Alaska Telehealth taking hold: telemedicine technology expands healthcare delivery.

• Author: Swagel, Will
• Position: HEALTH & MEDICINE

One could argue that some very significant technological advances in telehealth in Bush Alaska started with kids' earaches. Same as everywhere, kids in Alaska Bush communities suffer from earaches from time to time. Depending on severity, the problem could be solved with a round or two of antibiotics. Or it might require the intervention of an otolaryngologist--an Ear, Nose, and Throat doctor (ENT).

A physical exam could indicate the proper course of treatment, but conducting an exam can be a problem when the ENT is in Anchorage and the young patients hail from hundreds of villages spread across thousands of square miles. Travel is expensive for sick child and guardian both and may disrupt the whole family for days or more.

Today, that same child can be examined much closer to home by a medical clinician and high resolution images of the inside of the ear sent to the ENT along a secure network. Specialists can also hook up a video link to consult with the patient and the local clinician together. The child may be able to receive treatment in the village.

These capabilities are part of a telehealth revolution taking hold in the Bush. Videoconferencing, electronic medical records, the forwarding of secure diagnostic images and notes between providers, and home monitoring of patients with chronic conditions are four main ways this revolution is taking shape.

Store-and-Forward

The Alaska Federal Elealth Care Access Network (AFHCAN) is a federally-funded program that offers a system of secure and encrypted text and data transfer between medical providers. This is not just regular email--there are strict regulations governing the communication of medical information, such as the requirements of the Health Insurance Portability and Accountability Act.

Rachel Lescher, a pediatric endocrinologist at the Alaska Native Medical Center (ANMC) in Anchorage, says store-and-forward allows providers throughout the state to consult with her efficiently.

The remote providers can send their questions, along with the child's medical history, lab results, high-resolution images, and other pertinent information to Lescher in Anchorage. Lescher can then assess all the information and respond to the remote provider.

"It's very much the same as a telephone consult," says Lescher, "but it has even more information."

It was AFHCAN that lured Garrett Spargo to Alaska and the Alaska Native Tribal Health Consortium, where he now works. The Consortium, along with Southcentral...