Videoconferencing Insight - 6 - Issue No.2001/06

Application Sory

The Adirondack Area Network provides telemedicine and distance education to the rural areas of New York State over frame relay

Telemedicine for rural areas

Ms Slohm thinks telemedicine is a costly undertaking and that it can only be installed by rural hospitals and clinics with some outside financial assistance.

AANet is widely used for telmedicine. Doctors in Cambridge, Plattsburgh and Saranac — as well as other remote areas — are able to go on “grand rounds’’ at Albany Medical centre through its continuing education program. This year, doctors at McClellan will attend an Albany Medical College seminar on medical ethics via the network.

Cutting out the travel to meetings

The AANet network has also been used to train emergency medical technicians in a program that includes better and more routine training. Bonner said “Emergency medical training used to be done whenever possible. The crews for rural areas would come for training in their spare time. Now, at the end of their shifts, they go to their local hospital and participate from there. Instead of travelling for three hours to the main site giving the program to watch a two-hour program and back again, they have no travel time." That travel time is now avoided.

The AANet is used for more than teaching. Doctors and nurses at Elizabethtown Community Hospital in Essex County no longer have to worry that someone might break a leg when the hospital’s sole radiologist is off duty. Now, using AANet, they can transmit an X-ray to Plattsburgh and have a radiologist at Champlain Valley Physicians Hospital do an immediate diagnosis. There are many more uses of teleradiology, the electronic transmission of medical X-rays and images from the smaller facilities to Albany Medical Center for consultations with specialists and emergency room personnel, says David Bonner.

Views on the use of telemedicine

Dr. Henry Pohl, assistant dean at Albany Medical College and part the telemedicine initiative senses that "There are growing concerns that the use of telemedicine means the loss of physician contact with patients."

“One can use video in a very personal manner with the proper training and with the proper equipment. That way, the patient shouldn’t feel less attended to," he added. “When at all possible, there should be face-to-face meetings at least once.’’

And physicians, too, can meet with families or have consultations facilitated by the technology. But in the end, Pohl advocates that telemedicine be used only to make up for manpower deficiencies at distant sites.

Piloting teleheath care in the home

Right now, the prime objective of AANet is to connect doctors at hospitals and clinics to the network. But AANet’s Ford and Bonner have looked at home telehealth care

The new American telemedicine law includes language stating that “telehomecare’’ will be an eligible service under Medicare funding for home care. (See the Telemedicine column in our ... Issue.)

Ford recognises that “One problem is the expense of connecting patients at home. But compared to an institution, home telemedicine would be much less expensive.

Bonner's idea for “doc-on-a-stick’’

In the State Capital Region of Albany, AANet is working on its own unique innovation: “doc-on-a-stick’’ — a portable device that can be moved from room to room, allowing medical professionals in rural areas to tune in to places like Albany Med, where doctors there can do remote diagnoses.

“It is very easy to wheel around in a hospital and simply plug into a wall jack similar to a phone jack,’’ Bonner said. “It even has a power supply on board so that docs don’t shut it off while moving it. All the signals (that monitor the patient) come off the back of it. They can project the images or view them on a LCD monitor that is attached to the unit.’’

Federal Veterans Administration

The Federal Veterans Administration hospital system has invested in telemedicine after considering both patient care and cost efficiency.

Video hookups at rural VA-run clinics and group homes allow homecare physicians and psychiatrists at the Stratton VA Medical Center in Albany to monitor patients’ health and prescribe appropriate medications remotely. There is no need to drive to a town up to two hours away to visit just a few ill veterans.

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