CHAPTER 6. CONSULTING PROFESSIONAL SUPPORT

Ultimately, the telemedicine program will be successful only to the extent that consulting professionals embrace telemedicine technologies and use telemedicine services extensively. The following are some recommendations regarding development of consulting professional support.

Identify Affected Specialties. Based on the functionality of each Originating Site, the program should identify the medical specialties which are expected to participate in the telemedicine program. In each of these medical specialties, a clinical liaison should be designated for purposes of managing consulting professional support within the specialty.

The Number of Required Professionals. Based on the expected utilization of telemedicine services, the program must estimate the number of professionals required to support the program in each medical specialty, striking a delicate balance between a sufficient number of participants to assure reasonable service availability, but not so many participants that there is not sufficient volume to maintain technical proficiency with telemedicine technologies. Inadequate volumes of service and loss of technical proficiency will cause consulting professionals to lack confidence in clinical judgments, chilling their willingness to participate in the program.

The selected consulting professionals must be prepared to embrace innovative technologies and have a degree of familiarity with technical matters, in particular the concepts and limitations of telemedicine technologies in areas such as telecommunications and network computing. Ideally, two or three consulting professionals in each medical specialty should become familiar with telemedicine technologies and actively participate in the program. Having more than one professional in each medical specialty allows the professionals to share experiences and practice methods to enrich their professional experience. Limiting participation to one professional in a medical specialty can often lead to the demise of the program in the medical specialty if the professional leaves the Company.

Having more than one professional in each specialty trained in the use of telemedicine systems also facilitates expansion of the program as volumes increase. Experienced professionals can serve as mentors for other physicians who wish to participate in telemedicine, lessening training costs and providing institutional continuity in practice protocols.

Mainstream Telemedicine. The most successful telemedicine programs incorporate telemedicine as part of the routine clinical activities of the consulting professional. Participation in a telemedicine program should not be disruptive to the consulting professional's customary schedule. If "live" transmission is used, many Companys establish "telemedicine clinic" hours when the consulting professionals will be available. Any time not scheduled for telemedicine is released in advance (e.g. seven days) for regular clinical activities.

From an operational standpoint, attention must be given to the location of the site where interpretive services are to be performed by the consulting professional, again being most significant in cases of "live" transmission. This site is often referred to as the "Distant Site". The Distant Site should be in reasonable proximity to each consulting professional's customary office, to avoid inefficiency.

Company support in areas such as information technologies, medical records and financial services should not be significantly different for telemedicine services than any other clinical activity. Successful telemedicine programs seek to mainstream telemedicine to the extent possible, such that consulting professionals experience minimal disruption to their customary clinical practices. With less disruption to regular practices, consulting professionals more readily accept telemedicine as part of every day clinical life.