TV-6 Investigates: Telemedicine; Growth and Uses - News and Weather For The Quad Cities -

TV-6 Investigates: Telemedicine; Growth and Uses


Seeing your doctor over the Internet.

It's a technology, known as telemedicine, that's grown over the last twenty years.

It can increase access to doctors for people who otherwise have to drive hours for an appointment.

Telemedicine has not come without controversy though.

A debate over one Iowa telemedicine system could change this technology's course.

Earlier this year the Iowa Board of Medicine issued a new rule for doctors who prescribe abortion medications.

The rule says the doctor must be physically present.

Planned Parenthood of the Greater Heartland challenged the ruling.

It says the rule would force it to shut down its telemedicine service.

A service it says has provided prescription abortion access to 5,000 women using a doctor and a webcam in a clinic.

That debate is sitting in a judge's chambers.

In the rest of the world, telemedicine is changing medicine.

Iowa City based child psychiatrist Jennifer McWilliams believes in telemedicine. She is one of two doctors running the telepsychiatry program at the University of Iowa Hospital. She works with kids in five different cities. Dubuque, Decorah, Oelwein, Clinton, and Ottumwa.

"I see kids, I see patients in each of these sites back to back without have to get into a car and drive to go see them," says McWilliams.

The program has allowed her to see more patients without McWilliams or the patients having to drive more miles. It has also increased psychiatric services in parts of the state that lack them.

"So much of our evaluation is based on interview, so it really lends itself very easily to electronic communication," says McWilliams.

Not all of her patients will be able to use the technology at first. Some will still have to come to Iowa City because an initial evaluation is too difficult over a video chat. For the rest though, they simply drive to the clinic where McWilliams' teams are based.

"There is always someone in the community that they can go and talk to," says McWilliams.

Telemedicine has grown up from its roots in NASA and the military back in the 60's. Academic hospitals took the tool in the 80's and 90's. They created systems to improve care in areas that traditionally lacked access to health care, like rural Iowa. It began with simply taking an X-ray with the patient and sending it to the doctor in a different place to analyze. The technology has only advanced since.

"I think telehealth is invaluable," says Doctor Pat Brophy.

He helps run the e-health program at the University of Iowa. He says telemedicine has the power to keep people in their own communities, rather than having them travel for medical care.

"It's sort of a triple win, you reduce the number of transfers that may not need to happen, you expedite the ones that really do need to happen, but you also shore up some of the medical expertise so people can stay in their communities," says Brophy.

Iowa has seen telemedicine grow over the last 20 years. A federal grant helped connect 86 Iowa hospitals to the state's broadband network. The technology is helping address a shortage of doctors in rural areas. It can also connect specialists to those that need them immediately.

"To beam in essentially, with the Internet and see the patient, talk to them and their family, talk to the physician," says Neurologist Jeff Boyle.

He has been working on the telestroke program in Iowa City since it started two years ago. He says the technology improves emergency medicine for stroke care. Not every emergency room has a neurologist. When it comes to prescribing a stroke medication, emergency room doctors may want an extra set of eyes.

"There are complications to the medicine and emergency room physicians appreciate our help," says Boyle.

Using a stroke robot, Boyle can talk with patients and their families in Clinton from Iowa City. All without having to drive an hour and a half when minutes count.

"If they can't see one side of the picture or another that helps me know on what specific side the stroke is occurring," says Boyle.

He'll look for clues to help decide whether a clot busting medicine is the right call. The robot does have its limitations. For example, Boyle still needs the advice of others to know if a patient is acting differently.

"If I have questions I will ask somebody there, do they sound normal to you," says Boyle.

He says the technology is well suited to emergencies and routine follow up care. Although he still prefers to talk to patients in person for some cases. Brophy says it's up to doctors to decide what's best for their patients. However, telemedicine has not been addressed by most states in their official rules. It's an issue Brophy says will be telemedicine's biggest challenge.

"We really want to be thinking about where the puck is going to be in the next five to ten years, rather than where it is already," says Brophy.

That's a challenge already being faced in Iowa over a rule for prescription abortion providers. It's the first rule in Iowa connected to telemedicine and a judge's decision could shape the future of this technology.

Iowa's only medical policy on telemedicine was formed in 1996.

It says doctors treating patients in Iowa should be licensed by the state.

Telemedicine is not specifically stated in any rules.

The newest rule has raised serious concerns from the Iowa Medical Society.

TV-6 will explore the challenges of regulating telemedicine Thursday.

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