The doctor is in, Rural residents get specialty care with telemedicine

Nurses no longer have to wake up the lone doctor in Elbow Lake, Minn., when the sick and injured rush to the hospital emergency room.

They quickly assess the patient, perform triage and, in serious cases, fire up the camera, monitor and a T-1 line that links the Grant County Health Center to a community hospital in Buffalo, Minn., 120 miles away. A nurse places an electronic stethoscope over a patient's chest so the doctor can listen to the heartbeat, puts an otoscope into the patient's ear so the doctor can check for an ear infection, or sends an X-ray so the doctor can spot a broken bone-all from a remote location.

In Billings, Mont., psychiatrists at Deaconness Behavioral Health Center can check the progress of stroke victims 350 miles away or quickly process paperwork to get a suicidal person into a psychiatric unit.

"Many patients are very sick and live a long way away. There just isn't any other option," said David Carlson, a Deaconness psychiatrist who specializes in pharmacology. "For lots of people, it's a big deal to drive here, especially during calving or planting season. We had tended to see those patients a little less often be-cause

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