Telemedicine Demands Quality of Service From IT

Mary E. Shacklett, President, Transworld Data | 9/13/2011 | 8 comments

Mary E. Shacklett
Telemedicine was first used during the 1985 earthquake in Mexico. Its application was simple: via satellite, doctors provided voice-based assistance and coaching to Red Cross and Pan American Health Organization workers.

Since then, the Internet has expanded the possibilities for telemedicine to instant transport of images and x-rays, documents and instructions, voice-based coaching, and live video observation and interaction with patients who may be thousands of miles away from an attending specialist in a major medical center. The process even goes one step further: specialists in different areas of the country or the world have been able to perform minimally invasive surgical procedures remotely on patients by being able to operate via Internet-transmitted signals to robots in the operating room.

The benefits of cyber-medicine were directly felt by Michael Harrigan, a financial advisor who suffered a stroke while driving on an interstate highway in rural Wisconsin. As Harrigan retold his experience to the Milkwaukee Journal Sentinel, his face had felt odd and his breath had gotten short. He managed to pull to the side of the highway and call 911. Then he was taken to the nearest available medical facility -- a community healthcare center 22 miles off the highway.

“Paramedics from the town of Johnson Creek picked him up,” said Jacklynn Lesnia, vice president of patient services at the Watertown Regional Medical Center, which treated Harrigan. “In the past, he would have been treated by a physician in the ER (emergency room). Now, we activate our telemedicine protocols with a stroke alert over an Internet-enabled EMS (emergency response system).” The alert immediately goes over a secure T1 line to the University of Wisconsin Medical Center, which patches the alert through to a doctor who is a stroke specialist.

In Mr. Harrigan’s case, Internet-facilitated treatment resulted in a 90-minute window between onset of the stroke and treatment -- a “gold-level” response. “This is very important to rural healthcare centers because often victims of stroke don’t get to the ER soon enough,” said Lesnia. “Then, if you don’t have a stroke specialist on staff, there is a hesitancy to use stroke treatment medications right away, since they also have their risks. You want to run all of the tests first.”

With a telemedicine communications link, a specialist in a major medical center can directly interact visually and verbally with a patient in a rural area. This means that critical factors that frequently get lost in translation no longer do, because the specialist can see for himself what is going on.

The IT behind this medical immediacy consists of not only leasing and monitoring pipelines that are wide enough to transport heavy data over IP, but also a complex of failover mechanisms. So if one pipeline goes down or degrades, the communication can be cut over to another pipeline, in order to maintain constant uptime.

Central to this communications strategy is also the management of multiple ISPs (Internet Services Providers) in the process. Many sites insert network routing with advanced intelligence and then program these routers with business rules for a combination of both wireless and wireline service providers. These various providers can then be brought into the communications mix, depending on load balancing or failover requirements.

The message for healthcare IT is that communications strategies must be as well-funded and managed as application deployment, security, and data repositories. This is especially true in an era when more remote medical applications will be needed for underserved rural environments.

That message wasn’t lost on Michael Harrigan, who today is fully recovered from his stroke. “Time is a critical element in the treatment of strokes,” said Dr. Justin Sattin, the neurologist who worked over a dedicated telemedicine link to the clinic in Johnson Creek to treat Mr. Harrigan.

“Although there is new evidence that treatment can occur as late as 4.5 hours after the onset of stroke, the standard window of treatment is treatment response within three hours,” Sattin said. “If you delay beyond that, the chances for a successful outcome diminish by 15 to 20 percent.”

View Comments: Newest First | Oldest First | Threaded View
Mary E. Shacklett   Telemedicine Demands Quality of Service From IT   9/15/2011 1:44:58 PM
Re: telemedicine
Yes, Pedro, this is a multifaceted e-effort that is totally transforming healthcare.


User Ranking: Blogger
Pedro Gonzales   Telemedicine Demands Quality of Service From IT   9/14/2011 9:22:03 PM
IT department will play a more important role in the health environment with not just providing emergency services as this article indicated but much more. President Obama stimulus package includes supporting the adoption of electronic health records, so little by little telemedicine is becoming a more dominant in the field.

Let not forget that there are other technologies which include personal heatlh records, e-health, e-prescribing that are moving other aspects of healthcare into the electronic domain.

Mary E. Shacklett   Telemedicine Demands Quality of Service From IT   9/14/2011 11:25:27 AM
Re: Telemedicine Demands Quality of Service From IT
Hi Henrisha,

There are new medical apps being dispensed around the world that take advantage of the technology available--such as plain old telephone service and mobile  phones, This  allows laypersons to  administer to local residents with  the help and the coaching of medical professionals. It is "low tech" telemedicine , but it is nevertheless making an impact.


User Ranking: Blogger
nimanthad   Telemedicine Demands Quality of Service From IT   9/14/2011 6:33:24 AM
Re: An Incredible Challenge
Well, telemedicine lacks the quality or else IT hasnt done justice for the word TELEMEDICINE up to now. That is the sole reason why it has not kept up to its reputation it promised to be at the beginning. It really does need high attention of quality of service from IT and needs it to be fixed for a long term basis.
Henrisha   Telemedicine Demands Quality of Service From IT   9/14/2011 3:24:48 AM
Re: Telemedicine Demands Quality of Service From IT
It will be interesting to see what new developments will be made to make telemedicine more widely available all over the world. As demonstrated by Michael's story, this saves lives. When it comes to medical emergencies, time is of the essence. In fact, just a few minutes could mean either life or death for some of these people. IT in healthcare is something I believe deserves more focus.
zerox203   Telemedicine Demands Quality of Service From IT   9/13/2011 11:52:12 PM
Re: An Incredible Challenge
Unfortunately, as the medical field lags behind enterprise in general, it will likely be a couple of decades or so before stories like Michael's are commonplace.

Sara Peters wrote an article a couple of weeks ago about how new database sharing techniques were helping cut costs in the healthcare industry (, and I was surprised - because the technology sounded a lot like the kinds of database sharing other industries had been using for years.

Likewise, this kind of remote medical care, not the remote surgery but the visual and audio aspect, sounds like something a lot of companies might use for communication across the country all the time. There are plenty of good reasons medicine might have to take it slow when implementing good technologies, but I can't help but feel that any lagging behind is as much because of a lack of proper funding and an overabundance of red tape - which is a shame, because as we can see from this story, there's plenty of life-saving potential for these technologies.

Mary E. Shacklett   Telemedicine Demands Quality of Service From IT   9/13/2011 4:02:23 PM
Re: An Incredible Challenge
Hi EyeTee,


I am happy to say that there has been some support (through stimulus  money  and other grants) for constructing an information highway  capable of  supporting throughput for telemedicine. That being  said, there is much more to be done--not only technologically, but also legally and from the operational and policy sides.

Because so much is  at stake, healthcare always  lags other industries--but it is good to see some headway in critical areas.


User Ranking: Blogger
EyeTee   Telemedicine Demands Quality of Service From IT   9/13/2011 3:52:44 PM
An Incredible Challenge
As IT professionals, we all know that there is great pressure to provide always-on, always secure service. It's part of the job.

But let's face it: realistically, let's say a corporate website of an average company went down for 10 minutes. People might get mad, or people may not notice, but long-term... it's really not going to be that big of a deal.

Telemedicine, as you mention, is a whole other thing. People's lives are literally at stake. I can't imagine how challenging it will be to deploy such implementations. If you mess up, there seriously are dire consequences.

On the plus side, I can also imagine this being incredibly rewarding: far more so than, say, simply making sure people are able to read the latest celebrity gossip.

Anyhow, I do believe that we'll see more applications of this within our lifetimes. Unfortunately, as the medical field lags behind enterprise in general, it will likely be a couple of decades or so before stories like Michael's are commonplace.

The blogs and comments posted on do not reflect the views of TechWeb,, or its sponsors., TechWeb, and its sponsors do not assume responsibility for any comments, claims, or opinions made by authors and bloggers. They are no substitute for your own research and should not be relied upon for trading or any other purpose.

More Blogs from Mary E. Shacklett
Mary E. Shacklett   12/7/2011   7 comments
The promise of internal cloud infrastructures for organizations rests in a much hoped for seamless ability to traverse heterogeneous operating systems and hardware platforms, delivering ...
Mary E. Shacklett   12/5/2011   8 comments
Companies have recognized that they need to function 24/7 in a global economy -- and that they can ill afford to experience disasters and outages. This has given some "lift" to disaster ...
Mary E. Shacklett   12/2/2011   6 comments
Nothing is more important than your disaster recovery (DR) and business continuation plan when you really need it -- but the odds are pretty high that you never will. Hardly anyone ever ...
Mary E. Shacklett   11/29/2011   35 comments
CIOs have to know the business and how IT delivers value, but they also have to understand enough of the technology to inspire and earn the respect of their staff. Where is the fine line ...
Mary E. Shacklett   11/23/2011   24 comments
Right now, companies are striving to get their arms around real-time analytics and what it can mean for their businesses, but fraud detection software has been working in real-time for ...
Latest Archived Broadcast
We talk with Bernard Golden about accelerating application delivery in the cloud.
On-demand Video with Chat
Register for this video discussion to learn how tablets can provide true business usability and productivity.
E2 IT Migration Zones
IT Migration Zone - UK
Why PowerShell Is Important
Reduce the Windows 8 Footprint for VDI
Rethinking Storage Management
IT Migration Zone - FR
SQL Server : 240 To de mémoire flash pour votre data warehouse
Quand Office vient booster les revenus Cloud et Android de Microsoft
Windows Phone : Nokia veut davantage d'applications (et les utilisateurs aussi)
IT Migration Zone - DE
Cloud Computing: Warum Unternehmen trotz NSA auf die „private“ Wolke setzen sollten
Cloud Computing bleibt Wachstumsmarkt – Windows Azure ist Vorreiter
Like Us on Facebook
Twitter Feed
Enterprise Efficiency Twitter Feed
Site Moderators Wanted
Enterprise Efficiency is looking for engaged readers to moderate the message boards on this site. Engage in high-IQ conversations with IT industry leaders; earn kudos and perks. Interested? E-mail:
[email protected]
Dell's Efficiency Modeling Tool
The major problem facing the CIO is how to measure the effectiveness of the IT department. Learn how Dell’s Efficiency Modeling Tool gives the CIO two clear, powerful numbers: Efficiency Quotient and Impact Quotient. These numbers can be transforma¬tive not only to the department, but to the entire enterprise.

Read the full report
The State of Enterprise Efficiency in the Virtual Era: Virtualization – Smart Approaches to Maximize Gains
Virtualization is a presence in nearly all enterprise data centers. But not all companies are using it to its best effect. Learn the common characteristics of success, what barriers companies face, and how to get the most from your efforts.

Read the full report
Informed CIO: Dollars & Sense: Virtual Desktop Infrastructure
Cut through the VDI hype and get the full picture -- including ROI and the impact on your Data Center -- to make an informed decision about your virtual desktop infrastructure deployments.

Read the full report
A Video Case Study – Translational Genomics Research Institute
e2 Video

On the Case
TGen IT: Where We're Going Next

7|11|12   |   08:12   |   10 comments

Now that TGen has broken new ground in genomic research by using Dell's storage, cloud, and high-performance computing solutions, the company discusses what will come next for it and for personalized medicine.
On the Case
Better Care Through Better Communications

6|6|12   |   02:24   |   11 comments

The achievements of the TGen/Dell project could improve how all people receive healthcare, because they are creating ways to improve end-to-end communication of medical data.
On the Case
TGen IT: Where We Are Now

5|15|12   |   06:58   |   6 comments

TGen is breaking new ground in genomic research by using Dell's storage, cloud, and high-performance computing solutions.
On the Case
TGen IT: Where We Were

4|27|12   |   06:45   |   10 comments

The Translational Genomics Research Institute wanted to save lives, but its efforts were hobbled by immense computing challenges related to collecting, processing, sharing, and storing enormous amounts of data.
On the Case
1,200% Faster

4|18|12   |   02:27   |   12 comments

Through their partnership, Dell and TGen have increased the speed of TGen’s medical research by 1,200 percent.
On the Case
IT May Improve Children's Chances of Survival

4|17|12   |   02:12   |   8 comments

IT is helping medical researchers reach breakthroughs in a way and pace never seen before.
On the Case
Medical Advances in the Cloud

4|10|12   |   1:25   |   5 comments

TGen and Dell are pushing the boundaries of computing, and harnessing the power of the cloud to improve healthcare.
On the Case
TGen: Living the Mission

4|9|12   |   2:25   |   3 comments

TGen's CIO puts the organizational mission at the heart of everything the IT staff does.
On the Case
TGen Speeding Up Biomedical Research to Save More Lives

4|5|12   |   1:59   |   6 comments

The Translational Genomics Research Institute is revamping its computing to improve speed, storage, and collaboration – and, most importantly, to save lives.
On the Case
Computing Power Helping to Save Children's Lives

3|28|12   |   2:13   |   3 comments

The Translational Genomics Institute’s partnership with Dell is enabling them to treat kids with neuroblastoma more quickly and save more lives.
Tom Nolle
The Big Reason to Use Office

3|18|14   |   02:24   |   46 comments

Office and personal productivity tools come in a first-class and coach flavor set, but what makes the difference is primarily little things that most users won't encounter. What's the big issue in using something other than Office, and can you get around it?
E2 Editors
SPONSORED: Mobile Security — A Use Case

3|4|14   |   04:27   |   16 comments

New mobile security solutions can accommodate a wide array of needs, including those of a complex university environment.
Tom Nolle
Killing Net Neutrality Might Save You Money

1|16|14   |   2:13   |   16 comments

The DC Court of Appeals voided most of the Neutrality Order, and whatever it might mean for the Internet overall, it might mean better and cheaper Internet VPNs for businesses.
Tom Nolle
The Internet of Everythinguseful

1|10|14   |   2:18   |   19 comments

We really don't want an "Internet of Everything" but even building an Internet of Everythinguseful means setting some ground rules to insure there's value in the process and that costs and risks are minimized.
Tom Nolle
Maturing Google Chrome

12|30|13   |   2.18   |   25 comments

Google's Chrome OS has a lot of potential value and a lot of recent press, but it still needs something to make it more than a thin client. It needs cloud integration, it needs extended APIs via web services, and it needs to suck it up and support a hard drive.
Sara Peters
No More Cookie-Cutter IT

12|23|13   |   03.58   |   21 comments

Creating the right combination of technology, people, and processes for your IT organization is a lot like baking Christmas cookies.
Sara Peters
Smart Wigs Not a Smart Idea

12|5|13   |   3:01   |   46 comments

Sony is seeking a patent for wigs that contain computing devices.
Tom Nolle
Cloud in the Wild

12|4|13   |   02:23   |   15 comments

On a recent African trip I saw examples of the value of the cloud in developing nations, for educational and community development programs. We could build on this, but not only in developing economies, because these same programs are often under-supported even in first-world countries.
E2 Editors
SPONSORED: Is Malware Evading Your IPS?

11|18|13   |   03:16   |   4 comments

Intrusion prevention software is supposed to detect and block malware intrusions, but clever malware authors can evade your IPS in these five main ways.
Sara Peters
Where Have All the Mentors Gone?

9|27|13   |   3:15   |   38 comments

A good professional mentor can change your life for the better... but where do you find one?
Tom Nolle
SDN Wars & You Could Win

9|17|13   |   2:10   |   5 comments

VMware's debate with Cisco on SDN might finally create a fusion between an SDN view that's all about software and another that's all about network equipment. That would be good for every enterprise considering the cloud and SDN.
Ivan Schneider
The Future of the Smart Watch

9|12|13   |   3:19   |   39 comments

Wearing a bulky, oversized watch is good training for the next phase in wristwatches: the Internet-enabled, connected watch. Why the smartphone-tethered connected watch makes sense, plus Ivan demos an entirely new concept for the "smart watch."
Tom Nolle
Cutting Your Cloud Storage Costs

9|4|13   |   2:06   |   3 comments

Cloud storage costs are determined primarily by the rate at which files are changed and the possibility of concurrent access/update. If you can structure your storage use to optimize these factors you can cut costs, perhaps to zero.
Sara Peters
Do CIOs Need an IT Background?

8|29|13   |   2:11   |   23 comments

Most of the CIOs interviewed in the How to Become a CIO series did not start their careers as IT professionals. So is an IT background essential?
Ivan Schneider
The Internet Loves Birthdays

8|27|13   |   3:25   |   69 comments

The Internet has evolved into a machine for drumming up a chorus of "Happy Birthday" messages, from family, friends, friends of friends who you added on Facebook, random people that you circled on G+, and increasingly, automated bots. Enough already.