“Can You See Me Sweat?”: A Conversation with Danny Sands, MD via TelePresence

The question in the title of this post is a reasonable one to ask in Washington, DC, when entering a meeting after walking downtown, even in the morning, and a very reasonable one to ask when entering one’s first meeting using TelePresence, with its Blu-Ray (1024p) resolution and life size reproduction of a continuous video image.

This isn’t videoconferencing: Besides being a great patient advocate, Danny Sands, MD, is also a great innovator in the area of health information technology. His work contributed to the first philosophical platform around patient-physician e-mail, and now, he may do the same in the era of telehealth, so of course it was worth a visit!

This was my first time visiting a TelePresence room (it was Danny’s 100+, he told me); I admit (and admitted to Danny) that it’s disarming. As he pointed out, the room is constructed in such a way to reinforce the perception that another person is sitting across the table from you. I felt like I wanted to reach over and take a look at his mobile device and laptop – everything matches, down to the table surface, the chairs, and the paint colors.

Beyond TelePresence, there’s HealthPresence, which combines the video quality and continuity of TelePresence with clinical devices (electronic health records and biometric monitoring) in a clinical environment. A pilot of HealthPresence has been done in Scotland; you can see a YouTube video of that experience here.

After a nice introduction to the technology (and for doing this over 100 times, I have to say, Danny’s a great and patient teacher), we talked about ideas for using technology like this in health care.

This ranges from everything to providing care over distances where physicians or specialists aren’t present, to expanding the footprint of specialty of care regardless of distance. The promise of including family members in consultations seems interesting as well.

I was especially intrigued by the possibility that Danny suggested of there being special training to deliver health care using this format. The corollary to that is a curriculum in undergraduate and graduate medical education in providing care using different modalities (including e-mail as well as video) might result in a new specialty, or at the very least, new emphasis on patient-centered care in the medical education system.

UnitedHealthGroup is currently creating an infrastructure around this called Connected Care, with a mobile set of two HealthPresence units touring the country (you can see the YouTube video of that here).

By the end of an hour, I definitely felt more comfortable with the conversation. It was fun to bring a little Washington, DC to Boston via this technology, and vice versa.

Part of connecting with innovators like Danny is connecting with their enthusiasm for the future; to that end I took a few videos of my own – this is of Danny illustrating the 3-dimensional audio capabilities of the system. I’m going to edit the other and post it in a few days. See what you think.


Ted Eytan, MD