Telemedicine allows for long-distance diagnoses

The field of telemedicine has come a long way since a Harvard professor figured out a way to examine patients via television cameras so he wouldn’t have to fight traffic in a long car ride each day.

Dr. Kenneth Bird, a Harvard professor affiliated with Massachusetts General Hospital, was moonlighting as medical director at Boston’s Logan Airport in the late 1960s when necessity became the mother of invention. Tired of making an hourlong drive between the airport and hospital, a route that took him under the Charles River, he suspected there was a better way.

Informal as it was, he is credited with being the father of civilian telemedicine in the U.S. by using television to send black-and-white digital images that linked his medical station at the airport with the hospital when he needed help with diagnosis and treatment.

Today, telemedicine — the treatment of patients by remote means in many forms — is a “virtual” phenomenon in every sense of the word.

“The breakthrough is your mobile phone, the house call of tomorrow,” says Dr. Jay Sanders, a protege of Dr. Bird, referring to the possibility of sending images from a high-tech personal digital assistant device.

Dr. Sanders, president emeritus of the American Telemedicine Association and professor of medicine at Johns Hopkins University, sees telemedicine enabling technology to address many of the health care needs we have.

Beyond the mobile telephone, minimally invasive surgery performed by robots controlled from a remote location is being tried in Europe, according to David Balch, a technology consultant and former board member of the American Telemedicine Association.

Laparoscopic surgery using robotic devices already is done in the U.S. This allows a video camera to be positioned inside a patient’s body, becoming the surgeon’s “eyes” and eliminating the need for a large incision to see inside the body directly.

Duke University engineers are working on how to get a computer to direct robotic surgery on patients in dangerous situations such as a battlefield or in remote locations, such as outer space.

“Telemedicine is a pretty fast-paced industry,” Mr. Balch says. “What is interesting is what is coming — devices such as wearables, whereby patients with identified chronic illnesses will wear monitors and be remotely tracked and where you can set parameters so doctors are paged when necessary. Clearly, technology is ahead of the practice of medicine.”

Applications are expanding across the board — and borders — often in surprising ways, at both high and low ends since telemedicine, or telehealth, can refer to any kind of distant communication connecting patients with medical professionals or health personnel with their peers.

Inova Health System in Northern Virginia is an example of a major medical center that has taken advantage of up-to-date communication technology. Intensivists — doctors specializing in critical care — and a team of experienced critical care nurses work 12-hour night shifts, keeping tabs on 127 patients in five hospitals from a high-rise office building as far as 15 miles away.

The program, called EnVision eICU, allows personnel to monitor hospital ICU units from behind six computers at each workstation where they also have camera and phone access to duty nurses on-site as well as the patient. Inova expects to have two-way video capability in the near future.

Like air traffic controllers, their eyes are fixed on multiple signals snaking across the screens — patients’ vital signs — similar to those on view in the hospital room. They are ready to intervene if they, or the machines, detect something unusual. “It’s the small things that are the telling factors,” says Theresa Davis, eICU’s operations director.

“It isn’t a substitute for bedside care,” insists Dr. William Jackson, 37, eICU’s medical director. “It’s a safety net for the most vulnerable, the sickest patients in the hospital.”

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