Healthcare in the Digital Age

Growing up in the 1970s with a brother being actively treated for metastatic Ewing's sarcoma, I truly came to understand the burden that state-of-the-art medical care could have on a family. The travel to a world-class hospital only 25 miles away was a full-time job for my mother as she oversaw the care of my younger brother through his 5-year chemotherapeutic journey. An easy week required only 3 hospital visits, but most weeks the protocol required 5 days of on-site treatment, testing and monitoring. Family members and friends rallied to provide transportation for my mom and brother. When no one was available to drive them to Manhattan, the social services shuttle bus, driven by George, picked them up at 7 am, returning anywhere from 6 to 8 at night. Long days of travel, and often for a 15-minute doctor visit to assess the effects of his chemotherapy and radiation treatment. Everyone united to make this care by first-rate pediatric cancer specialists possible.

Fast forward 40 years and pediatric subspecialists are still in short supply nationally. Our clinic schedules are packed and the wait time for new appointments is weeks and sometimes months. I often longed for a 25-hour day so that we could make inroads to this problem, but soon realized that only cloning pediatric specialists would solve this issue! Well, virtual cloning of doctors has arrived with the clinical use of Cisco's HealthPresence technology.

In May of 2012, Stanford's Lucile Packard Children's Hospital began telemedicine visits from our outreach clinic in Monterey to our main ambulatory clinics at Stanford. Our Monterey patients have long enjoyed the easy access to Stanford pediatric subspecialty physicians in their home community through our on-site outreach program. These outreach clinics reduced time missed from work for 64% of parents and school for 47% of children. Unfortunately physicians can only make infrequent visits (once per month) to these more remote sites--there is a roundtrip travel time of nearly 4 hours associated with running each clinic session. With the use of Cisco HealthPresence, I am now able to substantially reduce these wait times by running clinics weekly, with no additional travel time. The high-definition videoconferencing equipment, coupled with the transmission of physical exam details through the use of digital medical instruments, yields a high-quality clinical interaction that rivals the traditional in-person doctor visit. By increasing the frequency of our clinic sessions through the use of Cisco HealthPresence, the hospital is able to both reduce wait times and increase the number of patient visits per month at Monterey.

In January of 2013 my wish of physician cloning will come true as we will bring on our second telemedicine site at California Pacific Medical Center (CPMC) in San Francisco. This will allow me to see patients at two distinct outreach locations on the same day, without ever leaving the Stanford campus! Cisco's HealthPresence extends my reach to both the rural and urban underserved pediatric populations of northern California, with a frequency that approaches our on-site services at Lucile Packard Children's Hospital.

Why stop here? As technology becomes more accessible, I foresee a day when patients and families will not even need to travel to a regional telemedicine center to facilitate their care. At Lucile Packard Children's Hospital, we are working to pioneer care for our most complex patients right from the comfort of their home. Using modern digital technologies, doctors may soon return to the practice of making house calls, not by carrying a black bag, but by using secured medical airwaves, USB compatible medical diagnostic equipment and their tablet computer!

Read more about the Lucile Packard Telehealth Initiative at csr.cisco.com.