On Washington, D.C. Panel, Lowery Talks Telemedicine

By Ben Boulden

 

Jan. 22, 2013 | A national spotlight recently fell on the University of Arkansas for Medical Sciences (UAMS) for its central role in building the state’s e-Link telemedicine network.

Curtis Lowery, M.D., director of the UAMS Center for Distance Health, was one of four panelists from across the United States invited to discuss telemedicine Jan. 16 at the Brookings Institution in Washington, D.C. He also is a professor and chairman of the Department of Obstetrics and Gynecology in the UAMS College of Medicine.

Arkansas e-Link, led by UAMS, is using high-speed data transmission lines to connect 413 community institutions for videoconferencing between medical professionals, patients and doctors and others along with the real-time exchange of patient data and readings.

“Applying technology in a meaningful way is how we change the world,” Lowery said.

In a keynote address before the panel discussion, Larry Strickling, administrator of the National Telecommunications and Information Administration, cited several examples of how e-Link and UAMS are doing that while improving the quality of health care in the state and access to it.

He recounted how in late 2011, Rhonda Smith, a 43-year-old nurse living in northwest Arkansas, had a massive stroke and how a UAMS neurologist was able to question and examine her through a telemedicine video connection. The connection was made through the Stroke Assistance Through Virtual Emergency Support network, now a part of e-Link. That quick, expert diagnosis enabled a blood-thinning drug to be administered that prevented her from experiencing other permanent neurological damage.

Strickling also praised the UAMS Antenatal and Neonatal Guidelines, Education and Learning System (ANGELS) program, which gives women with high-risk pregnancies access to genetics counselors and maternal-fetal medicine specialists who can monitor them and conduct live fetal ultrasounds from hundreds of miles away. Roughly a quarter of 450 mothers and babies in the practice of a Mena obstetrician have received at least one telemedicine ultrasound through ANGELS and e-Link.

“For these women, the ANGELS program means they don’t have to drive hours to get the care they need,” Strickling said.

During the panel discussion, Lowery told the Brookings audience that UAMS’ goal with e-Link has been to shorten that distance and ensure that no Arkansas resident is more than 60-90 miles from a facility with a connection to the network.

It also allows specialists to reach out through the high-tech links at those facilities in a state where specialists in many areas are in short supply.

“I’m one of only five maternal-fetal medicine high-risk obstetricians in the state,” Lowery said. “I’m reducing the work force by 20 percent just being here in Washington. That’s the reality of Arkansas.”

Of Arkansas’ 75 counties, 73 are considered medically underserved. It’s also tough for physicians to make a living with a rural patient population in which 40 percent of those 18 to 64 have no medical insurance, he said. That in turn makes it hard for rural counties to attract them to practice medicine.

Besides shortening the distance between a patient and specialized care, e-Link and other telemedicine systems also hold the promise of lowering costs.

“Health care is too expensive,” Lowery said. “I’m a doctor, and I can say that. We need to be more efficient in the management of the patient. The only way to do that is to become connected. We’re establishing virtual health care systems that go across funding lines. For example, we’ll be able to manage obstetrical patients across Arkansas in a better way. It’s making a difference every day and changing the way we do health care.”

Hometown medical providers through e-Link can collaborate with distant medical specialists to co-manage patient care, so they don’t have to refer patients to distant hospitals or clinics. Also, a higher education component of e-Link facilitates resource sharing, collaboration and research opportunities at two-year and four-year colleges in Arkansas.

In 2009, the federal government allocated $4 billion for expanding broadband connections through a program administered by the Department of Commerce’s National Telecommunications and Information Administration. UAMS received $102 million of that funding to support the construction of the e-Link network, which is expected to bring online its remaining community partners later this year.