Tuesday, June 8, 2004

Isle telemedicine
network expands

St. Francis Medical Center has expanded its telemedicine network to the neighbor islands.

"The whole idea of telemedicine is to get doctors to where they're not so we can help out patients who don't have access to doctors," said Dr. Willis Chang, St. Francis medical director.

He said the system, recently blessed and dedicated as the Harry and Jeanette Weinberg Telemedicine System Center, is valuable in areas without specialists.

For example, a small community cannot support an infectious disease specialist, he said, "but with telemedicine, I could see patients using the system and make consultations that way."

The St. Francis Healthcare System has improved its telemedicine capabilities during the past six years with $3 million from the Weinberg Foundation.

Foundation funding to St. Francis and other hospitals created the State of Hawaii Telehealth Access Network and hospital connections. In a pilot program, St. Francis linked electronic medical records from dialysis facilities at Waimea, Kauai, and Wailuku.

In the first telementoring project at St. Francis, ophthalmologist Jorge Camara assisted an ophthalmologist at North Hawaii Community Hospital with eye surgery.

Nephrologists (kidney specialists) are using the system for operational meetings and interaction between St. Francis nurses and dietitians on Oahu and the neighbor islands, said Dr. Jared Sugihara, Renal Institute director.

"On some units, because it's almost like picking up the phone, we go turn on the telemonitor and talk that way," he said. "It clearly works."

The next step, he said, is for the doctors to use telemonitoring to work on care plans with patients and nurses on neighbor islands or even Waianae, he said.

"Driving to Waianae is almost like flying to a neighbor island."

Sugihara said he goes to Kona once a month to see patients, but he cannot see all of them, so the telemedicine system would be ideal.

Chang pointed out that the system would benefit patients and professionals -- eliminating costly travel for some patients and enabling doctors to save time, be more efficient and care for more patients.

Hopefully, other specialties will start using it for consultative services, he said.

"We're trying to get the renal program most involved and best served right now."

St. Francis also is looking into broadening use of the system to care for intensive care patients at other hospitals, Chang said.

A physician, nurse, physician's assistant and clerical worker sit in a room with monitors connected electronically to intensive care units at different hospitals, and they cover 80 beds, he said.

"If a nurse or patient has problems in the ICU, they're able to examine the patient using the camera; they have access to all vital signs and lab tests and can tell the nurse what to do."

Noting a shortage of intensive care doctors in the United States, Chang said telemedicine would allow St. Francis specialists to care for intensive care patients at other hospitals lacking 24-hour intensive services.

But other hospitals would have to be hooked up to the system, he said. "We're looking into that technology."

Sugihara said telemedicine technology is "a whole different way of thinking about doing stuff," with such "neat things" as equipment allowing a doctor to listen to a distant patient's heart and lungs or look for infection.

However, expanded use of telemedicine for patients hinges on cost reimbursements from insurance plans, now a stumbling block, Sugihara said.


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