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Published August 25, 2013, 10:00 PM

Long-distance doctoring: Technology allows providers in one community to serve patients who are miles away

FARGO - You can shop, go to school, and now you can even visit your doctor through the computer.

By: Tracy Frank, INFORUM

FARGO - You can shop, go to school, and now you can even visit your doctor through the computer.

Area hospitals are implementing technology that allows patients to communicate with their doctors online. Some even have the capacity to conduct full office appointments by way of high-tech monitors, cameras and specialized stethoscopes.

Both Altru Health System in Grand Forks and the Fargo VA Healthcare System have the ability to conduct doctors’ appointments with patients who aren’t in the same room or even the same town.

Sanford Health has tele-appointments available in Sioux Falls, as does Essentia Health in Duluth. Sanford is working to bring the service to its Fargo locations in the future.

Through a system of video cameras and monitors, providers at the Fargo VA can treat veterans at clinics throughout the state. They even have the capability to look in patients’ ears and examine a mole or growth.

“The cameras are so good, they’re just unbelievable,” said Margaret Nelson, Fargo VA Telehealth manager.

Doctors can also listen to someone’s lungs and heart through an electronic stethoscope, she said.

“A lot of times for our veterans, especially our World War II veterans, travel is not very easy for them,” Nelson said. “Coming to a central location to have things done is just not a choice.”

Altru also has a service called telemedicine that uses secure, interactive video and audio connections between Altru specialists and patients and providers in other communities.

It helps expand services in rural areas and reduces travel time for patients, said Marsha Waind, Altru’s manager of regional services who leads their telemedicine initiative.

X-rays can be taken in one community and read in another. Pharmacists can review medications from miles away. Even someone with an infectious disease or in palliative care can meet with their doctor without driving hours for an appointment, Waind said.

Patients go to a clinic, hospital or nursing home near them that is set up with the proper equipment and connect with an Altru doctor in Grand Forks.

Last year Altru performed 1,200 telemedicine visits. This year, they’re on track to perform more than 2,000 Waind said.

Telemedicine visits are billed the same as an office visit, she said.

“We connect with sites that are not Altru sites,” she said. “We are very interested in supporting patient-care rurally.”

Telemedicine can help solve the problem of doctor shortages in rural areas, Waind said. They are also starting to use it to provide follow-up care for local patients who might be seeing a doctor in the Minneapolis area.

“It’s a bit of a challenge to get a provider to work in smaller, rural communities,” said Rollie Blixt, Fargo VA facility Telehealth coordinator. “Even if they want to, there’s a housing shortage in some communities.”

Psychiatrists, who are in short supply in rural areas, can hold group meetings with people from several different communities at once, he said, adding that it looks a bit like the TV show Hollywood Squares with each person occupying their own box on the monitor.

Veterans can also connect with VA providers from throughout the country. It’s especially useful for snow birds who winter in warmer states, she said.

Patient surveys show it’s been an overwhelmingly positive experience, Blixt said.

The program could be benefiting patients’ health, too. Diabetic veterans using the telehealth program are showing improved lab tests and blood pressures, Nelson said.

The VA is working on allowing doctors to connect with patients right in their own homes through web cams and computers, Blixt said.

Another service called remote patient monitoring uses special equipment to monitor the vital signs of someone with a chronic disease. It alerts medical staff to changes in their condition and allows some patients to stay home instead of being hospitalized, Waind said.

There are about 300 veterans in North Dakota on the VA’s version of the service, called in-home telehealth monitoring. It can be used to monitor a variety of conditions from congestive heart failure to post traumatic stress disorder.

Another 200 veterans are waiting to be enrolled in the program, Nelson said.

In Ada, Minn., telemedicine is giving emergency services a boost.

Through the use of high-tech equipment that includes high-resolution cameras, microphones and an electronic stethoscope, healthcare providers at Essentia Health in Ada can connect with emergency room doctors at Essentia Health in Fargo to get a second opinion on critically ill or trauma patients.

Doctors might be able to avoid sending patients to Fargo, or if they have to be transported, the Fargo doctor will already be familiar with the patient and her illness or injury, said Steve Spaeth, director of nursing at Essential Health in Ada.

“This is huge for patient care to have expertise in Fargo right in our ER room with us,” he said.

Readers can reach Forum reporter Tracy Frank at (701) 241-5526

Technology gives patients direct access to health records

FARGO – To give patients better access to their own health records, Fargo VA Healthcare System, Sanford Health, and Essentia Health in Fargo and Altru Health System in Grand Forks all have programs that allow patients to view their medical records online.

The programs also let patients schedule appointments, access test results, request prescription renewals, and send messages to providers.

“Patients are loving it,” said Melissa Braseth, Sanford Health manager for the My Chart program. “There are a lot of patients who don’t have time to pick up the phone and call. They like to message in.”

The programs use email alerts to let patients know when a doctor or nurse has responded to their question. Patients then need to log into the program to find the answer, so it’s a secure messaging system, administrators say.

Mark Waind, Altru’s administrative director of information services, said their MyHealth program will also be able to be used to give patients information on healthy living and forms that have to be filled out before office appointments.

“The bottom line is as a patient myself, it just makes things so much more accessible,” he said. “If we have patients who are more engaged with their health, the consensus is we’re going to have healthier patients.”

Braseth has used the system herself to print out her children’s immunization records.

“I think it’s a time-saver, especially in the electronic age that we’re in,” she said.

– Tracy Frank, The Forum

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