if you can believe it it was in 1925 that the father of science fiction and
that the father of science fiction and
that the father of science fiction and the namesake for the Hugo Awards Hugo
the namesake for the Hugo Awards Hugo
the namesake for the Hugo Awards Hugo Gernsback envisioned my favorite form of
Gernsback envisioned my favorite form of
Gernsback envisioned my favorite form of futurist telemedicine the Tell adaxel
futurist telemedicine the Tell adaxel
futurist telemedicine the Tell adaxel they used radio and television
they used radio and television
they used radio and television technology so that a physician could be
technology so that a physician could be
technology so that a physician could be miles away from a patient and with the
miles away from a patient and with the
miles away from a patient and with the patient was a machine that was equipped
patient was a machine that was equipped
patient was a machine that was equipped with heat and sensitive pressure heat
with heat and sensitive pressure heat
with heat and sensitive pressure heat and pressure sensitive fingers that was
and pressure sensitive fingers that was
and pressure sensitive fingers that was guided by the physician and that did the
guided by the physician and that did the
guided by the physician and that did the exam so tella
exam so tella
exam so tella meaning far or distant or dactyl meaning
meaning far or distant or dactyl meaning
meaning far or distant or dactyl meaning finger tella dactyl is actually
finger tella dactyl is actually
finger tella dactyl is actually incredibly clever and if you fast
incredibly clever and if you fast
incredibly clever and if you fast forward to today mr. Gernsback wasn’t
forward to today mr. Gernsback wasn’t
forward to today mr. Gernsback wasn’t too far off the mark
too far off the mark
too far off the mark telemedicine is here today and the tools
telemedicine is here today and the tools
telemedicine is here today and the tools are mind-boggling but what’s missing
are mind-boggling but what’s missing
are mind-boggling but what’s missing from the telemedicine equation is not
from the telemedicine equation is not
from the telemedicine equation is not the tools what’s missing is you each and
the tools what’s missing is you each and
the tools what’s missing is you each and every one of you individually I am here
every one of you individually I am here
every one of you individually I am here today to tell you that you can shape the
today to tell you that you can shape the
today to tell you that you can shape the future of worldwide care but first we
future of worldwide care but first we
future of worldwide care but first we have to zoom out for a little context
have to zoom out for a little context
have to zoom out for a little context you’d have to be under a pretty big rock
you’d have to be under a pretty big rock
you’d have to be under a pretty big rock to not know that the future of
to not know that the future of
to not know that the future of healthcare at least fiscally is we’ll
healthcare at least fiscally is we’ll
healthcare at least fiscally is we’ll just call it dire in fact overwhelming
just call it dire in fact overwhelming
just call it dire in fact overwhelming and if you’re feeling a little
and if you’re feeling a little
and if you’re feeling a little overwhelmed so are many of our policy
overwhelmed so are many of our policy
overwhelmed so are many of our policy makers Delaware’s Governor John Carney
makers Delaware’s Governor John Carney
makers Delaware’s Governor John Carney in the last round of budget negotiations
in the last round of budget negotiations
in the last round of budget negotiations said healthcare cost inflation was the
said healthcare cost inflation was the
said healthcare cost inflation was the number one challenge facing national and
number one challenge facing national and
number one challenge facing national and state budgets in our own little state of
state budgets in our own little state of
state budgets in our own little state of Delaware we are fifth in the nation per
Delaware we are fifth in the nation per
Delaware we are fifth in the nation per capita for health care spending and yet
capita for health care spending and yet
capita for health care spending and yet by many measures we are 31st for
by many measures we are 31st for
by many measures we are 31st for outcomes and in everybody’s personal
outcomes and in everybody’s personal
outcomes and in everybody’s personal households our insurance premiums rise
households our insurance premiums rise
households our insurance premiums rise way faster than we get raises and this
way faster than we get raises and this
way faster than we get raises and this is the story just about everywhere so I
is the story just about everywhere so I
is the story just about everywhere so I don’t know about you but that makes me
don’t know about you but that makes me
don’t know about you but that makes me feel a little powerless a lot like the
feel a little powerless a lot like the
feel a little powerless a lot like the people on top of this bus a bus that’s a
people on top of this bus a bus that’s a
people on top of this bus a bus that’s a little worse for wear and on a road
little worse for wear and on a road
little worse for wear and on a road that’s clearly not much better and this
that’s clearly not much better and this
that’s clearly not much better and this bus is going faster and the and these
bus is going faster and the and these
bus is going faster and the and these cliffs are getting higher and higher and
cliffs are getting higher and higher and
cliffs are getting higher and higher and nobody’s helped by the fact that inside
nobody’s helped by the fact that inside
nobody’s helped by the fact that inside of this bus every two turns of this road
of this bus every two turns of this road
of this bus every two turns of this road the people inside are fighting over
the people inside are fighting over
the people inside are fighting over whose turn it is to steer
whose turn it is to steer
whose turn it is to steer and so they’re hanging on and we’re
and so they’re hanging on and we’re
and so they’re hanging on and we’re hanging on but thankfully we can get
hanging on but thankfully we can get
hanging on but thankfully we can get another hand hold telemedicine so talent
another hand hold telemedicine so talent
another hand hold telemedicine so talent medicine goes by a couple different
medicine goes by a couple different
medicine goes by a couple different names M health a health telehealth they
names M health a health telehealth they
names M health a health telehealth they all mean essentially the same thing they
all mean essentially the same thing they
all mean essentially the same thing they mean the remote delivery of care using
mean the remote delivery of care using
mean the remote delivery of care using telecommunications technology the remote
telecommunications technology the remote
telecommunications technology the remote delivery of care using
delivery of care using
delivery of care using telecommunications technology so it’s
telecommunications technology so it’s
telecommunications technology so it’s not a scary new type of medicine it’s a
not a scary new type of medicine it’s a
not a scary new type of medicine it’s a new way to deliver existing medicine and
new way to deliver existing medicine and
new way to deliver existing medicine and so knowing from our definition just now
so knowing from our definition just now
so knowing from our definition just now that telemedicine means remote care and
that telemedicine means remote care and
that telemedicine means remote care and from tell adaptil that tella means far
from tell adaptil that tella means far
from tell adaptil that tella means far or distant that probably doesn’t
or distant that probably doesn’t
or distant that probably doesn’t surprise you at all that some of our
surprise you at all that some of our
surprise you at all that some of our first telemedicine patients were our
first telemedicine patients were our
first telemedicine patients were our most distant our Arctic explorers our
most distant our Arctic explorers our
most distant our Arctic explorers our astronauts when Neil Armstrong was
astronauts when Neil Armstrong was
astronauts when Neil Armstrong was walking on the moon his EKG was printing
walking on the moon his EKG was printing
walking on the moon his EKG was printing out in Houston it was incredible and we
out in Houston it was incredible and we
out in Houston it was incredible and we have incredible people here today but I
have incredible people here today but I
have incredible people here today but I imagine we’re a little short on
imagine we’re a little short on
imagine we’re a little short on astronauts and we’re a little short on
astronauts and we’re a little short on
astronauts and we’re a little short on Arctic explorers but I did tell you that
Arctic explorers but I did tell you that
Arctic explorers but I did tell you that you could shape the future of worldwide
you could shape the future of worldwide
you could shape the future of worldwide care and you can but collectively we
care and you can but collectively we
care and you can but collectively we need to first take this idea of
need to first take this idea of
need to first take this idea of geography as this measure of
geography as this measure of
geography as this measure of telemedicine and throat just throw it
telemedicine and throat just throw it
telemedicine and throat just throw it out in its place think of barriers so we
out in its place think of barriers so we
out in its place think of barriers so we all have barriers in our lives they are
all have barriers in our lives they are
all have barriers in our lives they are incredibly common so think of Doris
incredibly common so think of Doris
incredibly common so think of Doris retired on the beach you know but she
retired on the beach you know but she
retired on the beach you know but she has Alzheimer’s or Parkinson’s and she
has Alzheimer’s or Parkinson’s and she
has Alzheimer’s or Parkinson’s and she can’t drive or think about the young
can’t drive or think about the young
can’t drive or think about the young couple but both have very demanding jobs
couple but both have very demanding jobs
couple but both have very demanding jobs and they’ve just sent little Isaac to
and they’ve just sent little Isaac to
and they’ve just sent little Isaac to daycare but it seems like every other
daycare but it seems like every other
daycare but it seems like every other day Isaac is coming back to them with a
day Isaac is coming back to them with a
day Isaac is coming back to them with a new plague and so when they are out of
new plague and so when they are out of
new plague and so when they are out of sick days and they’re already late for
sick days and they’re already late for
sick days and they’re already late for work that pediatrician may be as close
work that pediatrician may be as close
work that pediatrician may be as close as just a few blocks away but to them
as just a few blocks away but to them
as just a few blocks away but to them that pediatrician is basically on the
that pediatrician is basically on the
that pediatrician is basically on the moon and these are cost drivers all of
moon and these are cost drivers all of
moon and these are cost drivers all of these barriers add up to a system of
these barriers add up to a system of
these barriers add up to a system of sick care where we spend eighty percent
sick care where we spend eighty percent
sick care where we spend eighty percent of our health care dollars on 20% of our
of our health care dollars on 20% of our
of our health care dollars on 20% of our population and if we can shift some of
population and if we can shift some of
population and if we can shift some of that attention some of that 80
that attention some of that 80
that attention some of that 80 of resources to that 20% of people using
of resources to that 20% of people using
of resources to that 20% of people using telemedicine we can catch their stage
telemedicine we can catch their stage
telemedicine we can catch their stage for cancer when it’s stage 1 or even
for cancer when it’s stage 1 or even
for cancer when it’s stage 1 or even stage 0 and that means that we can catch
stage 0 and that means that we can catch
stage 0 and that means that we can catch it really when it’s more curable but
it really when it’s more curable but
it really when it’s more curable but pragmatically is also much less
pragmatically is also much less
pragmatically is also much less expensive so thinking about our
expensive so thinking about our
expensive so thinking about our definition of telemedicine and the
definition of telemedicine and the
definition of telemedicine and the rethinking of it my first stop as a
rethinking of it my first stop as a
rethinking of it my first stop as a millennial was Google Images and it was
millennial was Google Images and it was
millennial was Google Images and it was way ahead of me so forget the stars
way ahead of me so forget the stars
way ahead of me so forget the stars instead think of a computer think of
instead think of a computer think of
instead think of a computer think of your smartphone and pair it with the
your smartphone and pair it with the
your smartphone and pair it with the classic example of a health symbol the
classic example of a health symbol the
classic example of a health symbol the stethoscope and really this is what
stethoscope and really this is what
stethoscope and really this is what you’re going to be thinking about and
you’re going to be thinking about and
you’re going to be thinking about and seeing as you get into this world of
seeing as you get into this world of
seeing as you get into this world of telemedicine these tools now would blow
telemedicine these tools now would blow
telemedicine these tools now would blow Hugo Gernsback minds thanks to almost
Hugo Gernsback minds thanks to almost
Hugo Gernsback minds thanks to almost 4.4 billion dollars a year on average
4.4 billion dollars a year on average
4.4 billion dollars a year on average being spent on telemedicine technology
being spent on telemedicine technology
being spent on telemedicine technology over the last three years these tools
over the last three years these tools
over the last three years these tools are getting smarter they’re getting
are getting smarter they’re getting
are getting smarter they’re getting slicker they’re getting more affordable
slicker they’re getting more affordable
slicker they’re getting more affordable and therefore they’re getting more
and therefore they’re getting more
and therefore they’re getting more accessible which means that they are
accessible which means that they are
accessible which means that they are revolutionising certain areas of care
revolutionising certain areas of care
revolutionising certain areas of care for instance think about home health
for instance think about home health
for instance think about home health monitoring remember Doris doors down at
monitoring remember Doris doors down at
monitoring remember Doris doors down at the beach she has what’s called a
the beach she has what’s called a
the beach she has what’s called a chronic condition that means that she
chronic condition that means that she
chronic condition that means that she often has to travel for these batteries
often has to travel for these batteries
often has to travel for these batteries of tests these tests that she has a lot
of tests these tests that she has a lot
of tests these tests that she has a lot of trouble getting to and if we could
of trouble getting to and if we could
of trouble getting to and if we could remove that barrier using
remove that barrier using
remove that barrier using telecommunications technology this home
telecommunications technology this home
telecommunications technology this home health monitoring so that Doris can get
health monitoring so that Doris can get
health monitoring so that Doris can get this battery of tests done in her own
this battery of tests done in her own
this battery of tests done in her own living room how much easier her life
living room how much easier her life
living room how much easier her life would be and that just really is the tip
would be and that just really is the tip
would be and that just really is the tip of the iceberg it really gets my mind
of the iceberg it really gets my mind
of the iceberg it really gets my mind going you know think about your own
going you know think about your own
going you know think about your own lives think about when you see your
lives think about when you see your
lives think about when you see your primary care doctor and they said that
primary care doctor and they said that
primary care doctor and they said that you have to go see a specialist maybe a
you have to go see a specialist maybe a
you have to go see a specialist maybe a therapist and you know that that’s going
therapist and you know that that’s going
therapist and you know that that’s going to mean weeks later a whole other
to mean weeks later a whole other
to mean weeks later a whole other location and if you could instead see
location and if you could instead see
location and if you could instead see that the specialists right on the spot
that the specialists right on the spot
that the specialists right on the spot from that very visit with your primary
from that very visit with your primary
from that very visit with your primary care doctor how much easier it would be
care doctor how much easier it would be
care doctor how much easier it would be and think about whole populations of
and think about whole populations of
and think about whole populations of people that we bury on purpose our
people that we bury on purpose our
people that we bury on purpose our prisoners if we were able to get them
prisoners if we were able to get them
prisoners if we were able to get them re-entry care that they need think about
re-entry care that they need think about
re-entry care that they need think about addiction services how much better that
addiction services how much better that
addiction services how much better that would be for recidivism and think about
would be for recidivism and think about
would be for recidivism and think about our most expensive care think about our
our most expensive care think about our
our most expensive care think about our emergencies
emergencies
emergencies it’s really driving up costs everywhere
it’s really driving up costs everywhere
it’s really driving up costs everywhere and if we could triage people so they
and if we could triage people so they
and if we could triage people so they didn’t go right into that really
didn’t go right into that really
didn’t go right into that really expensive emergency care but instead
expensive emergency care but instead
expensive emergency care but instead first we’re seen by a telemedicine with
first we’re seen by a telemedicine with
first we’re seen by a telemedicine with primary care we could divert a lot of
primary care we could divert a lot of
primary care we could divert a lot of that a lot of those patients away and
that a lot of those patients away and
that a lot of those patients away and really start to drive down these costs
really start to drive down these costs
really start to drive down these costs the potential is truly astounding
the potential is truly astounding
the potential is truly astounding so where does Delaware fit into all of
so where does Delaware fit into all of
so where does Delaware fit into all of this so if if you’re not fortunate
this so if if you’re not fortunate
this so if if you’re not fortunate enough to be one of the nine hundred and
enough to be one of the nine hundred and
enough to be one of the nine hundred and fifty thousand of us here in Delaware
fifty thousand of us here in Delaware
fifty thousand of us here in Delaware that’s okay you’re still you’re still in
that’s okay you’re still you’re still in
that’s okay you’re still you’re still in the right place I promise to you just
the right place I promise to you just
the right place I promise to you just consider this a case study a way that
consider this a case study a way that
consider this a case study a way that you can take it back to your community
you can take it back to your community
you can take it back to your community in fact I’m counting on you to take it
in fact I’m counting on you to take it
in fact I’m counting on you to take it back to your community because maybe you
back to your community because maybe you
back to your community because maybe you can beat us there but we’ve got a lot of
can beat us there but we’ve got a lot of
can beat us there but we’ve got a lot of good things going for us so we are a
good things going for us so we are a
good things going for us so we are a small state but we have these nation
small state but we have these nation
small state but we have these nation size challenges this gray wave of
size challenges this gray wave of
size challenges this gray wave of retirees is down at the beaches and they
retirees is down at the beaches and they
retirees is down at the beaches and they have high needs for services but we have
have high needs for services but we have
have high needs for services but we have some of the fastest broadband in the
some of the fastest broadband in the
some of the fastest broadband in the country and we also have a very
country and we also have a very
country and we also have a very tight-knit network of clinicians and
tight-knit network of clinicians and
tight-knit network of clinicians and physicians that we can very quickly show
physicians that we can very quickly show
physicians that we can very quickly show that proactively removing barriers from
that proactively removing barriers from
that proactively removing barriers from people’s lives will drive down these
people’s lives will drive down these
people’s lives will drive down these costs we also have some of the best laws
costs we also have some of the best laws
costs we also have some of the best laws so I was thrilled and honored to be able
so I was thrilled and honored to be able
so I was thrilled and honored to be able to work on these laws on behalf of the
to work on these laws on behalf of the
to work on these laws on behalf of the Delaware telehealth coalition and also
Delaware telehealth coalition and also
Delaware telehealth coalition and also the Medical Society of Delaware and
the Medical Society of Delaware and
the Medical Society of Delaware and thanks to some phenomenal leadership
thanks to some phenomenal leadership
thanks to some phenomenal leadership representative Brian short and she was
representative Brian short and she was
representative Brian short and she was Senator then but now she’s lieutenant
Senator then but now she’s lieutenant
Senator then but now she’s lieutenant governor Bethany Hall along in 2015 our
governor Bethany Hall along in 2015 our
governor Bethany Hall along in 2015 our governor jack Markell signed into effect
governor jack Markell signed into effect
governor jack Markell signed into effect our telemedicine law and it did a whole
our telemedicine law and it did a whole
our telemedicine law and it did a whole bunch of things but really two that are
bunch of things but really two that are
bunch of things but really two that are very important first patient safety
very important first patient safety
very important first patient safety patient safety is always paramount
patient safety is always paramount
patient safety is always paramount telemedicine is not perfect for
telemedicine is not perfect for
telemedicine is not perfect for everything we can’t yet do surgery
everything we can’t yet do surgery
everything we can’t yet do surgery through a smartphone maybe someday but
through a smartphone maybe someday but
through a smartphone maybe someday but until then we have to make sure that all
until then we have to make sure that all
until then we have to make sure that all care provided is appropriate and safe
care provided is appropriate and safe
care provided is appropriate and safe and it meets the standard of care second
and it meets the standard of care second
and it meets the standard of care second and make sure that we create this
and make sure that we create this
and make sure that we create this payment parity and what parity means is
payment parity and what parity means is
payment parity and what parity means is that if a service is being able to be
that if a service is being able to be
that if a service is being able to be delivered via telemedicine via a
delivered via telemedicine via a
delivered via telemedicine via a physician to that same standard of care
physician to that same standard of care
physician to that same standard of care as though it were in
as though it were in
as though it were in that insurance pays that same rate
that insurance pays that same rate
that insurance pays that same rate that’s parody and this is really
that’s parody and this is really
that’s parody and this is really important because if there was any sort
important because if there was any sort
important because if there was any sort of discrepancy it would create a
of discrepancy it would create a
of discrepancy it would create a disincentive for the adoption of
disincentive for the adoption of
disincentive for the adoption of telemedicine so we have a lot of things
telemedicine so we have a lot of things
telemedicine so we have a lot of things going for us in Delaware the table is
going for us in Delaware the table is
going for us in Delaware the table is set so many of us have actually already
set so many of us have actually already
set so many of us have actually already received cards in the mail from our
received cards in the mail from our
received cards in the mail from our employer I know that my wife did and
employer I know that my wife did and
employer I know that my wife did and nationally these ads are going up on
nationally these ads are going up on
nationally these ads are going up on television that basically say you know
television that basically say you know
television that basically say you know if you’re sick contact this telemedicine
if you’re sick contact this telemedicine
if you’re sick contact this telemedicine service and they’ll square you away and
service and they’ll square you away and
service and they’ll square you away and there’s nothing inherently wrong with
there’s nothing inherently wrong with
there’s nothing inherently wrong with those if you have a science a sinus
those if you have a science a sinus
those if you have a science a sinus infection and you want to be seen right
infection and you want to be seen right
infection and you want to be seen right away you know any one of us at this very
away you know any one of us at this very
away you know any one of us at this very moment could spend about forty dollars
moment could spend about forty dollars
moment could spend about forty dollars and we could sign into one of these
and we could sign into one of these
and we could sign into one of these services and be seen on the spot
services and be seen on the spot
services and be seen on the spot and that’s fine but really what’s
and that’s fine but really what’s
and that’s fine but really what’s missing and what Delaware can prove is
missing and what Delaware can prove is
missing and what Delaware can prove is what’s called continuity of care that
what’s called continuity of care that
what’s called continuity of care that it’s not just about seeing a doctor it’s
it’s not just about seeing a doctor it’s
it’s not just about seeing a doctor it’s about seeing your doctor your doctor
about seeing your doctor your doctor
about seeing your doctor your doctor that knows all 360 degrees of you that
that knows all 360 degrees of you that
that knows all 360 degrees of you that knows all of your challenges that knows
knows all of your challenges that knows
knows all of your challenges that knows all the specialists to bring into this
all the specialists to bring into this
all the specialists to bring into this team that can help you get from you’re
team that can help you get from you’re
team that can help you get from you’re invincible years your millennial years
invincible years your millennial years
invincible years your millennial years let’s say all the way through to your
let’s say all the way through to your
let’s say all the way through to your golden years with two that gray wave and
golden years with two that gray wave and
golden years with two that gray wave and that’s what Delaware can really prove is
that’s what Delaware can really prove is
that’s what Delaware can really prove is that by removing these barriers we can
that by removing these barriers we can
that by removing these barriers we can create this system and so I’ll really
create this system and so I’ll really
create this system and so I’ll really leave you with this because this is
leave you with this because this is
leave you with this because this is where you come back into play it’s as
where you come back into play it’s as
where you come back into play it’s as simple as an ask ask your physician
simple as an ask ask your physician
simple as an ask ask your physician asked your physician next time you are
asked your physician next time you are
asked your physician next time you are with them say listen I have some
with them say listen I have some
with them say listen I have some barriers in my life I would like your
barriers in my life I would like your
barriers in my life I would like your help removing them
help removing them
help removing them I’d like you to use telemedicine so I
I’d like you to use telemedicine so I
I’d like you to use telemedicine so I can see you so much easier and together
can see you so much easier and together
can see you so much easier and together collectively we can show the world what
collectively we can show the world what
collectively we can show the world what telemedicine can do to the future of
telemedicine can do to the future of
telemedicine can do to the future of health
health
health [Applause]
”
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