Before rural hospitals are expected to begin tuning into telemedicine.
As Washington focuses its attention on information highways and accessibility to healthcare, rural healthcare providers that long have been isolated stand to benefit as more federal dollars are pointed toward this growing technology.
"Our office is getting about $5 million this year for a new rural telemedicine grant program, and that's more than ever before," said Carole Mintzer, program analyst for the Office of Rural Health Policy.
Telemedicine is a two-way audio and video communications network that gives rural hospitals and physicians access to medical and technological resources via telephone lines or satellite link-ups.
"We can reach into the isolated areas of our state and bring them the services of a larger tertiary-care center," said Robert D'Alessandri, M.D., vice president of health sciences and dean of the West Virginia University School of Medicine, Morgantown.
After pilot projects at Texas Tech University and the University of West Virginia, more states are expected to tap into the Office of Rural Health Policy's new grant program.
In West Virginia, rural hospitals are gaining access to valuable medical services from Mountaineer Doctor Television, also known as "MDTV," which links them with the Robert C. Byrd Health Science Center's tertiary-care center in Morgantown. The MDTV project was paid for mostly through $800,000 grants in each of the past two years from the ORHP.
Telemedicine offers TV-quality pictures and sound, allowing for the transmission of images such as X-rays and sounds such as beating hearts as heard through electronic stethoscopes.
"We can hear and we can see (the patient), and it may not be long before we can touch," Dr. D'Alessandri said.
Cameras and monitors at each site allow for emergency medical assistance, medical consultation, resident programs, continuing medical education and other services.
An interactive video system based at Texas Tech University's Health Sciences Center in Lubbock links 46 Texas hospitals and another in New Mexico.
About 36 continuing education programs a month are beamed to rural physicians, nurses and other healthcare providers across the state, said Steve Cotton, director of marketing and program development for Texas Tech's system, called HealthNet.
More advanced telemedicine networks have been developed with satellite uplinks, but those can be too expensive for rural facilities, Ms. Mintzer said.
Hospitals can expect to spend about $1,000 a month on telephone line charges, but those costs differ from market to market depending on telephone rates and local taxes.
The line charges may seem expensive, but executives operating telemedicine networks say there are benefits for rural hospitals, such as enabling them to keep more patients at their facilities, and consumers benefit by not having increased transportation costs and more expensive care at tertiary facilities.
Grants allocated this year will fund studies to help ORHP staffers better analyze cost savings rural hospitals can achieve through the use of telemedicine. Ms. Mintzer said a comprehensive analysis of cost savings currently doesn't exist.
In West Virginia, the information system started in 1985 with an audio-only medical information service designed to provide rural physicians access to the medical resources available at the Robert C. Byrd Center. The service, known as Medical Access and Referral System, is a round-the-clock operation linking community physicians to the university medical center.
"Our system started with 10 to 12 calls in 1985 and it's now grown to more than 4,500 calls a month," Dr. D'Alessandri said. He expects the telemedicine project to have as great a need.
At least 15 states are active in planning and developing rural telemedicine projects. However, not all of those states will get money from the Office of Rural Health Policy.
Others are tapping into other federal resources such as the Rural Electrification Administration, which awarded $10 million for information networks that range from telemedicine to distance learning for schools; the National Telecommunications and Information Administration in the Department of Commerce where $26 million has been set aside for state planning, social services and telemedicine; and HCFA, where $5 million is available for telemedicine research and demonstration projects.
HCFA has a broad-based grant program available to many potential grantees, including hospitals, research institutions and other provider groups, HCFA officials said. The deadline for applications is March 24.
"Telemedicine is an important issue for this year and is being given a lot of attention," Ms. Mintzer said.