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Dial-a-doctor

Technology allows patients throughout the state to meet with their doctors via virtual connections
Saturday, July 21, 2007 | 12:00 a.m. CDT; updated 3:46 a.m. CDT, Tuesday, July 22, 2008
Karen Edison shows a map displayed in her dermatology clinic that indicates the locations of the numerous patients she has seen via telemedicine. The Missouri Telehealth Network began in 1994 and now has more than 140 sites in 43 mostly rural counties.

As technology becomes a bigger part of conducting everyday business, from online bill paying to camera phones, some in Missouri are working to make it a common aspect of medical exams as well.

The Missouri Telehealth Network began in 1994 and has been growing. It now has more than 140 sites in 43 counties around the state, particularly in the central counties and in the southeast and southwest corners. It’s embraced mostly in rural areas, where doctors are in short supply.

Breaking It Down

TELEMEDICINE: Technology such as videoconferencing and a high-speed data line is used to connect a doctor in one town to a patient across the state to conduct a medical appointment. SCOPE: The Missouri Telehealth Network has connections in more than 140 sites in 43 mostly rural counties and growing. Its biggest use is for mental health treatment. BENEFIT: Supporters say telemedicine saves time and travel costs for patients and doctors and can provide better care, especially to patients who rely on caregivers at home.

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Telehealth, or telemedicine, can mean a variety of things. It can be as simple as sending X-ray results electronically from a site to a doctor so the patient doesn’t need to travel far for the doctor to read the images.

It can also be a doctor sitting in one town examining a patient across the state through a video conference and high-speed phone line with specialized cameras and other medical tools. Telemedicine is used on conditions as varied as mental health problems, skin diseases or monitoring of those with chronic diseases.

“When you don’t have to physically touch a patient, it works perfectly,” said Rachel Mutrux, director of the Missouri Telehealth Network, which is owned by MU.

The state Mental Health Department uses the long-distance technique to provide care to some of its patients.

Interest is also growing from state officials. As lawmakers revamped the Medicaid health care program for the poor this year, they also created a health care technology fund, and the state budget includes more than $8 million for it.

Mutrux said the technique can work for nearly every medical specialty, if a doctor and patient are interested. But it’s especially well-suited to some fields, such as psychiatry and dermatology, she said.

Of 2,475 telemedicine patient visits in 2006 through MU Health Care, more than 60 percent were for mental health.

Burrell Behavioral Health’s Columbia-based mental health center is among the network’s biggest users and has been linked to the system for about six years.

Director Bruce Horwitz said it’s a critical part of providing treatment to mentally ill patients in the 10-county area the center serves, especially outside Columbia.

He agreed that treating mental illness works more easily through teleconferencing than some other specialties might.

“It lends itself to telehealth because most of the services that are provided are done through conversations between providers and patients,” Horwitz said. “That physical examination is less central to psychiatry and mental health services.”

At a university telemedicine clinic one recent morning, Karen Edison saw patients in Sikeston, West Plains, Nevada, Ava and Sedalia in just a couple of hours. A drive from Columbia to Sikeston alone — a distance of about 250 miles — would take roughly four hours.

Among the patients was LaWanda Freeman, who had a follow-up appointment on treating her acne.

Freeman, a mother of three, simply heads to the Sikeston Family Clinic in her hometown and is connected, with a nurse’s help, to Edison in Columbia. She has used telemedicine a few times and said she’s receiving good medical care.

“It’s like I’m sitting right next to them,” she said after completing her checkup.

The equipment allows the patient and doctor to see each other and talk back and forth in real time, with the sound as clear as if they were in the same room.

Freeman said the network was helpful because she couldn’t find a dermatologist in her area.

A dermatologist, Edison typically sees 20 to 30 patients during her weekly virtual clinic. She sees patients who otherwise would have to drive for care or skip it entirely.

“A lot of people just don’t get their follow-up,” she said. “There’s a lot of barriers to travel.”

The Marshall Habilitation Center also uses the network for mental health and other medical care for its roughly 260 disabled patients, eliminating the time and cost of transporting them to appointments. Plus, it allows their regular caregivers at the center to consult with the doctor.

“What this really prevents is the need to take a consumer and transport them 60 to 70 miles by car and ensures there are knowledgeable people at the other end who can help the consumer articulate his concerns,” said Felix Vincenz, the Mental Health Department’s operations officer for comprehensive psychiatric services.

“Care is really enhanced in many ways rather than being a poor second or substitute for face-to-face contact.”

The Telehealth Network said using telemedicine at Marshall has eliminated the need for 450 trips, at an estimated cost of $312 each, saving the state $140,400.

For more information about the Missouri Telehealth Network, go to telehealth.muhealth.org.


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