FCC funds to help expand telemedicine in the rural West

By Sue Major Holmes
Alburquerque, New Mexico (AP) 3-08

In rural areas, where the ability to access to health care is often an overwhelming challenge, the future will increasingly link doctors and patients via high-tech, virtual interstates.

That’s the vision of Dr. Dale Alverson, who predicts clinics, hospitals and private doctors’ offices routinely will be hooked into a computerized network for telemedicine – allowing specialists to review records of faraway patients, analyze medical tests remotely and consult doctors elsewhere.

“I believe, in the end, telehealth will be part of doing business in the health field, just like we use the telephone,” said Alverson, medical director of the Center for Telehealth at the University of New Mexico’s Health Sciences Center. “It won’t be looked at as something unique or special; it’s just what we do. ... Just as for many of us now it’s second nature to use the Internet and the Web for health information.”

A major step toward that will be taken with $15.5 million from the Federal Communications Commission to the Center for Telehealth and Cybermedicine Research at the Health Sciences Center. The money will be used to design, build, operate and evaluate a Southwest Telehealth Access Grid, a broadband network largely serving rural areas that typically lack such technology.

The grant to increase the bandwidth will be a great help to New Mexico, said Gary Bauerschmidt, UNM’s director for information technology services and co-chairman of the network design and modeling committee.

The regional telecommunication grid of telehealth networks will support rural systems and connections to more than 500 sites, primarily in New Mexico, Arizona and Indian Health Services in the Southwest, along with a few IHS sites in Colorado, California, Nevada, Texas and Utah.

“What this really means is a network of networks, a virtual electronic highway that allows you as a patient to access health care at a distance,” Alverson said.

Eventually, telemedicine could even make virtual house calls, he said. With an aging population and a related increase in chronic disease, “the shift is more to getting the care to the patient where they live,” he said.

Telemedicine isn’t new. The Health Sciences Center has had such programs for a dozen years and already connects to nearly 100 sites in 50 communities. It currently has telemedicine services in behavioral health, substance abuse, developmental disabilities, hepatitis C, HIV, children’s wellness, pediatric cardiology, diabetes and disaster preparedness training.

“There’s a lot of sites that have no connectivity or very poor connectivity,” he said. “Telehealth is such an advantage here. Doctors just can’t travel around our state, and when you get to the reservations, it’s even more challenging.”

But the grid offers a chance to expand.

“The idea with the FCC is not only to support our region, but eventually to connect these regions for a national telehealth network,” Alverson said. The Southwest initiative was one of 69 the FCC funded nationwide.

A grid would not only improve the network for patient care and training health professionals, but also allow everyone to switch into emergency mode for regional or national disasters or emergencies such as a flu pandemic, he said.

Leonard Thomas, chief medical officer for the Albuquerque area Indian Health Service – which serves 86,000 largely rural residents from southern Colorado to El Paso, Texas – said the IHS is maxing out its current infrastructure for telemedicine.

A grid will let the Albuquerque area IHS offer more than the teleradiology, teleopthlamology and telepsychology it now has. There are about 60 telemedicine services the network could make available, Thomas said.

“There’s a whole array out there that our providers could definitely use,” he said. In addition, the grid could offer training and Internet reference materials to health providers in the far-flung IHS system.

IHS now exchanges information on reportable diseases with the state of New Mexico, and Thomas said the grid could help expand that. In addition, he said it’s important to have a communication link in case of emergencies like pandemic flu.

“We’re not talking about just developing high speed networks but also developing functional relationships so it’s beneficial to both parties,” Thomas said.

Alverson expects demand to increase as people see the value.

“Telehealth doesn’t replace the value of physical interaction,” he said. “It can’t do everything, but it goes a long way to augment” the person-to-person doctor-and-patient relationship.

Telemedicine offers virtual travel to bring the patient to specialized care, allowing doctors to spot problems earlier, make adjustments in the patient’s care and avoid trips to faraway specialists or even hospitalization, Alverson said.

For example, specialized cameras can screen for eye diseases associated with chronic conditions such as diabetes. Screenings can pick up problems early, allowing intervention to prevent blindness.

Screenings done in rural areas through telemedicine can be reviewed by specialists in urban areas. Patients who need additional care could then travel to it; those who didn’t could avoid costly travel and hours of time away from home and work, Alverson said.

“It’s not only keeping people healthier in their community, but it’s also keeping them in that community,” he said.

The project has five years to complete the infrastructure. Alverson hopes it can be done sooner, but said the network needs careful design to “make sure it’s connected correctly and really is going to meet the needs of telehealth.”

Los Alamos National Laboratory will do computer modeling of the system in advance to test how well it would function in emergencies or disasters and see if there are weaknesses so builders can avoid costly mistakes.

“It’s going to take a lot of coordination ... it’s going to take good partnerships” with IHS and Arizona’s telemedicine network, Alverson said.

On the Net:

UNM Health Sciences Center: http://hsc.unm.edu/som/telehealth