Hospital Uses Telemedicine To Treat Rural Patients And PrisonersHospital Uses Telemedicine To Treat Rural Patients And Prisoners

While regulations and cost hold back telemedicine generally, some areas--such as in the care of prisoners and of patients in rural communities--are seeing innovative efforts.

For instance, dermatologists affiliated with Fletcher Allen Medical Center in Burlington, Vt., provide time slots for weekly remote examination of skin lesions and other problems for inmates in upstate New York prisons.

"This is less expensive and more secure than having to transport the prisoners to local hospitals," says Mike Caputo, director of telehealth operations at the UVM College of Medicine, which is affiliated with Fletcher Allen.

Two-way audio and one-way video hookups already are available between Fletcher Allen trauma doctors and the emergency rooms of eight hospitals in upstate New York and rural Vermont that lack trauma specialists.

Cameras have been mounted in examining areas of those rural hospitals. ER doctors who need trauma assistance with patients call a toll-free number to be connected with a Fletcher Allen trauma doctor. Eight medical-center doctors have videoconferencing gear in their offices and homes as well.

At the same time, Fletcher Allen has received government grants to test other uses for telemedicine, such as videoconferencing gear in ambulances.

"There's no doubt that digital ambulances could save lives, particularly in remote areas," says IBM's Dr. Richard Bakalar, an IBM senior clinical-solutions specialist and former U.S. Navy physician involved with the Navy's telemedicine programs. "It could be a two-hour ambulance ride in some places in Texas to the nearest critical-care hospital." Bakalar says ambulance-telemedicine programs are under way in that state, too.

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