[acb-hsp] Cisco's Virtual Doctor Will See You Now

[peter altschul]

Cisco's Virtual Doctor Will See You Now
  By: Elizabeth Svoboda April 20, 2011
  Deepak Chandrasekar gets his eye examined by internist Seema 
Sangwan (on screen).  Nurse Xenia Khesin assists.  bar Photograph 
by Cody Pickens
  Cisco's new health-networking systems could transform health 
care.



DEEPAK CHANDRASEKAR has been wondering why his right eye has been 
so red recently, which is what brought him to see the doctor 
today.  Internist Seema Sangwan examines his eye and inquires 
about whether he also has an itchy throat.
  "Look up, please," she asks her patient, peering closely at the 
eye, finally determining that his symptoms are consistent with 
allergies.  She prescribes some antihistamine eyedrops and 
recommends scheduling a follow-up appointment.  It's a pretty 
routine medical exam.  Except that Sangwan isn't in the same room 
with her patient -- she appears in front of him on a giant 
home-theater-esque display.
  Thanks to a new Cisco telemedicine initiative called 
HealthPresence, Chandrasekar was diagnosed remotely with the aid 
of videoconferencing and high-tech medical equipment that 
transmitted images, blood-pressure readings, and heart-rate data 
to Sangwan.  Xenia Khesin, the on-site nurse, focused a 
high-resolution video camera on Chandrasekar's eye and instantly 
a magnified image of his eye appeared on a smaller monitor next 
to the main video display in their location.  Sangwan saw the 
same image on her computer screen, which was how she was able to 
diagnose Chandrasekar's problem.  Patient and doctor were 
conversing face-to-face, though they weren't in the same room.  
The entire episode took no more than 10 minutes, and Cisco hopes 
it is the future of health care.
  Cisco launched its HealthPresence initiative in 2006.  
Executives realized teleconferencing could potentially solve a 
growing problem in the health-care field: Many Americans live in 
areas where doctors, particularly specialists, are far away.  So 
the company devised a network of exam stations that would supply 
specialized health care to patients regardless of their location.  
The HealthPresence system includes not only virtual-chat 
capabilities but also medical devices such as pulse oximeters, 
blood-pressure cuffs, and ear-nose-throat scopes that transmit 
patient information electronically to doctors anywhere around the 
globe, who are also equipped with Cisco's technology.  Exam 
kiosks can be installed in all kinds of places, from 18-wheeler 
mobile clinics to office parks.  The company already has 33 
kiosks up and running, including the one at the Cisco campus in 
San Jose, which is where Cisco consultant Chandrasekar was able 
to have his eye checked.
  Sangwan thinks users enjoy the participatory aspects of their 
virtual doctor visit -- getting to see an on-screen close-up of 
an inflamed eye, for example, or to listen to a chest noise 
recorded by the telephonic stethoscope.  "People get amazed," she 
says.  "They say, 'Yes, it does look red1' or 'Yes, I hear a 
whistling.' was Sangwan cannot use the system to diagnose 
conditions that call for palpation, such as appendicitis, but she 
says these situations arise rarely.
  Demographic trends suggest Cisco has timed its entry into the 
telehealth realm perfectly.  The ratio of health-care staff to 
U.S.  citizens is already about 40% lower than ideal, according 
to research firm Frost and Sullivan, and it's going to get worse; 
health-staffing needs are projected to triple over the next 
quarter-century.  Telehealth systems may be our best shot at 
extending the reach of the specialized providers we do have.  
Other companies are beginning to get in on the action: GE 
Healthcare and Intel joined forces this year in a telehealth 
venture called Care Innovations, and HP has teamed up with 
Lifebot to develop a telehealth system for emergency care.  But 
Cisco maintains an edge deployment-wise.  Its HealthPresence 
system is already being used by a variety of health-care 
providers, including a Tennessee not-for-profit that houses its 
kiosk in a truck.  The truck drives around rural parts of the 
state where specialists are scarce, and heart patients are able 
to see their cardiologists on a monthly basis without ever 
leaving their driveways.  "The more people are exposed to this, 
the more they're going to become comfortable," says Gloria 
Calderon, vice president of clinic operations at California-based 
Molina Healthcare.
  A variety of logistical challenges remain, such as persuading 
government programs like Medicare to reimburse doctors for 
telehealth visits, convincing HMO's that they should jump on the 
bandwagon, and -- the biggest one -- getting patients truly 
comfortable with seeing their doctors on a video screen.  The 
Cisco team, convinced that these are just temporary obstacles, 
remains committed to its goal of installing the system widely.  
"Jails, corporate campuses," says Kathy English, Cisco's director 
of global health-care marketing, "you could have patients go to a 
Walgreens or CVS to see a physician."
  Will HealthPresence kiosks someday be as common as Starbucks? 
It's possible -- as long as patients decide the technology is 
seamless enough that they can forget it even exists.
  A version of this article appears in the May 2011 issue of Fast 
Company.
  Copyright Ággc) 2011 Mansueto Ventures LLC.