Living in a rural environment often means traveling long distances to health care providers, but through telemedicine networks, like the Upper Peninsula Telemedicine Network (UPTN), physicians can confer with patients and colleagues across the state, the country or the globe.
Currently, 11 Michigan hospitals are connected to UPTN, and eight more may be added by summer, in part due to a $327,000 grant from the U.S. Department of Agriculture's Rural Economic Development program. That grant will also allow UPTN to expand its video conferencing capabilities.
"We feel we have one of the more advanced rural area telemedicine networks in the country," says James Bogan, chief executive officer, Portage Health System, Hancock. The rural physician does not have to feel like a "lone ranger," Bogan says. The network provides the opportunity to consult with colleagues anywhere.
Sally Davis, Marquette General Hospital, network coordinator, identifies three major uses of the system: education, both for health care providers and the community; administration and meetings; and clinical applications, physician-to-physician communication and physician-to-patient primary care.
In addition, community education programs, such as childbirth preparation and breast cancer support groups, can be offered to participants in rural areas, where travel can be difficult in inclement weather, or where the programs might otherwise not be available. And some sites rent conferencing time to area businesses. Davis tells of a local casino using videoconferencing direct from Las Vegas for instruction of its blackjack dealers.
Davis also sees three barriers to telemedicine: reimbursement issues, liability issues and state-to-state licensing. Both Davis and Bogan believe, however, that over the next few years such issues will be addressed as more networks are in use across the country. For example, California passed legislation, effective Jan. 1, which requires payments for telemedicine by insurance providers.
While telemedicine proponents see the potential for cost savings, both to medical providers and indirectly to patients, some of those savings are difficult to quantify. For example, instead of traveling nine hours for a post-surgery exam for their child, U.P. parents were able to confer over the network with the surgeon at the University of Michigan in Ann Arbor.
—Diane Wells
