OCR Text |
Show ARTICLES TELEMEDICINE IN UTAH'S RURAL COMMUNITIES by Jan Root, PhD Imagine: You live in Panguitch, and have recently developed an unusual skin condition. Your health care provider is unable to determine whether the condition is serious enough to warrant sending you to Salt Lake for further testing. You are sitting in your doctor's office and you notice that some of the equipment looks like it came from a TV studio and you 're wondering, "what is going on...?" Suddenly, you find yourself talking to a person on the TV screen. It turns out this person is a dermatologist (!) and the three of you are discussing your case. After the dermatologist has talked with you and your provider and viewed your condition using a special TV instrument that scans your skin, the decision is made that you can stay home: you don't have to go to Salt Lake for further tests. This could be the future for health care in rural communities: being able to consult with specialists in your home town, getting x-rays read immediately instead of waiting days, being able to keep your favorite health care providers because they no longer feel like they're practicing "solo". Telemedicine is moving with the telecommunications industry into many new and perhaps startling applications that can directly affect your health. Rural areas stand to benefit greatly in the various applications of this technology, but only if they decide to use it. The purpose of this article is to briefly discuss telemedicine and its use in improving access to health care in rural Utah communities. Telemedicine is a large, complex, and rapidly growing field of telecommunications and it is beyond the scope of this article to discuss it in depth. However, the author believes that, given the coming health care reform, telemedicine must be implemented on a broad scale in rural Utah. Without it, rural communities will be less and less able to attract and retain health care providers and rural health care institutions eventually will be unable to effectively connect to insurance and medical records systems. Telemedicine must happen in rural Utah. The question is "How"? Access to Health Care The issue of access to health care in sparsely populated rural and frontier portions of the county is a problem that is complex and tenacious. While there is no single solution, telemedicine can offer significant contributions towards alleviating some of the more chronic issues: isolation of rural providers, lack of readily available specialist care, maintaining a financially viable clinic or hospital, and others. Telemedicine is one tool that can contribute to increasing access to health care in rural areas but it is not a universal panacea. While telemedicine can be a boon to rural communities, it is not cost free. There are costs to rural providers and patients in terms of how they think about and practice/receive medicine and there are costs to the community - telecommunication systems, like telephone systems, require equipment, maintenance, and trained support personnel. It is critical that any community considering investing in telemedicine carefully evaluate their needs and compare these to the real costs. Telemedicine First, what is telemedicine? As stated earlier, telemedicine pertains to the adaptation of telecommunications technology to the field of health care. In practical terms, clinical telemedicine ranges from telephone consultations to teleradiology (transmitting x-ray films, CAT scans, MRI, etc., in digital form) to one-way video two-way audio, to two-way interactive video, and to multisite interactive video teleconferencing (Borow, 1993 and Proceedings of the Mayo Telemedicine Symposium, 1993). The technology involved in making telemedicine a reality ranges from simple, off-the-shelf, open1, inexpensive applications, to systems 1 By "open" the author means computer protocols or systems that are not exclusive or "locked". It is common in rapidly evolving technological applications for companies to initially attempt to market locked systems, that is, systems that can only interact with systems with the same protocol. This gives an obvious competitive advantage to any company that manages to Utah's Health: An Annual Review 1994 95 |