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09/30/2004 - INHS Pioneers Telemedicine

n Republic, Washington, a seriously ill patient was being evaluated. The symptoms included a severe rash. Thanks to the telemedicine system, including audio and video, linking Deaconess Hospital emergency room with the Republic hospital, the Spokane emergency room doctor could see the patient and the rash. The problem was diagnosed as being extremely critical and the patient subject to life-threatening hemorrhage at any moment. While the patient was being rushed to Spokane, an emergency vehicle was sent from Spokane to meet the transport with the platelets that might be needed for saving a life. Without telemedicine, the patient might have died.

Mount Spokane ski patrol will use telemedicine technology to help skiers and snow boarders who have mishaps on the mountain this winter. The emergency room at Deaconess Hospital will be connected to ski patrol huts by real time video and voice systems. In an emergency, the ski patrol can contact the Deaconess emergency room doctor who can visually assess the problem while talking to either the ski patrol or the patient. In this way, the emergency professional can better recommend follow up procedures; whether the patient needs air transport off the mountain; or if the patient can be sent home under their own power. The concept was successfully tested last spring, and should be in place by the beginning of ski season this winter.

This level of care is possible thanks to Northwest TeleHealth, a division of Inland Northwest Health Services (INHS), who pioneered the service in the Northwest. Northwest TeleHealth provides a telehealth network which allows a patient to receive a specialist's care from a distant location. It's called telehealth because the information travels via telecommunications technology. Telehealth sites use video monitors, specialized cameras, microphones, and diagnostic equipment that permit live interaction between patients and their specialists who are miles apart.

Telemedicine has many uses especially for those areas considered "underserved" in the medical community. An example is the Newport, Washington hospital where the professional on duty may be a physician's assistant (PA). The hospital in Newport has had a telecommunications link with the Deaconess Hospital emergency room for at least three years. Using a Polycom videoconferencing system on a fiber network, the PA can call the doctor at Deaconess; the camera can zoom in on the patient, and the medical professionals can confer, and the Deaconess doctor can even speak to the patient. The camera can zoom in on an X-ray or other image for better diagnosis. Working together, it can be determined whether the patient needs transport to a Spokane hospital, or if the patient will be fine under observation at the Newport facility. All this means better care, patient safety, and even lower cost to the patient. "For those of us in the trenches, the system has been a near Godsend," says Chris McGlothlen in Newport.

Telemedicine is also used for continuing education and training in rural areas. INHS serves forty-eight sites with TeleHealth. The education modules range from emergency medicine through emergency baby deliveries. Medical professionals produce classes live from INHS headquarters in the Holley Mason Building. This is a two-way system allowing questions and input from health care professionals in the outlying areas.

The INHS Wide Area Network (WAN) in Washington serves rural areas and hospitals from Newport to Aberdeen and from Republic to Goldendale. In Spokane, INHS has a Metropolitan Area Network (MAN) that uses gigabit Ethernet with a fiber ring connecting hospitals, physicians, imaging companies, pharmacies, and PAML, a large reference laboratory. The WAN connects through INHS to the MAN. Each hospital has a Local Area Network (LAN) that also connects to the MAN. Spokane's hospitals are among the "most wired" in the world. Because this is a dedicated network, it is unified, secure and stable.

As custodian of the networks, INHS creates and implements standards and protocols making all of the networks work together, and making sure that the entire network can be used for data exchange, or video, or voice. INHS is also the trusted source for security. They have implemented security standards, security practices, and are the watchdogs that monitor network security. Additional benefits of the fiber ring and infrastructure include data backup and storage, disaster recovery, redundancy, and bandwidth management.

To learn more about INHS and its many divisions, visit http://www.inhs.org.

Billie Moreland
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