Arizona Telemedicine Program: Telemedicine program brings quality healthcare services to even the most remote sections of the state. (What Works Awards 2nd Place).

For thousands of Arizona residents, leading edge healthcare exists 150 miles away or more. With a population spread over more than 113,000 square miles, a single academic medical center at the University of Arizona in Tucson, and academic specialty medical services available primarily in Tucson and Phoenix, Arizona was a state poised to profit from telemedicine.

Solution

That's exactly what has happened since legislation was enacted five years ago appropriating funds to the University of Arizona's Health Sciences Center's operating budget, resulting in the formation of the Arizona Rural Telecommunications Network (ARTN) and based on the following goals:

* enhance healthcare delivery in medically under-served regions;

* encourage healthcare professionals to establish rural-based practices;

* recruit students into rural healthcare and facilitate their ongoing training;

* create a test bed for other state agencies and health systems to evaluate telemedicine.

The ARTN was created and implemented using a distributed backbone with switches at Northern Arizona University and at two University of Arizona sites. The remote sites link into the nearest backbone switch, creating a more competitive, cost-effective scenario since more service providers could potentially offer ARTN leased lines. The system was implemented using an asynchronous transfer mode infrastructure with ASX[TM]-1000 switches from Marconi of Pittsburgh, PA at the backbone.

Little training was required for the ARTN staff on the backbone equipment. A Marconi ASX-1000 switch was deployed at the Health Sciences Center in Tucson, and the first remote site, the Mexican-border town of Nogales about 90 miles south, was brought online as quickly as telecom service could be established.

Results and Benefits

Patient Visits. Ninety-six telephysicians representing 60 medical subspecialties have seen more than 11,000 patient cases. They also have used telemedicine to reduce risky travel for patients with unstable medical conditions.

Cost Savings. The estimated cost for a rural patient's "visit" to an urban health center has dropped from $520 to $105. One of the original goals of the program also was to counter the high costs incurred with transporting inmates from the Arizona Department of Corrections' institutions to outside physician referrals. Using telemedicine, the department has reduced the average cost for an inmate's healthcare visit from $415 to $140. Another healthcare user saved $182,000 over a 12-month period by averting air evacuations of 26 patients, at $7,000 per evacuation.

Grand rounds. Healthcare workers at rural sites routinely participate in interactive videoconferencing originating from the Health Sciences Center in Tucson. These "grand rounds" in internal medicine, pediatrics, public health and psychiatry often take place at noon, so rural doctors can learn the latest medical practices over lunch.

Program growth. With federal grants from the U.S. Departments of Agriculture, Commerce, and Health and Human Services, the original program has been expanded beyond the eight original sites to include seven multi-specialty sites, six Department of Corrections sites, and connections to the Flagstaff Medical Center and Northern Arizona Behavioral Health Authority with 12 behavioral health sites.

Recent Updates

Kevin M. McNeill, associate director of the network, confirms that the program continues to meet with success in serving the needs of Arizona citizens. He reports that the ARTN also has recently added 11 more sites in conjunction with the federally funded Indian Health Services for services to the Navajo community. Four new switching stations are included in this expansion, providing healthcare services to an additional 25,000 square miles of territory, extending beyond state lines into New Mexico.

SOURCE

Dr. Ronald S. Weinstein
Director of Arizona Telemedicine Program
Kevin M. McNeill
Associate Director, Network
Development
Tucson, AZ
[phone]
[e-mail]
[e-mail]

PRODUCT/COMPANY

Marconi ASX[TM]-1000
Marconi Communications
www.marconi.com

Originally printed as "Powering the
Arizona Telemedicine Program," HMT, June 2001