Dr. Sanjeev Arora — Improving rural access to care: the role technology plays and the value of telehealth

Dr. Arora responds:

On the current reach of Project ECHO: “We are connected with 120 academic centers that have launched Project ECHO. It is being done for 57 different disease areas; it is a rapidly expanding project. In addition to the 120 or so that have launched, there are also 200 more organizations that have signed collaborative agreements with us to launch Project ECHO.

In order to really change the way the world works for these underserved patients, one has to change the way it is distributed.

On the current state of telehealth: “I think [the technologies] are fairly well developed now. They are sort of plug and play and I don’t see that as a technical gap. I think in terms of remote sensing there probably needs to be further progress. And I think this should happen in the next decade or so.”

On challenges and progress in telehealth: “I think another problem that I see in telehealth is really not a telehealth problem, but it is lack of interoperability of the electronic medical records in the U.S. healthcare system. Essentially, if a patient doesn’t belong to your particular hospital or practice then you can’t really see their electronic health records.”

“Other areas of progress for the future are big data and really interpreting all these new feeds that are coming in and creating intelligent outputs which are actionable. So there are many areas where I see a lot of progress will occur in the future.”

On interoperability: “It’s a source of great frustration for all of us who practice medicine… that we can’t get our act together to really develop a common platform where interoperability can offer the ability to see the patient’s data from any point of contact by the patient and their provider. I think that’s a sad thing, because many other systems have already done that. The VA does it; in other countries they’ve done that. I think it leads to bad patient outcome, so I’m hopeful that we can make greater progress in the future.”

“The problem could be solved in one stroke by law which would say that beyond, let’s say 2020, no healthcare provider or health system would get paid; no electronic medical record could exist unless there was this interoperability. It would get solved instantly, if there was regulation like that.”

Project ECHO overview, from the GE Developing Health Summit

On Project ECHO reaching one billion lives by 2025: “The reason for the big number like a billion is the fact that we’ve done some research in the United States where we ask the providers a very simple question: Is specialty access an area need for you? We published this data that showed 4.9 out of 5 providers said yes. Essentially in the United States, where we have more specialists than any other country in the world, they say they can’t access specialty care easily. So in order to really change the way the world works for these underserved patients, one has to change the way it is distributed.”