[Noozhawk’s note: This article is one in a series on the impact of technology on medicine in Santa Barbara County. Click here for a previous article.]
Back in the 1990s, telemedicine was a bad word.
Michael Chan had to talk up the business another way back then, when hospitals still frowned on the idea of sending robots into a patient’s room so a doctor miles away could remotely conduct assessments or assist in surgery.
“It’s pretty clear — whether you want to call it technology or innovation — the one thing that is constant is change,” he said.
Chan, a longtime colleague of Yulun Wang, helped him launch two different medical technology companies in Goleta, most recently in 2002 as general manager and executive vice president for marketing and international markets at InTouch Health.
“People would say, ‘You’re going to do what?’” Chan recalled. “That was a 15-year journey to making surgical robotics hit critical mass. Doctors were concerned about malpractice and if the technology was viable.
“Same thing when we started here at InTouch Health. More than a decade ago, we didn’t even want to use the word telemedicine.”
Chan would know. He was there when Wang was the first to invent and obtain approval from the federal government to manufacture a surgical robot at Computer Motion Inc.
After earning approval from the Food and Drug Administration, which regulates medical devices, Computer Motion went public in 1997 and merged in 2002 with Intuitive Surgical — now a Sunnyvale-headquartered leader in the field of robotic-assisted minimally invasive surgery.
InTouch Health opened shortly after, focusing on developing and manufacturing Class II telemedicine remote-presence medical devices, which allow physicians to perform reliable, real-time consultations from far away.
Today the company’s telehealth network facilitates more than 12,000 consults a month, working with more than 1,300 hospitals and adding more than one site every day.
Uses have expanded to neurology, mental health services and critical care.
“It’s access to that expertise in a timely manner to serve patients,” Chan said.
“There are a lot of folks who may not immediately see the benefits. Most of the (physician) expertise is in major regional hospitals or major academic medical centers. Roughly a third of all hospitals in the U.S. are serving rural communities. How do you get that medical expertise out to the broad-based population? Telemedicine is one way.”
Marian Regional Medical Center in Santa Maria is one institution seizing the benefit of a remote doctor.
The Dignity Health hospital has been using two InTouch iRobots — one that a physician can drive and another that must be pushed around — so on-call neurologists in Sacramento can assess stroke patients when one of two local specialists aren’t available, according to Tauny Sexton, Marian’s senior director of emergency services.
So far, patients have been content seeing the best of the best, she said, even if it means doctors aren’t technically standing in front of them.
InTouch Health owes its success to the trailblazers who didn’t get accolades, Chan said, with some physicians even being stripped of their licenses decades ago because they suggested less invasive ways to perform surgery.
They invented smaller instruments and cameras to assist in joint surgery without having to cut the body open, which eventually became widespread practice.
“The benefits are much less invasive, less blood loss, shorter recovery time,” Chan said, adding that telemedicine was taboo until technology inspired changes in behavior.
The FDA has been regulating medical devices since 1976, a move initially necessitated because the agency said so many people were starting fraudulent companies with false promises of rejuvenating youth, among other claims.
It’s no wonder physicians were at first skeptical of robots.
Goleta is home to a growing community of innovative medical-device manufacturers, including Inogen, which was founded by three UC Santa Barbara students in 2001 to develop a lightweight and travel-safe portable oxygen concentrator.
Another local company, Karl Storz Veterinary Endoscopy America Inc., is a growing leader in advanced minimally invasive endoscopic technology and operating room integration solutions.
The United States is the largest medical device market in the world, according to the Commerce Department, with a $110 billion market that’s expected to reach $133 billion in 2016.
Yet nonbelievers remain.
States like Florida, where many older “snow birds” go to retire, haven’t quite embraced telemedicine, Chan said, whereas markets in California, Colorado and the Midwest have numerous proponents.
One group of enterprising physicians in the Colorado-Wyoming area started a practice of about six doctors that cover nearly 100 hospitals remotely, he said.
InTouch is adapting its own strategy to address the market for the technology, hoping in 2016 to launch a new option to operate a telemedicine network and physician services — no longer merely establishing networks for devices but providing one contract for hospitals to sign.
Hospital customers are also asking the company to provide outpatient or ambulatory care services beyond hospitals as opposed to short-term care inside facilities.
“As telemedicine has hit the radar screen as a strategy for pretty much every major medical center in the U.S., it’s on the verge of broad adoption,” Chan said. “The adoption for and appetite for it has reached a point that hospitals now are believing in it.”