Fellow Presentations: Day 4 (Jack Higgins)

Jack Higgins is a pioneer in telemedicine, founding Video Housecall in 1994. He challenged the traditional notion that telemedicine was a tool for doctors to consult among themselves. Rather than relying on expensive, fixed setups that require long lead times to secure time slots and expensive per-hour operating costs, Jack looked at a way to put the technology within the reach of more people. By creating a simple, PC-based solution with a digital camera and communicating over the internet, he found that patients can communicate directly with their doctors with costs at a level easily within reach of the average school and many patients' home computing environment.

The school is an interesting application area: as school budgets have come under pressure and demand for nurses has exceeded the supply, the "school nurse" that I knew growing up is a thing of the past. Now, a single nurse might serve 7 schools, with just a health aide on site at the others. Jack started a program where schools would have access to doctors via telemedicine, allowing a response that's faster than an ambulance in many cases. For his innovative work, he was featured on a segment of national TV news.

A further experiment has proved out the capability of handling the diverse range of conditions and complaints that a clinic faces. A remote California town has a clinic that is closed on Mondays. The nearest hospital is a 4-hour roundtrip drive away, over treacherous mountain roads. Jack set up a system whereby he could remotely view and interact (telemedicine provides 2-way communication with both audio and video) with patients who would otherwise need to go to the hospital. His findings were that 70-80% of the cases could be treated remotely, saving considerable time and expense.

With two successful projects under his belt, he continued to pursue his goal of providing telemedicine in the developing world. A current project, Promotora Telemedicine project, tests the cross-cultural aspects of telemedicine. Targeting Hispanics with diabetes (some 25% of those over age 45), the pilot project took 20 cases and treated them in a combination of free, local clinics (without access to specialists) and remote consultations with specialists. Of the 18 who stayed in the study geography (San Jose to San Francisco, CA), 17 cases were in control, allowing the patients to resume work and normal activities.

After successfully proving the efficacy in these local trials, Jack is ready to tackle the international angle. Through a fortuitous connection with HP, he's able to piggy-back on the eInclusion effort. Mobile clinic vans with both the necessary technology and medical supplies were already planned for deployment in India as part of HP's program. Jack and Renee Chin will provide the medical expertise and localization/acculturation (the "software" to run on HP's provided "hardware", if you will) to make the project work. The medical expertise will initially be doctors volunteering from their homes or offices (most likely from America and Europe). Subsequent target geographies (based partially on interest from funders) are South Africa and Vietnam.