VC Daily’s ongoing interview series, The Future of Video Conferencing, is dedicated to gaining insights from industry leaders on how technology will shape the world of tomorrow. Milton Chen, VSee founder and CEO, is one of the world’s leading thinkers on telemedicine.
Dr. Chen completed his doctoral thesis at Stanford on the human factors of video conferencing and is the co-author of the XMPP protocol (used by Google and Facebook chat). Through his extensive work deploying telemedicine in the Middle East, Africa, and other areas of the world, Dr. Chen has witnessed firsthand how video can improve the lives of everyday people both overseas and at home.
VC Daily: Your bio on the VSee website quotes you as working to make “telemedicine an everyday experience across the world.” Can you tell us how you plan to bring VC to remote and rural places that have limited digital infrastructure?
Chen: Video conferencing needs to become so accessible that even in rural places a simple 3G connection can allow you to get on a video conference with a doctor. I’ll use Iraq as an example. People there don’t have personal access to high-quality physicians. Telemedicine, however, lets local doctors and even junior physicians link to expert physicians in the U.S. to discuss individual patients and get a great outcome. There’s also a benefit to doctors over here. If you practice medicine in the U.S., after about 10 or 20 years it gets boring because you see the same cases over and over again. In Africa and the Middle East, though, you see all these interesting cases that you might otherwise only see in a textbook. It’s an intellectual challenge for doctors.
VC Daily: What illness/disease and treatments do you see being delivered via video conferencing in the future?
Chen: Telemedicine is undergoing massive growth in the U.S. right now. Of the one billion consultations performed by doctors each year, 15% can be done by telemedicine. And when we start using telemedicine in one area of medicine, or within general health care centers, it becomes easy to think forward a few years and imagine lots of departments using it. As it is, we’ve seen telemedicine used in everything from oncology to hospice care to diabetes care–you name it. On a personal level, I’m really excited, because if you look at the state of healthcare in the U.S., telemedicine has a lot of potential to lower costs.
VC Daily: So how will telemedicine change the way general practitioners and family doctors see and treat patients?
Chen: We see this happening in two ways. Firstly, telemedicine will make it easier and more convenient for doctors and patients to see each other. Secondly, there’s opportunity to bring in a specialist for a consultation. If I go to a primary physician, they might refer me to a specialist, and with VC, that primary care doctor might be able to bring the specialist into the office and everyone can be in one room.You get greater continued care that way as well, because your primary doctor knows exactly what’s going on with the specialist.
VC Daily: This cooperation between multiple doctors must increase the need for security online. We’ve seen Mark Zuckerberg and James Comey place tape on their webcams–is video conferencing a safe way to discuss personal health information?
Chen: In order to do anything in healthcare you must be HIPAA compliant, but the good news is you can create a VC experience that meets these strict regulations. There are strong encryptions in video conferencing software, but the weakest link is your personal device itself–that’s the reason for the tape over the webcam. My hunch is that future security models will become more focused on protecting the devices themselves, and that will help people feel more confident about using telemedicine on their laptops and smartphones.
VC Daily: You’ve mentioned using personal devices like laptop and smartphones for telemedicine, but how will a future convergence of video conferencing and smart devices (the Internet of Things) benefit family medicine in the future?
Chen: I love this question. For people maybe our age the cost of healthcare isn’t too high, but for people our parents’ age the cost increases. The beauty of VC and IoT is that it is very good at monitoring health, which can help catch issues, especially in older people. For example, there’s already a tablet you place in your mattress that tracks health and wellness indicators like sleep, which can allow for much more effective clinical decisions.
Looking to the future, we know that after surgery the amount of movement you do has a direct influence on your outcome. Even if you’re in pain, you should be moving to help blood circulate. If you had just a simple tool to monitor movement this could have a big impact on outcome. There’s also scope for developing a tool to monitor sleep apnea without having patients check into a lab. And then there’s technology around pregnancy, including fetal screenings via IoT, or even small ultrasound probes that can easily monitor a baby’s health and send data to a doctor.
VC Daily: Switching to a different area of medicine, how will telemedicine be used by first responders in the future?
Chen: We have clinical use cases where the EMTs can attend a patient in the field and can connect to a remotely located doctor while they’re onsite. Traditionally, the first responder does an initial assessment and then automatically sends the patient to the ER, which is expensive.
If I were to make a prediction, I’d say that in 5 to10 years you will be able to click a button on a smartphone or computer and talk to an emergency physician directly. This makes sense because, for example, if you go to an ER the smallest bill is $700 and scales up into the thousands, whereas you could talk to a physician via video conferencing for $100. In major metropolitan areas, there’s such a long wait in the emergency room that this could divert significant patients and take the stress off hospitals.
VC Daily: So, if you were building a telemedicine system from scratch, what would be the essential elements you’d include?
Chen: The first component would be integration with the laboratory and simple medical devices that would capture and pass on data for the physician. The second element would be the inclusion of biometric data that would let you identify the patient and quickly pull up their medical history, which would decrease the likelihood of making mistakes. Finally, I’d find a way to make the system more productive. I’d consider questions like, how do you create workflows that allow physicians to get better outcomes, and how do you create a telemedicine experience that everyone can enjoy?
VC Daily: Finally, when we look around, most telemedicine is actually still being done over the phone. What do you think is holding up the mass adoption of video telemedicine? When will we think it’s “normal” see our doctors over video?
Chen: I think the drama of getting connected, having good audio, getting crystal clear video, and dealing with network scenarios, just getting everything set up and working correctly is difficult for people. In 5 to 10 years, I think we might be starting to think of telemedicine as more “normal,” and even right now we’re beginning to see things like concierge physicians using telemedicine. But because there are something like 1 million physicians in the U.S., it’s hard to get everyone on board. Even if there’s a great new thing that comes into the healthcare field, it usually takes about 18 years to become common practice. Essentially, the healthcare field moves fairly slowly. However, I also think that the U.S. healthcare system is reaching a breaking point, and that telemedicine will be a key tool to solving many of these health care inefficiencies and high costs. Thus, this will force us to find new ways to shorten the cycle.