More News

Dr. Andrew Barbash swears he's not a tech geek.

But last week, the medical director for neurosciences at Silver Spring's Holy Cross Hospital read the results of a CT scan in his car outside a garden supplies store, logging in to the hospital's records portal through his HTC Thunderbolt cell phone.

"I'm not a gadget guy — really!" he laughed. "It's when the gadget becomes: Drop gadget in hand; push button; and use gadget. Then I can use it."

Barbash is pioneering new technology at Holy Cross, and he said he is the first doctor at the hospital who is using tools such as Google Talk for chatting, Vidyo for videoconferencing and the hospital's secure records portal to read test results for patients, their families and other specialists wherever he might be. And Barbash is hoping to expand this use of technology — what he calls the virtualized care environment —to the entire care community. This includes Holy Cross and community health clinics, which often struggle to get enough volunteer physicians to treat patients, he said.

Like many doctors, Barbash said he's always experimenting with different techniques and searching for ways to handle his patient load. He knew technology was a piece of the puzzle from his days working with patient computer records at Kaiser Permanente in the 1990s. But it wasn't until 2001 that Barbash had what he calls his "a-ha moment," where he realized remote, or cloud, computing and mobility were the way of the future.

Previously, mobile technology has had a limit — slow download times, overloaded networks and choppy videos, Barbash said. But now he said cell phone and Internet companies are getting to the point that face-to-face, instantaneous contact is becoming easy.

Barbash uses Verizon Wireless' new 4G LTE network, which has speeds up to 10 times faster than its 3G network, said Verizon spokeswoman Melanie Ortel. Only available in certain locations, Verizon Wireless will expand its 4G LTE footprint by the end of 2013 to include all markets currently served by 3G, Ortel said.

Other wireless companies also have a version of 4G, including Sprint and AT&T.

With his cell phone, Motorola Xoom tablet and MiFi mobile Internet hotspot by his side, Barbash said he's become "untethered and unshackled" in his meetings with patients and colleagues. He can oversee the Intensive Care Unit while running errands, having nurses "ping" him if they have a question. Patients can videochat with relatives in South America after they give birth to a new baby. And he can consult with specialists across the country, showing them test results on the same screen that also hosts a video conference.

Barbash said he interacts with other specialists who are comfortable using technology for health care. If he has an interesting case, he may send out a message to several colleagues to see if they want to videoconference to look at test results and brainstorm treatment options, he said.

"Health care is fundamentally based on human beings looking at each other face-to-face and making decisions," he said. "... Now, you don't even have to think anymore about what vehicle you're going to use to connect. That's a huge breakthrough."

Angela Henley, a former Silver Spring resident, lives in the town of Sault Ste. Marie, Mich., with her husband, Donald, who suffered a stroke two-and-a-half years ago. The town is 345 miles north of Detroit, near the Canadian border, and is not near any specialists. Barbash already was familiar with her husband's file as his former physician. Henley and her husband keep in touch with Barbash via videochat and text messaging, using his primary care physician or the emergency room if necessary.

"In my area, if I had to go to a neurologist, I would have to drive three hours," she said, later adding that she doesn't miss sitting in traffic and a waiting room.

The first few times her husband had a post-stroke seizure, Henley frantically texted Barbash with questions. Now that she is a more comfortable caretaker, she and her husband jot down questions to remember to ask Barbash the next time they videochat, she said.

"It's just comforting to know he's there," she said. "I'm able to ask what things are normal and what to expect, so it's keeping in contact [in a way] that even if I lived in Maryland, I wouldn't even be able to."

There are limits to virtual care, Henley said. Barbash can't check reflexes or blood pressure via the Internet, but she said she imagines that will be a possibility in the future. Henley said she and her husband don't miss the face-to-face contact; the video quality is great, and she wouldn't be able to interact with Barbash otherwise, she said.

Earlier this month, Barbash met with the head of the Primary Care Coalition, a Montgomery County-based nonprofit that operates a network of clinics for low-income, uninsured residents. Barbash thinks the virtual care environment can help those clinics, because it would allow doctors to volunteer remotely, videochatting between their everyday schedule of appointments.

"We have a serious and persistent need for specialty consults," said Steve M. Galen, the president and CEO of the Primary Care Coalition. "Trying to figure out ways to use technology is attractive to us. There are some applications of telemedicine that are relatively doable — things such as if you wanted to have a dermatology consult, you could take a picture and ask a specialist to respond based on a picture."

Many technology barriers have been overcome, Barbash and Galen said. Speed is up, costs are down and most people know how to use a webcam. But they also agreed that it's important to do small pilot tests of these applications before they can be universally applied in their organizations.

Barbash said he is careful to select mobile applications that have secure networks and are user-friendly, so anyone can use them regardless of their technology comfort level. After all, it's all about forming relationships and recreating the exam room environment.

"It's not institutionalized," he said. "It's about people connecting to other people."

jderbedrosian@gazette.net