telemedicineI recently got the opportunity to meet Tom Hale, MD, PhD, the Executive Medical Director of Mercy Virtual, which is a division of Mercy Health.  Mercy Health is a Catholic Health System founded by the Sisters of Mercy with its corporate offices in St. Louis, Missouri.  Mercy has just built the world’s first telemedicine center in St. Louis, aka “the hospital with no beds.”

What is telemedicine you might ask?  According to the American Telemedicine Association, “Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology.”

Telemedicine is cool, it’s improving health care if we do it right, and it’s coming to a city near you.  It is reshaping not only how and where patients receive care, but also how hospitals operate, even changing what they look like.  Dr. Hale is an ambassador for telemedicine, and in many ways, his career path has led him to this naturally.

Telemedicine Center in St. Louis

Telemedicine Center in St. Louis, Architecture by Forum Studio, Construction by CLAYCO and Experiential Design Elements by Click Spring

LS:  What is your background?  How did you get where you are today?

TH:  I graduated from Iowa State with a degree in Zoology, received a PhD from St. Louis University with a major in Pharmacology, my Medical Degree was earned at the University of Missouri, completed my  residency in Internal Medicine in St. Louis receiving board certification in 1983.  I practiced general internal medicine for 23 years during which a group of physicians started an integrated medical group with Mercy St. Louis — beginning with 17 physicians in 1994 growing to where it is now which is a little over 450 physicians strong.  I was the first president of the group and remained in that position for 15 years. In 2005 I was asked by our system CEO to be the lead physician on Mercy’s Epic implementation.  It was during this time that I received a Master’s in Medical Informatics from Northwestern.  In 2010 we started the center for innovation for which I was he Executive Medical Director which evolved into Mercy Virtual.  The name of the organization and its focus evolved, the title remained the same.

LS:  What are some cool initiatives you are working on now?

TH:  We presently are monitoring over 500 ICU beds in 5 states from our new virtual care center.  We provide tele-stroke services for over 30 facilities, consultative services in multiple specialties – adult and pediatrics – established virtual units to manage sepsis improving outcomes significantly for the deadly condition, placed smart devices in chronically ill patients through which our virtual primary care team has augmented the management of their condition virtually, established Nurse on Call as a service to the patients of our 700 primary care physicians triaging and averting 70% of the physicians night calls and redirecting > 30% of the potential ED visits to a less costly and more available site.  Essentially we are creating increased access to care, 24/7/365 of both primary and specialty care, utilizing data and decision support to improve quality of care, decrease cost and improve service to our patients.

LS:  What advice would you give folks involved with designing hospitals or office spaces, as it relates to accommodating telemedicine?

TH:  Both physician offices and hospital rooms will need to be equipped for the virtual environment and thus should allow for an architectural integration of the virtual technology so that it is part of a patients routine care.  That would mean that you can’t just design a TV monitor on a wall with a camera – this would like you are placing a critically important part of a patients care team on the same level as entertainment.  Designers will need to consider the ability to wirelessly exchange information over networks, blend the technology into the fabric of the care delivery work flow so that the care giver – patient relationship is not only maintained but strengthened.  Designers will need to increase the flexibility of the work space as through technology it will be able to be used for everything from ICU rooms to observation rooms – all in the same space.  Spaces will need to be designed so that staff can remain at the bedside and not at the documentation station as most of the documentation will be done virtually.  Hospitals will be designed less as megaplexes of specialty care delivery and procedural interventions and rather as smaller facilities that are patient centric, significantly improved in regards to communication and thru put and visually flexible to display information and images on demand.

LS:  For those who are interested in reading more about you and your work, where can they go?

TH:  http//

LS:  What are good books, magazines, journals, blogs we should read if we want to learn more about telemedicine?

TH:  The American Telemedicine Association (ATA) represents the best resource to further explore the possibilities of telemedicine

LS:  What health or medical professional do you most admire (past or current) and why?

TH:   Richard Reider who was Chief of Medicine at my training program – he taught me to be thorough, complete and kind and that at the end of the day it doesn’t matter if you are right only that the patient got better.

LS:  Five years from now, what will we all be talking about as it relates to telemedicine?

TH:  Five years from now virtual care will be standard of care, communication with your physician over a smart device will be expected, medical care will come to the patient instead of the patient coming to care, we will be proactive and not reactive and that through it all Medicine remains a personal experience and not a commodity.