Years ago, a fisherman on a crab boat out of Dutch Harbor wrapped a line around his boot as he was throwing pots over the side of the boat. The line, weighted by a commercial crab pot and sucked out by winter swells, sliced through the man's boot and into the flesh of his foot. Luckily, crewmates were able to free the line before the man was pulled overboard, but his foot was crushed.
It cost thousands of dollars to transport him to Anchorage and to provide the emergency health care he required. Advances in telehealth and telemedicine may soon reduce associated costs of such catastrophes.
Telemedicine, the most commonly used term for electronically transmitted medical information, provides clinical services between urban health centers (such as Providence Hospital, Elmendorf Hospital, and the Alaska Native Medical Center) and rural health centers and clinics.
Some would claim that Alaska has been involved in telemedicine for as long as health care providers have been in Alaska. They have long used communications technology to reach their patients, from ham radios to telephones. The goal of telemedicine is to use new communications technology, like e-mail and the Internet, to improve long-distance discourse between patients and their providers.
In Alaska, teleradiology is the most frequently used new form of telemedicine. Rural health care providers transmit information to Anchorage-based radiologists for consultation and diagnosis. In some cases, this alleviates the need for patients to travel outside their communities for care. This is especially relevant for those patients who might be placed at risk by travel, for instance elderly patients or pregnant women. Using telemedicine for ultrasounds is currently being researched.
According to Kathe Bouche, director of Providence Hospital's Alliance in Telemedicine, Alaska is in the process of reengineering health care and enabling health care professionals to deliver services differently.
There are two different sectors working on this process: the federal health care system and the private health care system. Funded in part by the federal health care system, and sanctioned by the State of Alaska, the Alaska Telemedicine Project's stated goal is to "improve the delivery of health care in Alaska using telecommunications and information technologies while providing user-friendly access to electronic communications and information for every health care provider in Alaska." The Alaska Telemedicine Project is a partnership of 53 organizations founded in 1994 by the Applied Science Lab at the University of Alaska Anchorage, Providence Health Systems in Alaska, and Alascom Inc.
While this might seem like a vast endeavor, the funding for it appears forthcoming. According to project coordinators, over $5 million in federal telemedicine funds has already been awarded to project partners throughout the state. Bouche says that the Alaska Telemedicine Project has been particularly helpful in evaluating the success of telemedicine in Alaska and its economic impact.
The potential for economic returns is what guides telemedicine progress made in the private sector where federal funds are not a factor. One major influence in a physician's decision to utilize a telemedicine system is the cost required to do so. Bouche says that while medical professionals often provide consultations grafts through telecommunications, there is not a system in place for them to recover the enormous expense involved in fully implementing the practice of telemedicine in their day-to-day practices.
The Alaska Telehealth System has 4,000 registered users, but only 400 to 600 full-time users. There have been appeals for Medicare and insurance coverage, but that legislation is still in the works. One place rural providers can look for assistance, however, is through Federal Universal Service Fund subsidies.
Through this fund, rural health care providers can be reimbursed in part for telecommunication expenses. Providence Hospital, according to Bouche, has application packets available for those seeking subsidies from the fund and can provide assistance to rural health care providers to complete these applications. Bouche adds that Alaskan health care providers have been highly successful in accessing these funds.
There are potential economic rewards through a successful telemedicine system in Alaska. When health care is a basic component in a community, it enhances the economic health of that community. Telemedicine could enable rural communities - those without permanent clinics, or with only rudimentary services-to develop adequate health care facilities and to keep health care dollars in the communities.
The payback for developing Alaska's telemedicine resources reaches far beyond Alaska and even the United States. Because of Alaska's geographic and, in some cases, demographic similarities to underdeveloped countries, Alaska's telemedicine developmental progress is being used as a model outside of the United States and especially in the Russian Far East. Bouche says that Alaskan health providers are teaching and sharing the processes they've gone through with foreign health care providers and organizations.
"By developing telehealth systems," says Bouche, "we are exploring new uses for telecommunication to make something better."
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|Title Annotation:||telemedicine in Alaska|
|Publication:||Alaska Business Monthly|
|Date:||Mar 1, 1999|
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