Q & A With John Lund: The Telemedicine Expert
John Lund shares his thoughts on the field of telemecine
Q: Could you start off by giving us some background on who you are and what you do in telemedicine?
I’m the CEO of PDS, Inc. (which stands for Precision Diagnostic Services). We’re a diagnostic sleep company that partners with hospitals in the Midwest. Precision Diagnostic Services has been in business for little over 18 years. I’ve worked in healthcare for more than 30 years, and as some can attest, the Midwest in some ways is a little geographically challenged. And I say that because we don’t really have a high density of population. So early on, we believed that we could bring technology and expertise to those outlier communities (those without dense populations and lack of access to the facilities and care that those living in bigger higher population density areas would).
Our business was built on helping hospitals have a sleep program, especially those that normally couldn’t have specialized staff or support for a sleep center. It’s often very challenging for these hospitals in rural areas to get what we take for granted: a sleep technologist or a sleep physician. So that’s why we decided we would bring that technology and that expertise you would get from sleep physicians and sleep technologists into these communities that wouldn’t necessarily have them. So we contact these hospitals and start their sleep programs; we provide the sleep technologists and in some cases we also provide staff training, and we provide physicians to do interpretations.
So there was an interesting article published years ago, actually in Walla Walla Washington, the boyhood home of William Dement, who is considered the founding father of modern sleep medicine. Dr. Dement went back to Walla Walla, Washington and trained family practitioners to identify sleep disorders of a certain kind.
Q: So how did that story impact your business?
We were aware of that story and we thought: wow, what a great basis for us to start a business where we can go out and kind of duplicate what he did in Walla Walla. So that’s what we did! We obtained contracts with hospitals, provided those services. Early on, like many people, we were FedEx-ing or express mailing polysomnography studies. We would send the study raw data on a disk to be scoree in Fargo, North Dakota, have the study interpreted by a board certified sleep physician, and then send results back. After about a year of doing that we discovered that even though people were not dissatisfied with that method, it wasn’t quite as quick a turnaround as if you went to a lab where scoring and the physician were right there. That’s why we started to investigate technology that could move the data much quicker. So our first technology entrance was to set up a virtual private network between our location and the remote location. score sleep study data, forward it to Fargo, forward it to the physician for interpretation and then forward the results back. So that’s what we started doing about 17 years ago. Then about 12 years ago, we decided we needed to bring the physician to the community as well, and to also bring education. We wanted to be able to provide a physician virtually, and physician education virtually using televideo conferencing.
We applied for a telemedicine grant through the USDA, where they do a lot of rural technology grants to support people in their local community. We were fortunate enough to be awarded a grant, so it helped us make a significant investment into telemedicine technology and then we slowly started to roll it its use in sleep medicine. Today, we have a medical director in Fargo. She provides approximately a day’s worth of telemedicine for sleep patients in any given week.
Q: So you delved into telemedicine because, like Dr. Dement, you wanted to provide that access to care to those who don’t get it easily. Is that what excites you about telemedicine?
In that article about Dr. Dement, there was a quote that stated “there is a river of patients with sleep disorders that is flowing through family practice offices everyday, there are so many patients that remain undiagnosed.” Twenty years ago that was probably 90% of patients in the country with a sleep disorder that hadn’t been diagnosed yet. Today, depending on the source you hear it from, it’s probably close to 75-80% of patients with a sleep disorder that remain undiagnosed.
We’re really not making up a lot of ground, there is still a huge pool of patients to be tested. I think we have a shortage of physicians in sleep medicine and I think that telemedicine is probably a more efficient way to use their time. I think, even more importantly, the distance to get to a specialist also contributes to this gap of care. So even if we don’t gain much on the efficiency side for physicians, I think if we’re able to provide more access to medical care for patients in rural areas this is still a win win. So that’s what excites me most about telemedicine.