We are on the cusp of a broad roll-out of various types of "e-presence" programs in hospitals. Just to get on the same page, here's a definition for e-presence: The act of being "live" online. Whether in an IM exchange, or video, or even email. ePresence is that quality of feeling that the entity at the other end of the exchange is actually there and responding (see: e-presence). I think that one of the common denominators of e-medical video applications is that providers and patients are interacting on a live basis. These e-presence programs and apps will range from relatively low complexity ambulatory visits (see: Details of Cleveland Clinic's MyCare Online Virtual Telemedicine Visits) to telepsychiatry visits (see: Telepsychiatry) to virtual ICU's care in small hospitals from specialists in larger ones (see: Anatomy of a virtual ICU: Study probes teamwork among on-site, remote staff).
The reasons for my optimism about the rapid growth of e-presence initiatives is that they offer the most cost-effective way to deliver medical services to the growing number of health care consumers. The major expenditures for live on-line services involve networks, software to mange the provider/patient interactions, and the cost of retraining healthcare professionals to use this technology. These costs substitute for bricks-and-mortar costs which will always be substantially more and lack the flexibility of e-presence programs. Patients, of course, need their own devices in their homes but many will already own smart phones or tablets. I fully understand that there questions remain regarding telemedicine reimbursement (see: Telemedicine Reimbursement), but I fully expect them to get ironed out quickly.
As these e-presence initiatives emerge within individual health systems, there will be a need to blend them under some type of organizational structure within health systems because the technical infrastructure will be similar or the same for most of them. For example and for most of these initiatives, one common need will be to order lab tests and to view test results so that they are visible to patients and the physicians delivering services. This note is intended, in part, for my pathology informatics colleagues, suggesting that they take the initiative in developing the technical infrastructure, processes, and organization structures for their own hospital e-presence programs.