# Presentation: 182765

## Telepresence and Telepsychiatry: When the very best is finally good enough

- Jess C. Jamieson, Ph.D.
- Chairman of the Board
- Advances In Technology
- jess.jamieson@advancesintech.com

## Advances In Technology

- Provides computer products and services to health and behavioral health companies
- Representing TelepresenceTech products to the healthcare industry:
- Technology for next-generation remote doctor – patient collaboration in care.
- _[www.advancesintech.com](http://www.advancesintech.com/)_

## Access to Psychiatric Care

- Rural counties with Telepresence collaboration initiatives

- San Juan (Islands) County

## Rural Barriers to Service for Patients:

- Distance and isolation
- Lack of providers
- No psychiatrists
- No other specialty providers
- Ten Primary Physicians on three islands
- Funding & payment
- Political resistance
- Quality of technology
- Patient acceptance
- Physician acceptance

## Telepsychiatry Demonstration Project

- Rural Health Care Services Outreach Grant Program (HRSA)
- Submitted by a consortium:
- Inter Island Medical Center
- Compass Health
- Regence BlueShield
- $375 K over 3 years awarded May 1, 2007

## Goals of the Grant:

- Create a technology infrastructure that gives access to psychiatry by live video
- Serve a mix of children & adults in the demonstration
- Convince payers to pay for telepsychiatry by demonstrating its acceptability & quality
- Determine characteristics of the telepsychiatry service that improve the experience and quality of care

## Making it Work

- Technology to improve the consumer experience
- Review of existing telemedicine technologies
- Issues of “presence”:
- eye contact
- Three-dimensional effect
- clarity and size of image

## Technology solution:  32” video display on a cart with true eye contact - 

- Technology solution:  32” video display on a cart with true eye contact -

## Patient Outcomes

- Do you think it made any difference in your treatment using telepresence vs. face-to face?  NO DIFFERENCE
- What worked best for you?  CONVENIENCE – NOT LEAVING ISLAND
- What could have made it better? CAN’T THINK OF A THING
- Comments?  	ACCESS TO THERAPY NOT OTHERWISE NOT AVAILABLE

## Physician Responses

- What has been your experience involving Telepresence?
- Psychiatrist: “Very positive, comparable to face-to-face encounter.”
- Primary Care Physicians: “Much needed resource for our patients.”

## “ . . .the ‘virtual’ person on the screen is looking at, and talking directly to, each person in the room.  The presenter's head and eyes even follow you as you move about in front of the screen. Might we some day enter "virtual' clinics where the world's best doctors pop up in 3-D and ‘examine’ us with remote sensors and PCR-enabled labs on a chip? ” 

	Bill Crounse, MD, Senior Director of Worldwide Health, Microsoft Corp., describing the TelepresenceTech product exhibited at HIMSS in Orlando, February 2008.
	http://blogs.msdn.com/healthblog/archive/2008/02/28/himss-08-redux-swimming-in-the-same-pond.aspx

- 	Bill Crounse, MD, Senior Director of Worldwide Health, Microsoft Corp., describing the TelepresenceTech product exhibited at HIMSS in Orlando, February 2008.
- 	_[http://blogs.msdn.com/healthblog/archive/2008/02/28/himss-08-redux-swimming-in-the-same-pond.aspx](http://blogs.msdn.com/healthblog/archive/2008/02/28/himss-08-redux-swimming-in-the-same-pond.aspx)_

## Challenges still faced:

- Technical –3D only simulated
- Managerial – Payment by health plans
- Cultural – Each new install:  “Show Me”
- Network – Bandwidth in rural areas (need 768K minimum)
- Support – sufficient to preclude troubleshooting by end user.

## Future plans

- Rolling out at ten locations in four other rural WA counties
- Adding desktop version for provider side of the patient encounter
- Military & VA installations under discussion

## Q & A