Dr. Richard Bakalar, KPMG in the US 

Richard is helping push back the boundaries of healthcare through better use of technology; gathering, analyzing and sharing data to improve outcomes.


I’m Rich Bakalar. I’m Managing Director based out of the U.S. practice in Denver, Colorado.

One of the lessons learned, I managed a telemedicine program about 10 years ago, and one of the things we found is that telemedicine is much more than just a technology implementation project. It really needs to engage people, process and technology with aligned incentives. So what do I mean by that? What do people have to do with telemedicine projects? Well, first and foremost, you have to have a governance support for the projects that you’re going to engage in. For example, there has to be support at the top for setting objectives, setting milestones, and you have to have the providers who are engaged and are willing to participate in something a little outside of their normal comfort zone. In order for that to be successful, you need to have a support staff and you need to have patients who have been selected to be in the cohort that are going to benefit from that type of a service.

Telemedicine is one of the strategies that we’re finding a lot of our clients are interested in using, to try to achieve better and more affordable practices with higher quality care being delivered for their patients. One of the things we find, one of the lessons learned is that it’s more than just a technology insertion project or implementation project. You really do need to have people, process and technology all aligned to provide a successful program.

So what do I mean by people? Well, first of all, you need to have a governance structure that’s going to support with objectives and measureable outcomes so that you can have the proper resources assigned to maintain the program. You need to have providers who are selected because of the interest not only in the telemedicine program, but they are good teachers and they are often times highly regarded by their peers to provide a high quality product.

And then of course you need the service support so that they can be successful and have high reliability of the programs when they need it, and when the technology is going to be available for them.

And then finally, the patients. Make sure that you select those patients that are going to benefit from that type of capability, based not only on their conditions, but also on their temperament and their willingness to participate in a remote consultation.

Now beyond the people, the process is equally as important, and we look at ideas around standardization of protocols, selection of protocols based on the appropriateness of the chronic condition or the acute condition for the use of telemedicine as an alternative to face-to-face practice.

And finally, we look at aligned incentives to make sure that the appropriate reimbursement models are in place to provide not only the right technology but at the right time, and provide the right outcomes. So with all that keeping in mind, I think we can really implement programs a lot more effectively and have higher quality and more sustainability of new and innovative approaches to healthcare delivery.

Harnessing technology to change the face of healthcare

A specialist in health information technology, Richard seeks to unlock the power of data within electronic health records and other systems in order to improve patient care. He has extensive clinical, operational and technical knowledge and experience, including eHealth, telehealth and telemedicine.

Richard spent 20 years in clinical medicine, initially in the US Navy, where he pioneered the use of telemedicine, establishing the Naval Telemedicine Business Office including ship-to-shore communications.

After the Navy he joined IBM as Chief Medical Officer, carrying out research and clinical consulting, as well as software and infrastructure improvements, setting the direction for clinical healthcare IT solutions. Richard then worked for Microsoft, developing and delivering innovative health IT solutions to hospitals, health systems and communities.

He is passionate about the possibilities for technology, to better share information between providers and patients, improve operational performance and raise the quality of patient care while lowering the cost.

Richard is a past president of the American Telemedicine Association and was a member of the Clinical Advisory Group of the National Alliance for Health Information Technology. He has a BA from Rice University, Houston, and gained his Doctorate in medicine from the Uniformed Services University of the Health Sciences, Bethesda, Maryland.

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