Distance Doctors
They've
Got the Kilobytes to See for Miles
You're
a kid who lives in what some people call a "bad neighborhood."
One morning, you wake up with an earache.
Your throat feels thick and sore.
Your mom's not home from the night
shift.
Even if she were, she'd be pressed
to afford a doctor.
You go to school and check in at the
nurse's office. She sits you down in front of a computer that's equipped
with a video camera. It pipes an image of your sick face through a computer
line, at 128 kilobytes a second, to a local hospital.
A doctor at the other end, studying
you on a TV screen, tells the nurse to check your ears, nose and throat
with a video otoscope; this lets him peek inside you as if he were in
the room, too.
Then she checks out your heart and
lungs with an analog stethoscope.
After these checks, the doctor faxes
a prescription to the school. Your mom can pick it up. It's filled for
free from a stock of samples supplied to a nearby drug store by clinicians
at the hospital.
Sound like a dream?
For those kids lucky enough to attend
one of 10 schools in USD 500, Wyandotte County, Kansas, it's come true.
The Tele-KidCare program based at the
University of Kansas is delivering this kind of service, within this
kind of system and set-up, to seven elementary schools, two middle schools
and one high school.
The program, to which several KU Medical
Center Department of Pediatrics staff members donate time, is now in
its second and final year of funding.
In
the program's first two-and-a-half months, doctors had 187 consultations,
mostly involving ears, noses and throats, said David Cook, associate
director of the Department of TeleMedicine Services at the KU Medical
Center and one of the key players on this project.
Gary Doolittle, the department's director,
is the program's principal investigator.
"We expect the number of consultations
to triple this school year," Cook
said.
The program is the brainchild of the
former director of the KUMC telemedicine office, Pam Whitten, now at
Michigan State University, and Julie Taylor, a registered nurse who
used to work in the school district.
Cook said, "Kids in the district weren't
getting health services, so the system approached us and asked, 'Can
you help us out?' We thought we could."
While doctors deliver clinical services
via computer, researchers are trying to answer several questions, Cook
said: Is the service cost-effective? Is the diagnosis of the child as
good as an in-person check? What problems do the parents of these children
face, and why do the kids use the school-based service rather than other
free services available to them?
Tackling those questions are Doolittle,
Cook and Whitten; Pam Shaw and and Donna Dailey, associate professors
of pediatrics; David Ermer, assistant professor of psychiatry; and Art
Williams, a health economist at the University of Missouri/Kansas City.
"I really want to sing Shaw's praises,"
Cook said. "She goes out to the schools and trains the nurses on health-care
issues. She's the district's liaison for those issues. She really understands
the importance of a team. Tele-KidCare works because of people like
her and the nurses."
Funding the research is a two-year grant
from the National Telecommunications and Information Administration
that, including matching funds, totals more than $857,000. Southwest
Bell also chipped in $22,000.
Said Cook, "You can't just take a technology
and slap it into locations and have it drive the project. Telemedicine
in every school may not be the best idea, but there may be a lot of
schools that could really benefit from it."
Not to mention the kids.
Roger Martin
Research Writer/Editor
Center for Research
