|
A
major cultural barrier for distance education and medicine is the inability or
hesitance by providers themselves to incorporate technology into service
delivery. Once in place, many
telemedicine applications are possible by adding periperhals such as an
otoscope, dermasope, or electronic stethescope.
One IHS service unit director whose hospital had low telemedicine use
pointed out that a successful program required 15-20 clinical and support
staff buy-in before it could realize its full potential. Others said that an
administrative advocate was useful, but a clinician advocate was a necessity
to demonstrate use and benefits.
This
technology cultural barrier is also evident at lower levels.
The Alaska Telemedicine Test Bed project deployed mainly ear, eye and
throat telemedicine services using community health aides who meet a minimum 6th
grade education requirement and have four weeks of health training.
The 26-villages recorded over 6,000 consults in three years.
Project success is attributed three factors.
The technology was simple and easy for aides to understand those
benefits for themselves and the village.
Secondly, a coordinator established a personal relationship with the
aides and coached them when usage dropped or through a problem.
Lastly, the project is easily replicated and sustainable by using a
plain old telephone to transfer images for remote consultation.
This project recognized that time has a
relationship to the geographic and remoteness of Alaska.
Seven minutes to transmit an image is not a long time compared to a
2-week waiting on exchange of medical information to and from Anchorage or the
cost of an emergency transport or scheduled clinic visit.
This concept is being changed in Alaska because the universal service
discount program now includes long distance charges in the discount
calculations. In Fund Year 2,
ninety-two Alaskan villages received $4 of the $6 million approved nationwide
for subsidies. This amount,
however, may be lowered based on paperwork showing actual installation of
satellite services. Local
villages or outside programs pick-up a portion of the actual cost so there is
an incentive to select a cost efficient telecom costs.
Previous
- Home - Next
|
Home 
