.The deployment of IT in the health professions is still very much in its infancy. What other uses of technology could potentially improve the quality of health care? Brainstorm several alternatives.

CASE: Brain Saving Technologies, Inc. and the T-Health Institute: Medicine Through Videoconferencing.On average, every 45 seconds, someone in theUnited States suffers a stroke, the third-leadingcause of death as well as the leading cause of permanentdisability in the nation, according to the AmericanHeart Association.The first three hours after a stroke are critical to a patientssurvival and recovery. For instance, depending on thetype of stroke suffered by a patient, certain drugs can vastlyimprove the patients survival and chances for full rehabilitation.Those same drugs, however, can be deadly if given to apatient suffering another type of stroke. Due in part to ashortage of specialty physicians trained to accurately diagnoseand treat stroke victims, not all U.S. hospitals have theexpertise and equipment to optimally care for stroke patients,particularly in the critical early hours.The new Neuro Critical Care Center, operated by BrainSaving Technologies Inc. in Wellesley Hills, Massachusetts,will begin to connect emergency-room doctors at a numberof suburban hospitals in the state with a remote universityhospital that will act as a hub with on-call critical-care neurologistswho can assist in making remote diagnoses andtreatment recommendations for suspected stroke patients,says Stuart Bernstein, CEO and chief operating officer atBrain Saving Technologies. The connection occurs througha visual-communication workstation that can connect via IP,high-bandwidth communications, or private leased line. Theworkstation allows the remote specialists to examine and talkto patients, and collaborate with on-site doctors to improvetimely diagnosisof strokes and optimize treatment options,Bernstein says.Our purpose is to provide member hospitals with a majorhospital stroke center, 24 by 7, Bernstein says. CTscansdigital images of patients brainscan also be transmittedfrom the member hospitals to the Neuro Critical CareCenter specialists to improve diagnosis of the patients, hesays. The images are seen simultaneously by doctors at bothlocations so that they can collaborate. The technology canalso help train emergency-room doctors about what characteristicsto look for on the CT scans of stroke patients.A key component of the Neuro Critical Care Centersoffering is the Intern Tele-HealthCare Solution from Tandberg,which provides simultaneous audio and video transmission andbidirectional videoconferencing and image-display capabilitiesto hub and member hospital doctors. Emergency-room doctorscan wheel the mobile Tandberg system to patients bedsides,Bernstein says.Tandbergs medical video-communication products arealso used in other telehealth applications, including situationswhere doctors need an expert in sign language or a foreignlanguage to communicate with patients or their family members,says Joe DIorio, Tandbergs manager of telehealth.The technology provides real-time visibility and collaborationto help assess patients well-being and facilitate real-timeinteraction, he notes.Doctors have long had a tradition of holding grandrounds to discuss patient cases and educate aspiring physicians.The centuries-old practice certainly has its merits, butmedical leaders in Arizona want to improve, update, andbroaden it to include a larger list of health care practitioners,such as nurses and social workers, regardless of their locations.So the Arizona Telemedicine Program (ATP) drew on its extensiveuse of videoconferencing equipment to develop theInstitute for Advanced Telemedicine and Telehealth, or theT-Health Institute, to facilitate a 21st-century way of teachingand collaborating across disciplines and professions.Its specific mission is to use technology to permit interdisciplinaryteam training, explains Dr. Ronald Weinstein,cofounder and director of the ATP. Now were opening it upto a far broader range of participants and patients. TheT-Health Institute is a division of the ATP, which Arizona lawmakersestablished in 1996 as a semiautonomous entity. TheATP operates the Arizona Telemedicine Network, a statewidebroadband health-care telecommunications network that links55 independent health care organizations in 71 communities.Through this network, telemedicine services are providedin 60 subspecialties, including internal medicine, surgery,psychiatry, radiology, and pathology, by dozens ofservice providers. More than 600,000 patients have receivedservices over the network.Project leaders say the goal is to create much-neededdiscussion and collaboration among professionals in multiplehealth care disciplines so that they can deliver the bestcare to patients.Its the effort to be inclusive, Weinstein says. Medicineis quite closed and quite limited, but were counting ontelecommunications to bridge some of those communicationgaps. The institute is essentially a teleconferencing hub thatenables students, professors, and working professionals toparticipate in live meetings. Its technology also allows themto switch nearly instantly between different discussion groupsas easily as they could if they were meeting in person and merelyswitching chairs.Gail Barker has noticed that participants who dontspeak up during in-person meetings often become muchmore active in discussions held via videoconferencing. Perhapsits because they feel less intimidated when theyre notphysically surrounded by others or because the videoconferencingscreen provides a buffer against criticism, says Barker,who is director of the T-Health Institute and a teacher at theUniversity of Arizonas College of Public Health.When used poorly, videoconferencing can be stiff anddull, just a talking head beaming out across cyberspacewithout any chance to engage the audience. But Barker andothers are finding that when the technology is used in athoughtful and deliberate manner, it has some advantagesover real-life sessions because of its ability to draw more participantsinto the fray.Its literally a new method of teaching medical students.Its a novel approach, says Jim Mauger, director of engineeringat Audio Video Resources Inc., a Phoenix-basedcompany hired to design and install the videoconferencingequipment for the T-Health Institute.The T-Health Institute uses a Tandberg 1500 videoconferencingsystem, and its video wall has 12 50-inch ToshibaP503DL DLP Datawall RPU Video Cubes. The video wallitself is controlled by a Jupiter Fusion 960 Display WallProcessor utilizing dual Intel Xeon processors. The Fusion960 allows the wall to display fully movable and scalable imagesfrom multiple PC, video, and network sources.Although Weinstein was able to articulate this vision ofinterprofessional interactionthat is, he could clearly layout the user requirementsimplementing the technology tosupport it brought challenges, IT workers say.Mauger says creating a videoconferencing system thatlinked multiple sites in one video wall wasnt the challengingpart. The real challenge was developing the technology thatallows facilitators to move participants into separate virtualgroups and then seamlessly switch them around.The biggest challenges to making this work were theaudio isolation among the separate conference participantsas well as fast dynamics of switching video and moving participantsto meetings, he explains. He says his team also encounteredother challengesones that affect more typicalIT projects, such as budget constraints, the need to get staffersin different cities to collaborate, and the task of translatinguser requirements into actionable items. Its necessaryto have someone there on-site who understands all the complexparts of the project, he says. Someone who is not justmeeting with people every now and then, but someone whoworks with them on a daily basis.Barker, who teaches in the College of Public Health atthe University of Arizona and is a user of the system, leda trial-run training session at the T-Health amphitheater.She met with 13 people, including a clinical pharmacist, twofamily nurse practitioners, a senior business developer, twoprogram coordinators, a diabetes program case manager,and an A/V telemedicine specialist. For that event, Barkersays the biggest benefit was the time saved by having thefacility in place; without the T-Health Institute, some participantswould have had to make a four-hour round trip toattend in person.Now the system is opening up to others in Arizonashealth care and medical education communities. T-HealthInstitute officials say they see this as the first step toward ahealth care system that truly teaches its practitioners to worktogether across professional disciplines so that they can deliverthe best, most efficient care possible.We think, Weinstein says, that this is the only wayyoure going to create coordinated health care.CASE STUDY QUESTIONS:1.From the perspective of a patient, how would you feel about being diagnosed by a doctor who could be hundreds or thousands of miles away from you? What kind of expectations or concerns would you have about that kind of experience?2.What other professions, aside from health care and education, could benefit from application of some of the technologies discussed in the case? How would they derive business value from these projects? Develop two proposals.3.The deployment of IT in the health professions is still very much in its infancy. What other uses of technology could potentially improve the quality of health care? Brainstorm several alternatives.CASE: Brain Saving Technologies, Inc. and the T-Health Institute: Medicine Through Videoconferencing.On average, every 45 seconds, someone in theUnited States suffers a stroke, the third-leadingcause of death as well as the leading cause of permanentdisability in the nation, according to the AmericanHeart Association.The first three hours after a stroke are critical to a patientssurvival and recovery. For instance, depending on thetype of stroke suffered by a patient, certain drugs can vastlyimprove the patients survival and chances for full rehabilitation.Those same drugs, however, can be deadly if given to apatient suffering another type of stroke. Due in part to ashortage of specialty physicians trained to accurately diagnoseand treat stroke victims, not all U.S. hospitals have theexpertise and equipment to optimally care for stroke patients,particularly in the critical early hours.The new Neuro Critical Care Center, operated by BrainSaving Technologies Inc. in Wellesley Hills, Massachusetts,will begin to connect emergency-room doctors at a numberof suburban hospitals in the state with a remote universityhospital that will act as a hub with on-call critical-care neurologistswho can assist in making remote diagnoses andtreatment recommendations for suspected stroke patients,says Stuart Bernstein, CEO and chief operating officer atBrain Saving Technologies. The connection occurs througha visual-communication workstation that can connect via IP,high-bandwidth communications, or private leased line. Theworkstation allows the remote specialists to examine and talkto patients, and collaborate with on-site doctors to improvetimely diagnosisof strokes and optimize treatment options,Bernstein says.Our purpose is to provide member hospitals with a majorhospital stroke center, 24 by 7, Bernstein says. CTscansdigital images of patients brainscan also be transmittedfrom the member hospitals to the Neuro Critical CareCenter specialists to improve diagnosis of the patients, hesays. The images are seen simultaneously by doctors at bothlocations so that they can collaborate. The technology canalso help train emergency-room doctors about what characteristicsto look for on the CT scans of stroke patients.A key component of the Neuro Critical Care Centersoffering is the Intern Tele-HealthCare Solution from Tandberg,which provides simultaneous audio and video transmission andbidirectional videoconferencing and image-display capabilitiesto hub and member hospital doctors. Emergency-room doctorscan wheel the mobile Tandberg system to patients bedsides,Bernstein says.Tandbergs medical video-communication products arealso used in other telehealth applications, including situationswhere doctors need an expert in sign language or a foreignlanguage to communicate with patients or their family members,says Joe DIorio, Tandbergs manager of telehealth.The technology provides real-time visibility and collaborationto help assess patients well-being and facilitate real-timeinteraction, he notes.Doctors have long had a tradition of holding grandrounds to discuss patient cases and educate aspiring physicians.The centuries-old practice certainly has its merits, butmedical leaders in Arizona want to improve, update, andbroaden it to include a larger list of health care practitioners,such as nurses and social workers, regardless of their locations.So the Arizona Telemedicine Program (ATP) drew on its extensiveuse of videoconferencing equipment to develop theInstitute for Advanced Telemedicine and Telehealth, or theT-Health Institute, to facilitate a 21st-century way of teachingand collaborating across disciplines and professions.Its specific mission is to use technology to permit interdisciplinaryteam training, explains Dr. Ronald Weinstein,cofounder and director of the ATP. Now were opening it upto a far broader range of participants and patients. TheT-Health Institute is a division of the ATP, which Arizona lawmakersestablished in 1996 as a semiautonomous entity. TheATP operates the Arizona Telemedicine Network, a statewidebroadband health-care telecommunications network that links55 independent health care organizations in 71 communities.Through this network, telemedicine services are providedin 60 subspecialties, including internal medicine, surgery,psychiatry, radiology, and pathology, by dozens ofservice providers. More than 600,000 patients have receivedservices over the network.Project leaders say the goal is to create much-neededdiscussion and collaboration among professionals in multiplehealth care disciplines so that they can deliver the bestcare to patients.Its the effort to be inclusive, Weinstein says. Medicineis quite closed and quite limited, but were counting ontelecommunications to bridge some of those communicationgaps. The institute is essentially a teleconferencing hub thatenables students, professors, and working professionals toparticipate in live meetings. Its technology also allows themto switch nearly instantly between different discussion groupsas easily as they could if they were meeting in person and merelyswitching chairs.Gail Barker has noticed that participants who dontspeak up during in-person meetings often become muchmore active in discussions held via videoconferencing. Perhapsits because they feel less intimidated when theyre notphysically surrounded by others or because the videoconferencingscreen provides a buffer against criticism, says Barker,who is director of the T-Health Institute and a teacher at theUniversity of Arizonas College of Public Health.When used poorly, videoconferencing can be stiff anddull, just a talking head beaming out across cyberspacewithout any chance to engage the audience. But Barker andothers are finding that when the technology is used in athoughtful and deliberate manner, it has some advantagesover real-life sessions because of its ability to draw more participantsinto the fray.Its literally a new method of teaching medical students.Its a novel approach, says Jim Mauger, director of engineeringat Audio Video Resources Inc., a Phoenix-basedcompany hired to design and install the videoconferencingequipment for the T-Health Institute.The T-Health Institute uses a Tandberg 1500 videoconferencingsystem, and its video wall has 12 50-inch ToshibaP503DL DLP Datawall RPU Video Cubes. The video wallitself is controlled by a Jupiter Fusion 960 Display WallProcessor utilizing dual Intel Xeon processors. The Fusion960 allows the wall to display fully movable and scalable imagesfrom multiple PC, video, and network sources.Although Weinstein was able to articulate this vision ofinterprofessional interactionthat is, he could clearly layout the user requirementsimplementing the technology tosupport it brought challenges, IT workers say.Mauger says creating a videoconferencing system thatlinked multiple sites in one video wall wasnt the challengingpart. The real challenge was developing the technology thatallows facilitators to move participants into separate virtualgroups and then seamlessly switch them around.The biggest challenges to making this work were theaudio isolation among the separate conference participantsas well as fast dynamics of switching video and moving participantsto meetings, he explains. He says his team also encounteredother challengesones that affect more typicalIT projects, such as budget constraints, the need to get staffersin different cities to collaborate, and the task of translatinguser requirements into actionable items. Its necessaryto have someone there on-site who understands all the complexparts of the project, he says. Someone who is not justmeeting with people every now and then, but someone whoworks with them on a daily basis.Barker, who teaches in the College of Public Health atthe University of Arizona and is a user of the system, leda trial-run training session at the T-Health amphitheater.She met with 13 people, including a clinical pharmacist, twofamily nurse practitioners, a senior business developer, twoprogram coordinators, a diabetes program case manager,and an A/V telemedicine specialist. For that event, Barkersays the biggest benefit was the time saved by having thefacility in place; without the T-Health Institute, some participantswould have had to make a four-hour round trip toattend in person.Now the system is opening up to others in Arizonashealth care and medical education communities. T-HealthInstitute officials say they see this as the first step toward ahealth care system that truly teaches its practitioners to worktogether across professional disciplines so that they can deliverthe best, most efficient care possible.We think, Weinstein says, that this is the only wayyoure going to create coordinated health care.CASE STUDY QUESTIONS:1.From the perspective of a patient, how would you feel about being diagnosed by a doctor who could be hundreds or thousands of miles away from you? What kind of expectations or concerns would you have about that kind of experience?2.What other professions, aside from health care and education, could benefit from application of some of the technologies discussed in the case? How would they derive business value from these projects? Develop two proposals.3.The deployment of IT in the health professions is still very much in its infancy. What other uses of technology could potentially improve the quality of health care? Brainstorm several alternatives.

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