"A person venturing into a new territory and combining a unique perspective with substantive content." This is how Feedback Research Services, a US publisher of newsletters and market reports about telemedicine, care management, home care, and related subjects, motivates the decision to make Doug Perednia, M.D. this year's Telemedicine Speaker-of-the-Year. The current President of the Association of Telemedicine Service Providers (ATSP) earned his title with two thought-provoking presentations, which were held in the course of 1998. In the first speech, for the audience of the ATSP September 1998 Meeting, Dr. Perednia addressed the subject of "Regional Planning for Telemedicine". In the second talk for the 1998 TeleMed Meeting, the award winner states that "telemedicine IS like an underdeveloped country with a death rate graph which matches India's."
Dr. Perednia has been involved with telemedicine since 1993. The recent ATSP presidency has transformed the innovative health care approach into a full-time job for this experienced author and speaker who is concerned with the global establishment of telemedicine to improve existing methods of health care delivery. His ambition is to expand the reach of medical services by building a market for telemedicine applications. Dr. Perednia majored in Econcomics at Swarthmore College in Pennsylvania before moving on to the School of Medicine at Washington University in St. Louis to obtain a medical degree. He completed residencies at the University of Arizona in Tucson and at Oregon Health Sciences University (OHSU) in Portland. Between 1994 and 1998, he served as Director of the Advanced Telemedicine Research Group at OHSU. In addition, Dr. Perednia is still active as the medical director for the Telemedicine Information Exchange.
In the "Regional Planning for Telemedicine" talk, Doug Perednia illustrated the alarming phenomenon of "geographic mismatch" between health care providers and patients on the basis of statistical data for the state of Oregon. Residents in Eastern Oregon have only limited access to medical specialists, such as cardiologists, oncologists, and endocrinologists. It appears that barely 8% of the cardiac hospitalizations occur in this region while it accounts for 20% of the total decease caused by heart failure. Only 2.6% of the state's cardiologists are situated in Eastern Oregon and there is a lack of specialized facilities. In this specific case, telemedicine constitutes a blessing as a virtual "point of presence" between St. Charles in Bend, which is the largest regional hospital, and in-patient cardiology units in Burns and John Day to support telemetry monitoring.
"Telemedicine as an Underdeveloped country" formed the topic of the second presentation. Here, Dr. Perednia identified demographic, social, and economic factors to analyse the types of barriers impeding the growth of entities, like a developing country or a telemedicine programme. Parameters such as the mortality rate, the population pyramid, the investment needs, as well as the uneven distribution of wealth are taken into account to measure the "developed" status of a country. Translated to the model of telemedicine, one has to consider the ratio of new and discontinued projects. Telemedicine initiatives are fairly young of age and need extensive funding to generate a solid infrastructure. For the fiscal years 1994 to 1998, the United States have spent approximately $735 million to offer the innovative field of telemedicine a decent chance to expand in a more or less equal way in every part of the country.
Dr. Perednia will continue to advocate for a larger publicity to the benefit of telemedicine and will take up the challenge presented by federal telemedicine policies in the complex issues of reimbursement. Needless to stress that cost effectiveness remains one of the major problems in the use of telemedicine on an extensive scale. If you like to describe the current status of the newly emerging applications and services of distance medicine in the speaker-of-the-year's very own words, this is what you are bound to hear: "This type of work isn't glamorous, and it seems to take forever to see progress."