Telemedicine Today Jonathan D. Linkous, CEO American Telemedicine Association

NAME GAMES Telemedicine Telehealth m-Health Remote Medicine E-Health Telecare

A COUPLE OF HELPFUL DISTINCTIONS HIT and Informatics Telemedicine

Focused on support systems Management Information Systems HIT AND INFORMATICS Focused on support systems Electronic Records E-Prescribing Management Information Systems Electronic Payments

TELEMEDICINE Focused on patient care Telehealth Mobile Health (mHealth) Remote Monitoring Outsourced Specialty Services

WORLDWIDE DRIVERS FOR TELEMEDICINE Accelerating demands and costs Shortages of health professionals Global public health concerns

Kathleen Casey-Kirschling January 1, 1946, 12:00:01 am

694,000 1,078,000 384,000 32,000,000

TSUNAMI OF CHRONIC ILLNESS “Frequent Flyers” 5-10 percent of admissions, 1 percent of users 22 percent of costs Primary chronic conditions: cardiac/COPD/mental health/diabetes

COST OF CHRONIC CONDITIONS

POPULATION > 60 YEARS Country 2000 2050 World 10.0% 21.4% China 6.9% 22.7% Germany 23.2% 34.5% United States 16.1% 25.5%

HISTORY OF TELEMEDICINE

HISTORY OF TELEMEDICINE Boston Logan Airport to Massachusetts General Hospital 1967

HISTORY OF TELEMEDICINE STARPAHC – On the Papago Indian Reservation 1975

TELEMEDICINE CIRCA 2005

HOSPITAL HUB-AND SPOKE NETWORKS 200 networks3,000+ sites

ARIZONA TELEMEDICINE PROGRAM © American Telemedicine Association

TELEMEDICINE SERVICES Service contracts - prisons, oil rigs, ships, international Outsourced services – teleradiology, neurology, mental health

PRISON HEALTH MEDICAL NETWORK TEXAS PRISON HEALTH MEDICAL NETWORK © American Telemedicine Association

VETERANS ADMINISTRATION © American Telemedicine Association

EMERGENCY SERVICES AND DISASTER RESPONSE

CONTINUING MEDICAL EDUCATION

TELEMEDICINE CIRCA 2013

BIG MED

Abdominal Radiology Gastrointestinal Radiology Pediatrics Radiation Oncology Angiography and Interventional Radiology Genitourinary Radiology Teleradiology Head and Neck Radiology Thoracic Body Imaging Ultrasound Breast Imaging Interventional Vascular and Interventional Radiology Cardiovascular Radiology Mammography MRI Radiology Chest Radiology Musculoskeletal Diagnostic Radiology Neuroradiology Nuclear Medicine Emergency Nuclear Radiology Radiology

OUTSOURCED AND SHARED SPECIALTY SERVICES

ONLINE SERVICES AND CONSUMER HEALTH APPS

ADVANCED TECHNOLOGIES Live Monitoring via Cell Phones Remote Surgery Live Monitoring via Cell Phones Robotics

PATIENTS SERVED BY TELEMEDICINE 2012 North America data

PATIENTS SERVED (2012) Outsourced Specialists Teleradiology Internet Clinical Consults Internet-Pharmacy Services Cardiac Monitoring Implanted Devices Remote Monitoring Federal Network Consults Civilian Network Consults

ADOPTION ISSUES Historic resistance to change Lack of consistent adoption and integration pathways Changing service delivery models and payment coverage

Discovery to implementation in medicine = 15 years RESISTANCE TO CHANGE Discovery to implementation in medicine = 15 years TIME Rate of Change Society Business Technology Healthcare

WHAT ATA DOES

ROAD MAPS FOR ADOPTION AND INTEGRATION Assuring the major players in healthcare, as well as consumers, that telemedicine can be easily and painlessly be used, is a critical step in assuring its development.

ATA PRACTICE GUIDELINES Goal Quality Assurance for Payers, Public, Policy Leaders There is little to turn to for help to guide those involved in healthcare out of this confusion.

ATA PRACTICE GUIDELINES Technical ATA has 12 Special Interest Groups that will be tapped to provide expertise. Clinical Business

COLLABORATIONS ATA will be working with NIST staff to help coordinate many aspects of this effort. Both organizations worked together in support of the development of a set of recommendations for diabetic retinopathy. It is hoped that ATA can access both subject matter experts and coordinating staff within NIST. In addition, ATA will be seeking financial support from a variety of sources to enable the Association to achieve the goals of this effort.

OTHER ATA ACTIVITIES Meetings and Education Member Networks

Identifying and Translating Market Changes OTHER ATA ACTIVITIES Consulting with Policy Leaders Identifying and Translating Market Changes

The World's Largest Telemedicine, Telehealth & mHealth Trade Show 600 Scientific Presentations 200,000 Square Feet of Exhibits 6,000 Attendees The World's Largest Telemedicine, Telehealth & mHealth Trade Show ATA 2013 - 18th Annual International Meeting & Trade Show May 5-7, 2013 in Austin, TX www.ATA2013.org

1100 Connecticut Avenue, Suite 540 www.americantelemed.org 1100 Connecticut Avenue, Suite 540 Washington, DC 20036