High-Tech Equipment Keeps Doctor (Far) Away but Helpful

Antiseptic lingers in the air. Medical staff escorts you in. But this is not a run-of-the-mill examination room.

The doctor examining you is hundreds of miles away, and your only contact is through sophisticated camera equipment, computers, scanners and high-speed data lines.

This particular telemedicine examination room is in the state prison here, but sites just like it are cropping up across rural Arizona through a state program designed to offer better medical services--in particular, the services of specialists--to those living in outlying areas.

“Telemedicine is a good idea because there is a tremendous need for specialty service in rural and underserved areas. There is generally a maldistribution, because it takes a large group of people to support a specialist,” said Dr. Ronald Weinstein, the head of the Arizona Telemedicine Program.

For years, government has been trying to persuade medical specialists to set up practices in rural Arizona, but practices are much more profitable in large cities, said state Rep. Lou-Ann Preble, a prime supporter of the state program.

Weinstein said the combination of few services and the push by the Legislature to make rural areas more attractive for economic development were catalysts for the program.

Telemedicine takes patients via cyberspace to specialists at the University of Arizona Health Sciences Center in Tucson.

Real-time video and fiber-optic scopes equipped with cameras allow doctors to see everything from patients’ skin to the inside of their ears and noses. Some examination rooms even have stethoscopes that allow the specialist to hear a patient’s heartbeat as it’s being taken hundreds of miles away.

Images from the equipment are so clear that doctors in Tucson can see the fine hair in ears and the pigment of skin lesions as medical staff on the remote end operate the equipment.

Arizona’s program, which is still in the pilot phase, is operating in Yuma, Springerville, Payson and Nogales. Telemedicine sites in Ganado and Tuba City are expected to begin working in the upcoming months.

Cindy Rice, a Nogales pediatrician, said telemedicine has been spectacular for her patients.

“We love it. Almost every day we find a way to use it,” she said.

Many of her patients, who live just north of the U.S.-Mexico border, speak only Spanish and are too intimidated to go to Tucson.

There are others whose immigration or residency papers aren’t in order, making patients afraid to go north.

“We can get around all that for them,” Rice said.

Telemedicine has been used most in dermatology and psychology, she said, but it is also being used for radiology, infectious disease and a variety of other fields.

In northern Arizona, telemedicine is being employed extensively for consultation and ongoing treatment of psychiatric patients, said Susan Morely of the Northern Arizona Regional Behavioral Health Assn.

The high-tech equipment generally makes people feel less uncomfortable, and it allows doctors to see patients’ reactions and movements more closely than they might have in a face-to-face session, she said.

Telemedicine does have its limits in surgical applications, but it frequently makes tests and examinations more efficient, allowing doctors in remote locations to perform some of the preoperative work.

Telemedicine provides the same benefits to the Department of Corrections but with a bonus--security.

Sam Sublett, warden of the Arizona State Prison in Yuma, said telemedicine will significantly reduce the number of inmates that need to be taken out of the prison for medical treatment.

That will save money in guard personnel and transportation while reducing the likelihood of escape, he said.

The telemedicine examination rooms in Yuma and other areas are being funded by the Legislature and numerous grants.

It costs about $150,000 to set up a room with video conferencing capability, cameras and high-speed data lines. Smaller facilities that use a laptop computer to store photos, audio and video clips, and charts cost about $10,000.

“All it takes is money. If they would give me a blank check, I could get it covered,” Preble said.