A three-state cooperative is staffed and ready to launch a telecommunications network linking physicians and major medical centers in New England.
Under the direction of the C. Everett Koop Institute at Dartmouth College, the initial network structure won't be anything fancy: standard personal computers, telephone modems and store-bought camcorders, all linked to the national Internet, a patchwork of electronic roads and subdivisions.
In the mainly rural states of Maine, New Hampshire and Vermont, the first priority of such a network is to connect physicians to a base of patient information, medical education and specialist expertise through computerization, said David Serra, administrative director of the Hanover, N.H.-based Koop Institute. "We see it as a way of supporting primary-care physicians in rural areas," he said.
Besides tackling the region's communication problems, the initiative will try to "form a model or template for what can work nationally," Mr. Serra said.
Former Surgeon General C. Everett Koop, M.D., is heading a national consortium to create an information infrastructure that can meet the demands of healthcare reform. That consortium is a division of Vice President Al Gore's National Information Infrastructure initiative.
A primary question is whether states can communicate with one another, Mr. Serra said. Intrastate telemedicine networks are mobilizing in several states, including Georgia, Iowa, North Carolina and Oklahoma, but a national network will depend on the ability of states to work in concert, he said.
The New England project's concern about serving rural areas also is important to health reform efforts that rely on primary-care physicians. "Under any scenario, we'll need to induce people to go into underserved areas to practice," Mr. Serra said.
One inducement is a promise that rural physicians will be able to participate interactively in the medical education and specialty consultation available at major medical centers, he said.
The Koop Institute will get that initiative off the ground Sept. 1 when a project director with a NASA background reports for work. Michael Caputo comes to the job from Krug Life Sciences at Johnson Space Center in Houston.
The aim is to develop computer and telemedicine programs that can use personal computers and modems already in physicians' homes and offices or available at low cost. For the price of a camcorder, physicians may be able to link into interactive video services, Mr. Serra said.
Other projects include efforts to develop remotely accessible administrative information systems and computerized patient results and records, he said.
Governors of the three participating states have pledged start-up contributions, and the Koop Institute is seeking grants and contributions from industries in New England.