Providence chief of staff sees future, hurdles in telemedicine
"We’ve shown we have the technology. I think the opportunities are endless," he said.
"Alaska is particularly positioned to work with Far East Russia," List told members of the World Trade Center Alaska on Feb. 7. He spoke during the group’s monthly luncheon at National Bank of Alaska headquarters at C Street and Northern Lights Boulevard.
List, who speaks Spanish and Russian fluently, studied at the University of Costa Rica, where he has also practiced medicine, and at the First Medical Institute of Leningrad. Today he also handles otolaryngology/head and neck surgery in private practice at Alaska Ear Nose and Throat Inc. in Anchorage.
Maintaining a healthy work force is important to production around the globe, he said. However, healthy workers are less important than a manufactured product, he noted. In 1974 List served as a resident in St. Petersburg working with Russian doctors.
"They have some talented, bright people," but lack the resources needed for some health care services, he said. Unlike manufacturing in Russia in the 1970s, health care was not given the emphasis it deserved, List said.
Telemedicine can operate beyond borders to help solve this problem. Yet some barriers still hinder the service, he noted.
One such issue concerns the application of professional health care services from people who are licensed in other states or countries, List said. So far state officials have not ruled on this issue, he said.
Expected improvements and competition in telecommunications technology should help telemedicine efforts, List said.
Another major barrier for telemedicine is defining payment for physicians, List said. So far models have not been developed, and many doctors have provided their expertise out of enthusiasm for telemedicine, he said.
"I do a fair number of consultations and triages from the U.S. and abroad, and I haven’t charged a cent," List said.
However, it is difficult to persuade some doctors to do telemedicine work without a reimbursement plan in place, he said.
Telemedicine procedures also could be affected by the federal Health Information Portability Act, designed to regulate and protect medical records transmitted electronically, he said. The legislation could be implemented in 2002, List said.