  2. ATA is in an important position with the exploding interest in wireless health. Recent ATA comments before the Federal Communications Commission regarding wireless broadband and “wireless body networks” were snatched up by many of the attendees. They are available under the Public Policy area on the ATA web site. ATA’s contribution in this area includes the fact that we represent health providers and traditional health institutions as well as our expertise and presence with a number of government bodies.


The Cartagena Telemedicine Meeting, hosted by Jorge Velez, was attended by over 100 people from around the region. Silvio Vega, the current chair of ATA’s Latin America and Caribbean Chapter (ATALACC) provided an excellent overview of telehealth activities in the ATALACC region. I was shocked at the growth and diversity and have asked Silvio to prepare a written report to be posted on the ATA web site. There are several U.S. hospitals that provide healthcare using telemedicine to areas of South America. However, more important is that almost every country in the region has at least one telemedicine program of their own and many have several. The Health Ministry of Mexico announced that they will start coordinating 17 different telehealth programs that operate throughout Mexico, which include the participation of 148 educational institutions. Government funded telemedicine centers exist in Colombia and several other countries. Panama is using telemedicine for its prison population. A program in Venezuela has extended to 17 sites within the country and four more in neighboring Equator. Plus, private remote cardiac monitoring companies are witnessing significant growth and already consider South America a profitable market for their services.

I’m looking forward to the ATALACC meeting in Puerto Rico this December. It will be very interesting to learn more about the current state and the future directions of telemedicine throughout the Caribbean and Latin America.


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