telehealth now and then: a northwest perspective
DESCRIPTION
Telehealth Now and Then: A Northwest Perspective. Jere Retzer, [email protected] Oregon Health & Sciences University. 22 September 2014. Disclaimer. All views expressed in this presentation are those solely of the presenter and he doesn’t know much!. About the Northwest. Big/diverse - PowerPoint PPT PresentationTRANSCRIPT
Telehealth Now and Then: A Northwest Perspective
Jere Retzer, [email protected]
Oregon Health & Sciences University
April 21, 2023
Disclaimer
All views expressed in this presentation are those solely of the presenter and he doesn’t know much!
About the Northwest
Big/diverse• House-calls rarely happen• Largely medically underserved – losing obstetricians, others due to malpractice
• Drive/fly hours to see specialist – or go without
Independent• “Fate-sharing” usually considered a bad thing
Mostly on the network “edge”
A Sampler of current activities
Lariat/BRINOregon AHECDistance Education for nursing and Medical Informatics
Telemedicine projects in CardiologyRural Health EducationArgentina brain trauma trainingORPRN – AHRQ Medication listVisions of remote surgery ….
The state of telemedicine today
Most projects fail to be sustainable
More effective at demonstrating technology than medical care
Why is telemedicine so unsuccessful?
Insurance reimbursement – making progress in Oregon
Independent culture
Cost of dedicated connections & poor quality available on the Internet
Northwest communities largely on the network edges
Life on the edge
Problem: the lack of local connections between networks is a barrier to applications that need high quality within region
Example: historically, connections from OHSU to Portland Community College (PCC) via Sacramento, San Jose, Seattle, 20-30 ‘hops’
Poor quality even across town
A regional issueFeb 2003 DSL
Lincoln City to Intel in Hillsboro via Dallas, Texas, Chicago, Seattle
Sometimes talking to the phone company can fix
Solutions
Regional exchanges
Communities of interest – future TAO
Local Health Information Infrastructures
An Engineer’s View of the Internet
Law of Network Effects:“the value of a network grows as the square of the number of users.”
Both quality & connectivity important
Source:Caida.org
Metcalfe, Robert, “The Internet After the Fad,” Remarks at the University of Virginia, May 30, 1996
National/Local Health Information Infrastructures
NHII• Improve healthcare through IT• 100,000 accidental deaths per year?• Administration 25% of healthcare cost, $1.6 Trillion industry
Focus is on LHII• Most care is local• Relationships are local• View: solutions will be local
Oregon Health Information Infrastructure (OHII)
Need + opportunity spurs intense competitors to work together
“Information technology will be the key driver of change in the US Healthcare system in the 21st century.”
-Tommy Thompson, Secretary HHS
An opportunity for Internet2
Internet2 created to enable advance networking and applications
•Needed because commercial Internet didn’t•Works because it flattened the network and cares
about quality across networks•Next phase of network applications predominantly
local – connections between people
Internet2 should extend to LHIIEngage Internet experts to develop & facilitate common tools, middleware to connect LHII – “LHIItools.org?” (see sourceforge.net to see how open source projects work)
