Technology links doctors to rural areas

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 since. 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.

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 with 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 the University of Missouri.

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

In Cape Girardeau, Cross Trails Medical Center, 408 S. Broadview St., offers the high-tech service for dermatology patients, according to Mike Stause, Cross Trails' chief information officer. He said information is exchanged via a high-speed phone line reserved for consultations with University of Missouri doctors.

He said nurses are trained to operate cameras, giving distant doctors close-up views of specific areas of the patient's body. The next step, Stause said, is implementing an electronic medical record system. When that happens, he said, doctors will be equipped with wireless tablets for adding notes to the patient's virtual chart.

Five other Southeast Missouri sites are listed on the Telehealth Web site: One each in New Madrid, Kennett and Bernie, as well as two in Sikeston, the Missouri Delta Medical Center and the Sikeston Family Clinic.

Missouri Delta Medical Center uses its high-tech equipment for a slightly different purpose, according to Gary Gaines, Delta's director of information services.

"Students who come here for training use this to view live broadcasts over the Internet," he said, adding that on Wednesday, a Delta obstetrician delivered a lecture to students at five locations around the state.

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 University of Missouri 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.

Staff writer Peg McNichol contributed to this report.