Lack of cooperation kills South Florida's tele-health progress
By Frank Norton
An effort to advance telecom-based health-care distribution in South Florida is dead, but experts say the need for such services is very much alive.
Telemedicine, as it is referred to in the industry, began as way to distribute health-care services to distant or immobile patients through the use of telecommunications technologies, as in patient-doctor video conferencing and live, multimedia web interfacing. But the potentially cost-efficient distribution system has already evolved to include remote robotic surgery and real-time data sharing between patients, doctors, hospitals, insurance providers and HMO's.
Experts see double-digit growth for the industry during the next several years, both in Florida and the US.
New York-Based Waterford Telemedicine Partners, with the Telemedicine Index that tracks 100 publicly traded companies, says the industry will grow 40% annually through 2010 and represent at least 15% of all health-care expenditures by then. Waterford and other national researchers estimate the current US market for telemedicine at $5 billion to $20 billion, up from less than $100 million in 1998.
But while industry growth seems inevitable, local tech advocates say it was apparently not enough to gel support around South Florida's "tele-health" initiative, a funding plan that died two months ago before reaching state decision-makers.
"It just kind of fell apart," said InternetCoast member Leslie Croland, who chaired the Tele-Health effort. "It was something the local universities just couldn't agree to work on together," he said, referring to the University of Miami, Florida International University, Florida Atlantic University, Nova Southeastern University and Miami-Dade and Palm Beach community colleges.
The InternetCoast, a consortium of South Florida universities, planned to lobby the state for at least $10 million of Gov. Jeb Bush's $30 million "Centers of Excellence" initiative to boost applied research dollars at campuses statewide. The effort fell through in October in favor of a new $15 million information security plan.
"The challenge for telemedicine is getting all interested parties to cooperate and set their own objectives aside," said Rick Kearney, chairman of ITFlorida. "Our aging population and traffic problems inhibit people from getting the medicine they need due to physical limitations. But it's definitely a huge opportunity."
According to Carl Taylor, former vice president of North Broward Hospital District, South Florida should lead the drive toward telemedicine for four reasons: aging retirees, offshore medical client bases in the Caribbean and Latin America, nursing shortages and higher-than-average Medicaid costs.
"We have got to work smarter and in a more cost-effective approach than throwing dollars at more nurses, more support staff and more hospital space," said Mr. Taylor, who heads Immediate Care, a Virginia-based telemedicine consultancy with offices in Broward County.
He said Miami could also become an international hub for servicing medical clients in the Caribbean, Central and South America.
"South Florida and especially Miami hospitals already have a natural relationship with Latin America in terms of their patient base. This could be a wonderful electronic umbilical cord to service medical needs in Latin America with top experts in Miami," he said.
Jonathan Linkous, executive director of the American Telemedicine Association in Washington, DC, agreed.
"There is a growing interest in using Miami as a referral site for the Caribbean basin, which could mean accessing a specialist in Miami from wherever you are in the Caribbean or Central and South America," he said.
"So you're not just talking about patient access but about distribution and possibly new market penetration for providers."
Indeed, recent breakthroughs in bandwidth capacity - the amount of data that can be transmitted per second - have enabled more information robust data transmissions like voice, video and 3-D pictures in real-time.
And that means more medicine at increasingly greater distances, says Dr. Bernard Harris, president and CEO of Houston-based Vesalius Ventures, a national telemedicine incubator.
"There will be a paradigm shift in the way we practice medicine from provider-based care, where you get sick and have to go to the doctor, to patient-centered care, where the medicine comes to you," said Dr. Harris, a physician, marketing expert and former astronaut and senior consultant for NASA. On his second flight he conducted the first telemedicine conference from space with the Mayo Clinic.
"We'll go right back to the old house calls, only it won't be doctors, it will be virtual," he said.
Although the University of Miami and Florida Atlantic University have dabbled in telemedicine programs, no school in the tri-county area has funneled more dollars or attention to the subject than the University of South Florida in Tampa, state leader in the field that now combines telecommunications, medical devices (remote-controlled robotics for surgery) and information management technologies.
"It's still a pretty fragmented market, but it will consolidate as it matures," Dr. Harris said. "Since Florida has a large aging population, it is certainly going to need this technology. I see it playing a significant role, especially in telemedicine for home healthcare. Florida should see this as opportunity to get out ahead of the country on the development of the industry."
In March, the Florida Department of Health established a tele-health workgroup to investigate opportunities for improving health-care distribution in the state.