To launch its new device for heart failure management, Minneapolis-based Medtronic planned a two-day training for reps at a San Diego hotel. Business as usual — except that terrorists attacked the U.S. about two weeks before the launch. Medtronic imposed a travel moratorium and the meeting's organizers found themselves scrambling to come up with an alternative plan. Talk about heart failure.

In evaluating their options, Medtronic's primary goal was to preserve the program's interactive format. They decided to try a new service — RepLINKtv, offered by Interactive Medical Networks in Rockville, Md., a production company specializing in the health care industry.(IMN is owned by Primedia Inc., which also owns this magazine.) RepLINKtv combines satellite broadcast and Internet technologies. Programs are produced in a studio and beamed to RepLINKtv's network of classroom suites across the country, which are equipped with digital satellite receivers, TV monitors, phone and fax lines, and PCs with Internet connectivity for each participant. Attendees interact with speakers via phone, fax, e-mail, or Internet chat. Programs can include features such as audience polling and testing — exactly the kind of interactive elements Medtronic was looking for. “We concluded all our learning objectives could be met using this technology,” says Judith Ann Robinson, director of training and education, cardiac rhythm management, Medtronic.

Nine Days to Show Time

The RepLINKtv team first met with Medtronic on September 20. The program, which consisted of two nine-hour broadcasts and involved 780 participants in 59 classrooms across the country, was scheduled to air on the 29th. “Even under normal circumstances it would have been challenging,” acknowledges Jan Perez, vice president, market development with IMN.

Fortunately, the program content, including the PowerPoint presentations, had already been developed. IMN team's task was to transfer the content for a live meeting into a production.

“We had to migrate over without missing a step,” says Chris Perez, director, market and product development, IMN. (And yes, Chris is Jan's husband.)“We sat down with our producer and the Medtronic team and talked through all the content,” he says. To make the training interactive, Med-tronic built in questions to poll the audience, explains Robinson. Medtronic also designed workshops to be delivered by trained facilitators in the classrooms.

While IMN productions are usually filmed in the company's Dallas studio, for this event IMN used an auditorium at Metronic's headquarters in Minneapolis, so that the presenters did not have to travel. One benefit: there was a live audience in Minneapolis, including several participants who would not have been able to to attend the San Diego meeting. A physician, nurse, and patient team from Atlanta were also on the speaker roster; IMN rented space in an Atlanta studio and broadcast their presentation from there.

Preparing Presenters

Robinson had no concerns about the technology — her main worry was that her presenters, although seasoned, had never used the broadcast medium before, and they had only a short time to prepare. Robinson conducted dry runs with them, inviting IMN's production team to attend.

“IMN did a great job, continuously assuring [the presenters] that though it might feel awkward, the finished product would ‘look and feel professional.’ It really helped.” Robinson adds that the presenters “stepped up to the plate and did a great job.”

900 E-mails

And judging by the results, participants also felt comfortable with the format — presenters received 900 e-mails with questions, Robinson says. A product technical expert acted as a sort of triage person — ranking questions by priority and sorting them into folders by content, such as clinical issues, reimbursement questions, marketing. Presenters responded to some questions right away, others were held for an expert panel to answer toward the end of the program.

Before the launch, Medtronic had trained its reps in a selling skills program called Counsel Sales Person, which teaches reps to ask doctors questions that will uncover their need for a particular product. During the virtual product launch, Robinson wanted reps to apply their new sales skills to a heart failure device. At certain points, participants went off line, and facilitators in each of the classrooms, following written lesson plans Robinson had given them, helped reps develop customer questions. Each classroom worked on the questions for about 20 minutes, then, via telephone, reps in various locations shared their discovery questions. “It really worked beautifully,” Robinson says.

Smooth Sailing

Medtronic's travel moratorium is lifted, but based on her experience and the participant evaluations, Robinson says she is considering using RepLINKtv for future programs. Most participants said the information they received via the broadcast would allow them to sell the therapy to their customers. Asked whether the medium was a viable option for disseminating information to the field on strategic directions or scientific information, 91 percent of participants responded “yes.”

If she does use the format again, Robinson says she'd hold a shorter meeting — one day instead of two — build in more time for presenters to answer questions, and make those offline workshops a little longer. Because they were working on such a short lead time, she wasn't able to set up an audience-response system for participants in the studio where the broadcast originated — something she'd want to include next time around.

As for tech glitches, always a worry when planning virtual meetings, the only major problem was that a windstorm in New Jersey knocked over one of the satellites, so the video feed was lost, though the audio portion was still intact. But IMN facilitators were on site in the classrooms to handle any equipment problems, and this one was fixed quickly, says Robinson. “It was free sailing from then on.”

Three thousand physicians were gathered at the Washington (D.C.) Convention Center on September 11 for the first of two days of pre-conference programs for the TCT 2001 conference, a interventional vascular medicine event that was scheduled to begin on Thursday. They were especially looking forward to a special symposium on drug-coded stents — a hot topic in the field — as well as a board review course and other pre-con programs. Then news of the attacks hit.

The conference organizer, the Cardiovascular Research Foundation (, held a session to ask people what they wanted to do. With air travel at a standstill, it was obvious that the other 9,000 or so attendees expected for the opening session September 13 would be unlikely to make it. It was equally obvious that those who were already there wouldn't be going anywhere anytime soon. They decided to go on with the program as scheduled for Wednesday, then cancel the rest of the conference, which was to have run through September 16. But still the question remained: What to do with three days' worth of important presentations? What else but to take the sessions online?

Attending Sessions@home

The CRF teamed up with Clinsights Inc., which provides Internet-based services for medical organizations, to create an online version of the conference. “The bulk of presentations at medical conferences consists of presenters going through slide sets, then answering questions,” says Beatrice Ellerin, Clinsights' New York City — based executive vice president, clinical programs. “So that's what we're doing at the Web site,”

Clinsights contacted presenters to get their slide sets, then created virtual sessions that include opportunities for attendees to add a comment or a question to make it more interactive. As of mid-October, they already had more than 40 sessions online in categorical groups, and were adding more every week. Anyone who completes a short registration process on the Web site can access the materials — there's no cost to enroll. The downside is that there's no CME credit, either. TCT chose to go the noncredit route in order to save costs and get the information out to people as soon as possible.

“If someone wants to fund a CME program using the material, I'm sure we'd be glad to work with them on it,” says Ellerin, emphasizing that the Web site is completely separate from the conference, although it and Clinsights have a close working relationship with TCT and the CRF.

Clinsights was able to get support to develop a more high-tech version of a portion of the program. “We did one webcast already that was very well-received, and very well-attended,” says Ellerin. With financial support from Boston Scientific, they produced a webcast on a major clinical trial. The U.S. presenter was joined by the principal investigator of the European clinical trial for a live Q&A.

“It was very cool,” says Ellerin, who adds that the archived portion is still getting a lot of traffic. She says that more webcasts will be in the offing if they can get assistance from more industry organizations.

“While it's not pricey, it does take a lot more resources than just putting a slide set up,” she says. “Going forward, I believe that even basic audio linked with slides will become more important. They'll still get the content, and they'll still get to hear and see the speakers. So it's close.”

But I Need My Credits, Now!

Other medical societies whose meetings were canceled needed to provide a means for their members to obtain their CME credits as fast as possible. As a result, online providers are seeing a spike in their business.

One of those vendors is, an applications service provider based in Pittsburgh, Pa. Her company offers what she calls a “Healthcare Learning Management System,” explains Simone Karp, vice president, sales and marketing. Attendees take post-tests, complete evaluations, and receive certificates. CECity can put together an e-meeting in three weeks, since the platform is already built.

“There is no hardware or software go buy,” she says. “We ‘re-purpose’ a society's content.” The medical society, retains ownership. “We don't own, create, or accredit content,” she says. “That is very important to us.”

CECity also protects the society's brand: Programs are available at an organization's Web site and say “Powered by” For examples, visit To decide what type of technology to use to replace or augment your CME programs, Karp offers the following advice:

Webconferencing works best for interactive programs with fewer than 100 attendees. It allows a presenter to walk through PowerPoint presentations online, mark up slides, and speak to the audience. There is no video transmission, but participants network in chat rooms, ask presenters questions, and participate in online polling, modeled after the audience-response systems used at many live meetings. Attendees can access the conferences with only a 56K modem. Only presenters need higher bandwidth, Karp says.

Webcasting is suitable for larger audiences, when content is presented in lecture format. Transmission capabilities include audio, PowerPoint, and video presentations. Participants view the program on their own computers, using media players such as RealPlayer or Windows Media Player. Interaction between the presenter and the audience is more limited than in webconferences, but participants can e-mail questions to presenters, and send the webcast to a friend; and presenters can conduct surveys.

Webconferences and webcasts can then be morphed into on-demand programs. Archived versions are accessible with low-bandwidth, Karp says.

But will online CME ever replace live meetings? “Maybe in 20 years, or 10, or 5, the technology will be so incredible that it will be able to take over,” says Clinsights' Ellerin. “But it's not there yet. We'd never try to pretend that a Web site can take the place of a conference — it's just not possible.”


“Don't panic. Don't buy equipment you'll never be able to use,” says Thomas Sullivan, president, Rockpointe Broadcasting (, a Washington, D.C. — based production company specializing in health care education. In the wake of 9/11, Sullivan says some organizations are rushing out and purchasing expensive videoconferencing systems to replace face-to-face meetings. Instead, Sullivan advises, “Take a deep breath, and think, ‘I've got a problem. How am I going to solve it?’ Don't spend money unless you are sure the equipment will benefit you and meet your purpose.”

To illustrate his point, Sullivan points out that desktop videoconferencing systems require high-speed bandwidth. Most organizations have one to five T1 lines running to their facilities. Four people using videoconferencing systems takes up a T1 line. Do the math: A videoconference using three T1 lines can shut down a whole hospital.

Sullivan is helping organizations such as The Endocrine Society evaluate their options for alternative methods of delivery. Here are his suggestions.


Not all face-to-face meetings can be effectively replaced with technology. But board meetings, says Sullivan, are a good example of conferences that can be replaced by an old-fashioned, low-tech, low-cost method: teleconferences. The facilitator can e-mail slides to attendees, who then print them out for reference during the conference call. The teleconference option is appropriate for small groups of 10 to 12 people, Sullivan says.

“It sounds boring, but it does the trick for a board meeting,” he says. “There's no sense spending money for travel. Associations and hospitals sometimes go overboard and fly people on a whim. Do only meetings that are necessary.”


If your speakers are leery of air travel, you can arrange a satellite broadcast from a local studio, which can be delivered to multiple sites, for example up to 50 hotels. That way attendees and speakers use only ground travel.

“Offer people alternatives as much as possible,” says Sullivan. “You don't have to ruin people's lives.”

For those (in)famous dine 'n' dash meetings, rather than flying in the speaker, you can create a CD-ROM of a speaker's presentation and give it as a gift during the dinner. You can augment the event by bringing the speaker in via conference call for a Q&A.

“The key is that different events require different media,” says Sullivan. “Not everything has to be done live with speakers.”