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INNOVATIVE COMMUNICATIONS SYSTEM IMPROVES ACCESS TO PHYSICIANS FOR RURAL PATIENTS

          INNOVATIVE COMMUNICATIONS SYSTEM IMPROVES ACCESS
                 TO PHYSICIANS FOR RURAL PATIENTS
    ATLANTA, Nov. 13 /PRNewswire/ -- An innovative communications system is in place that enables physicians at the Medical College of Georgia to peer down throats, listen to heartbeats, examine X-rays and see and talk directly with patients 130 miles away in Eastman, Ga.
    For patients this means improved access to specialists at MCG, often without leaving their hometown.
    For Eastman's Dodge County Hospital it means expanding services while dramatically reducing the need to transfer patients to a larger facility.
    For the bigger picture of health care in rural areas, this new telemedicine network improves access by pooling an interactive television system, cameras that can zoom in on a skin cancer, electronic stethoscopes that magnify the heartbeat and machines that instantaneously transmit digitized X-rays and laboratory results with Southern Bell's extensive local network and the state Department of Administrative Service's extensive statewide network.
    MCG is the first facility to use this level of interactive telecommunications that lets physicians actually do physical examinations long distance to address the issue of rural health care, said Dr. Francis J. Tedesco, president of the Medical College of Georgia.
    "We have an unusual bias in Richmond County as they have in Atlanta," Dr. Tedesco said, referencing the huge physician populations in both metropolitan areas.  "But that view is not realistic for much of Georgia and much of the entire nation."
    Dr. Tedesco sees this use of telemedicine as a new way to impact on the old problem of access to health care in rural areas of Georgia and other states.
    "As a state institution we are helping enhance the health care of Georgians and we are helping rural health care.  I think that is one of our responsibilities," Dr. Tedesco said.
    "You really have to think of telemedicine as a way of bringing the patient to your office if you are a physician, or if you are a patient, bringing the doctor to you," said Dr. Gregory L. Eastwood, dean of the MCG School of Medicine.
    "If you get beyond the technology, it's not really that different from any other patient-doctor interaction," Dr. Eastwood said of telemedicine.
    "We will be able to provide them with an on-line, on-time consultation without the trouble and expense of transferring the patient down here," said Dr. Daniel F. Ward, director of the Section of Emergency Medicine at MCG and clinical director of the new telemedicine program.
    "A large number of problems may not require the actual presence of a patient in this facility," Dr. Ward said.  "So the advantages to accrue to the patient by not having to travel should accrue to Dodge County Hospital by being able to retain more of its primary care patients and should accrue to this institution by allowing it to function as what it is, a tertiary-care hospital."
    Initially, telemedicine will operate during regular office hours Monday through Friday.  To schedule an appointment, Dodge County physicians may call MCG's Section of Emergency Medicine office.
    But part of the idea of basing telemedicine in the emergency room is eventually to expand it to a 24-hour-a-day program so patients in Dodge County with life-threatening emergencies, such as a severe heart attack or some type of trauma, also can be seen by specialists at MCG, Dr. Ward said.
    Dr. Tedesco was first introduced to the idea of telemedicine by Dr.  Jay H. Sanders, president and chief executive officer of Interactive Telemedical Systems in Coral Gables, Fla.
    With the president's strong commitment and support, Dr. Sanders, consultant for MCG's telemedicine system, designed and developed the telemedicine system in use between MCG and Dodge County Hospital.
    Dr. Sanders' experience with telemedicine began in the 1960s when he was a resident working under Dr. Kenneth Bird, an internist at Massachusetts General Hospital.  It was Dr. Bird's idea to establish a telemedicine network between the Boston hospital and nearby Department of Veterans Affairs Medical Center and a medical facility for employees and passengers at Boston's Logan Airport.
    In 1973, Dr. Sanders received a grant from the National Science Foundation to evaluate telemedicine's role in health care.  Dr. Tedesco was a faculty member at the University of Miami for several years in the mid- to late-1970s when Dr. Sanders also was at Miami.
    Today, telemedicine technology has improved, the costs of providing it have gone down, and the need for such technology is still very real, Dr. Sanders said.
    "This system that (MCG has) is the most complete, comprehensive system that exists.  It does things that no other system has done before," Dr. Sanders said.
    And today the technology can be applied to any segment of society that has been disenfranchised from health care, geographically or economically, he said.
    "We're excited to see what this technology is going to be able to provide for us," said Richard O. Couey, administrator of the 87-bed Dodge County Hospital.
    He sees telemedicine maximizing the potential of his primary care hospital so that patients get the best care for the least time, trouble and expense.
    "It will be comfortable for the patients; we think it is going to be effective for the physicians," said State Rep. Terry L. Coleman, whose district includes Dodge County.
    MCG was looking for a hospital large enough to support telemedicine that was financially solid but still rural, Coleman said.  "We just happened to fit the mold," said the lawmaker.  "It's going to be absolutely phenomenal the way the thing is going to develop and how quickly.
    "Southern Bell has been tremendously aggressive and helpful in this situation.  Local physicians have been supportive.  They have seen people die on the way to Augusta or Macon," Coleman said.
    "The thing that I am the most excited about is having the opportunity in Georgia to take the basic, inherent capabilities of the public telecommunications network that we have and to bring an application to that which can genuinely contribute to the quality of life and provide more opportunities to the people of our state," said Tom Hunt, general manager of Network-Atlanta for Southern Bell.
    Southern Bell and Georgia Power also have provided substantial funding to purchase equipment being used at both ends of the communication lines between Augusta and Dodge County.
    CAE-Link, a distance learning and videoconferencing integrator in Alexandria, Va., worked with Dr. Sanders and Southern Bell to put the system together.
    The state Department of Administrative Services (DOAS) Telecommunications Division worked with Southern Bell to make part of its state communications network routinely used for telephone and data transmission also available for use by telemedicine.
    "We're excited about providing the state network that links the cities of Augusta, Atlanta and Macon and connecting with the Southern Bell network to participate in this telemedicine project," said George A. Christenberry Jr., director of telecommunications for DOAS.
    The state telecommunication network between Augusta, Atlanta and Macon enables long distance communication between Southern Bell's local networks in Augusta and Eastman possible.
    The state system was designed in 1987 to handle video communication with the future in mind, Christenberry said. Telemedicine is the first use of that capability.
    Dr. Tedesco and others associated with telemedicine see this as just the beginning of realizing the potential of such a communications system.
    "There is no reason you could not have a telemedicine setup in a nursing home or in a prison," said Keith Milner, manager of New Service Planning and Network Marketing Support for Southern Bell. "There is no reason why you couldn't put one in a van for catastrophes.  Because of Southern Bell's robust, extensive network, there are almost limitless uses," he said.
    "Georgia has one of the most technologically advanced telephone systems in the world," said Carl Swearingen, president of Southern Bell's Georgia division.  "Thanks to Southern Bell's 100 percent electronic switched network, we've been able to introduce more services in the last five years than in the 100 years prior to that. Telemedicine is one of the most exciting new applications being offered over our network," Swearingen said.
    "I think we want to show this technology works, that it's beneficial and cost-effective," Dr. Tedesco said.  "Then I think we should let the marketplace and others carry on from here."
    System potential includes use in the prison systems to reduce the need for prisoner transport, a continuing education network for physicians and other health care providers, and, less directly, a way to ease physician isolation in more rural areas by permitting direct contact between physicians in two or more cities.
    Dr. George S. Walker, an internist and chief of staff at Dodge County Hospital, sees information flowing in both directions, with the potential for Dodge County doctors helping students and residents at MCG learn about areas such as rural health care.
    For now he believes it will often mean no trips or fewer trips to Augusta for his patients.
    Back at MCG, Dr. Eastwood, the medical school's dean, predicts that a year from now, MCG will be exploring how this telemedicine network can be applied to other hospitals in Georgia.
    "Part of our purview is to look at mechanisms for caring for the citizens of Georgia," Dr. Eastwood said of MCG's role as Georgia's health sciences university.  "If we can set up a model to show that, yes, health care is delivered more effectively in a particular area, that's science really."
    -0-                 11/13/91
    /CONTACT:  Toni Baker of Medical College of Georgia, 404-721-4421/ CO:  Southern Bell Georgia; Medical College of Georgia ST:  Georgia IN:  TLS HEA SU: BR-BN -- AT006 -- 3832 11/13/91 10:07 EST
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Date:Nov 13, 1991
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