J.R.B. (Jim) Hutchinson, M.D. practiced family medicine in a small Virginia coal mining town, the United States Air Force and after residency training, in group and solo Ear Nose and Throat practices before devoting his efforts to the evolving area of Telemedicine/Telehealth. Serving his profession in many administrative capacities further illuminated the need for improved communication within the health care provider community. Belief that the challenge of delivering quality health care to more people at reduced per unit cost demanded a new approach initiated his recent work.

Faced with reduced reimbursements, the health care industry is forced to respond creatively. He feels that technology offers many solutions to this challenge while enhancing both patients and providers. The mechanisms of change are difficult and often painfully slow. Education lubricates the process.

Georgia offered the first statewide telemedical program in the United States. Unfortunately, it is a T-1 point to point system with low, although growing utilization. Recognizing this as only a small portion of evolving Telemedical/Telehealth applications, the then director of the Georgia Hospital Association's Educational TEL NET and myself suggested a format for expanded discussion in a time/cost effective manner. Via the Association's telephone bridge, many helpful volunteer TM/TH experts, and by Internet distribution announcing the sessions, we have offered to an international audience a varied topic agenda since early 1996.

Registration is by email and the only cost to attendees is that of the connecting phone call. Also there are no written materials or handouts from the program, but by exchange of email addresses amongst presenters and interested participants Multiple benefits have been reported to us. Currently we are expanding access and distribution of the effort by agreement with the Association of Telemedicine Service Providers (ATSP) to post the sessions on their web site. Applying streaming technology they may then be utilized globally and without time zone restrictions by interested participants albeit minus the live Q&A available to those on the conference call.

Jim, tell me a little more about the Georgia Telemedicine Association and how it developed.

As stated above the need to raise Telemedicine/Telehealth to more people the GHA sessions came about. An early expert was Mr. Jeff Dunbar, who now is at Triad Technologies.

He arranged the formative meeting in conjunction with a Medical Association of Georgia meeting in Nov of 1996. Twenty-two people attended, most non-physicians, and most wished to be included in the group.

Your position as Chairman of the Georgia Telemedicine Association, what does that entail and how did you become involved?

At that meeting the reasons for such a group was brought into focus, goals formulated and interests of each person expressed. The most pressing issue was reimbursement and virtually everyone wanted to be on the committee addressing this subject. Interest in additional in person meeting was limited and thus by the will of the group present, I was selected to chair the organization. Using the Center for Total care offer, a listserv was established and the donation of a web site for posting information was given as well. Use of the GHA bridge for information transfer was suggested by Mr. Robert Searfoss from GHA. Thus, this tool has evolved as the meeting site and information distributor to the group.

How has the Georgia Telemedicine Network grown?

The network has grown by virtue of the people who have joined the conferences.

I know your doing on line continuing education and workshops. What else are you doing?

We are providing input to state and national legislative representatives, hospital and medical organizations.

How has this been accepted?

The provider community remains skeptical of the technologies, although there is no overt resistance to Telemedicine/Telehealth.

Have there been any problems or pitfalls?

There is little enthusiasm for another organization in this area since the ATA exists as an international organization. This group wished to remain independent of any other group and thus avoid conflicting interest areas. Thus, as a functioning effort, the thrust is totally educational at this point.

What are you planning for the future?

We plan to expand the availability of the information of the Telemedicine Telejournal, the GHA is donating their conference bridge and staff support, while the Association of Telemedicine Service Providers is assisting in furthering their programs with staff support, and web site streaming of the conference on a delayed basis. I serve as moderator and coordinator of the program.

If you could look into the crystal ball next to your computer, what do you see the future of Telemedicine?

Gradual inclusion into the providing of medical services by many differing technologies with constantly changing applications as we gain experience with the pros and cons of each effort.

If you had any advice to give to your peers in new programs or established programs, what advice would you give?

Gather data of your effort, publish in mainstream publications and educate colleagues, the public and the political arm as well. And remember that even in this time of "rapid" change, that all progress comes slowly. Do not get discouraged.

Is there anything else you want to add, Jim?

The Telehealth Discussion List http://telehealth.net/subscribe/subscribe_list.html is one of many forms of this educational effort.

Cheers and keep up the good work, Jim!