AMA Journal of Ethics^®

If any single physician's name has become synonymous with the nascent field of telemedicine, it is that of Dr. Jay Sanders. Like any pioneer Dr. Sanders helped define a new frontier that few have seen or crossed. Telemedicine, he says in simple terms, "uses technology to deliver medical services to the point of need"¹. The power and potential implied in that brief definition, however, give telemedicine the ability to redress the concerns of accessibility, cost, and quality in medical care. Believing that such systems promise to promote more equitable delivery of health care by lowering cost and reducing other barriers that block access to care among rural and low-income families, Dr. Sanders has become not only an advocate but an activist for the cause.

Despite growing acceptance and adoption of telemedicine, there remains no shortage of challenges. These include the high costs of system design and set-up; insurance reimbursement for telemedicine services; licensure regulations that restrict physicians from practicing in states where they are not licensed; liability matters (suppose an indistinct image leads to misdiagnosis?), and privacy concerns.

But Dr. Sanders is convinced that these obstacles can be overcome. To improve rural health care in Georgia, he designed a system employing interactive voice and color video and telecommunication systems coupled with telemetry that connects some 60 hospitals across the state to a central hub. Doctors at the hub examine and treat patients at the multiple satellite locations. He also initiated an "electronic house calls" project at the Medical College of Georgia thereby offering patients the opportunity to be cared for in their own homes or in nursing homes. Although equipment and start-up costs run into the six figures, hospitals participating in the Georgia-based program have not only improved the quality of patient care, but achieved it with greater efficiency².

A graduate of Harvard Medical School, Dr. Sanders directs the U.S. telemedicine initiatives to the G-8 nations and is a founding member of the American Telemedicine Association. The author of numerous articles and a recent book, Telemedicine: Theory and Practice, Dr. Sanders also serves on several editorial boards including The Telemedicine Connection and Telemedicine and Virtual Reality.

As a pioneer advocate and activist in the field of telemedicine, Dr. Sanders has trail blazed a new frontier for physicians and the medical profession, one for which we recognize him as a role model in medicine.