I attended the ATA annual meeting in Seattle a couple of weeks ago. This is a roughly two-day affair with pre and post sessions available for those who wish to take full or half-day seminars. The ATA is one of the largest associations for implementers and practitioners of telemedicine in the U.S. There was a good-sized trade show with impressive exhibits by well-known companies like Intel, Polycom and Tandberg as well as dozens of smaller companies. A portion of the show floor was given over to about eight enormous mobile clinics, large buses or recreational vehicles transformed into mobile hospital or clinic facilities.
The meeting was divided into several different tracks. These included:

• Emergency and Remote Telemedicine
• Patient sensors and home telemonitoring
• Videoconferencing
• Business models, management and finance.

This was my first ATA meeting, and the first time I had been in Seattle.
The format for most presentations was a fifteen minute lecture followed by a few questions. Presentations fell in to the tracks as described above. I was interested in particular in hardware, including video and sensors. While there were a couple of presentations that described work similar to ours, nobody described a program delivered over multi-point videoconferencing. Some random notes:

• Every person in the United Kingdom is registered with a family doctor
• Virtually all primary care in the UK is computerized
• When an entity (like the National Health Service in Britain, or Kaiser Permanente in California) is both the payer and the health-care provider barriers to automation and improved productivity via electronic medical records and telemedicine are reduced. Much of the lag in the U.S. of implementing the electronic medical record is due to the lack of clarity over who benefits, and who pays for its implementation. When these are not the same entity, there is conflict.
• The Continua Health Alliance is an industry group implementing interface standards for sensor data transmission using exisiting hardware; Bluetooth, USB and Zigbee.
• Sensors are a big deal. There was a great deal of discussion of patient self-administered readings which are sent via a wireless connection to a hub connected to a telephone.
• Some patients may have a different perception of “good health”, than might otherwise be expected. Some patients described themselves to be in good health, although they are on oxygen, confined to a scooter or wheel chair, and have had a third heart bypass operation.
• In focus group studies patients said they liked being able to take readings at home. It allowed for more privacy, and allowed the patient to be involved in their own care.
• Things that people didn’t like about home health-care equipment; having to move it around, “smells like a hospital”, disruptive of routine.
• The “smart home” for assisted living could involve sensors and motion detectors . Think of smoke detectors, which are an example of a sensor.
• All medical students have PDAs. When they get out of medical school they are going to be expecting digital connections. They don’t expect to see patients for 12 hours a day. There may be a whole new group of physicians in areas like correctional telemedicine.
• We don’t have “real-time” now. I have to walk across the street to get my meds, down the hall to get blood drawn. Patients wearing sensors are already much faster (whether tele or not).
• The American crisis in health care is THE opportunity for Telemedicine.
• Find a forward-thinking governor in a small state that would be willing to grasp the opportunity with long-term care and telehealth, Opportunities under medicaid “308”? Pennsyvania “ERA” program. Remote monitoring and chronic disease management Several very large self-insured employers are taking this on.