MICHIGAN TAKES ITS TELEMEDICINE

Imagine needing immediate health care — and the nearest specialist is almost 300 miles south. Residents living in the most isolated parts of Michigan's Upper Peninsula, where transportation can be tough and weather wavers between harsh and hellish, are all too familiar with this scenario. But for some, medical help is now just a broadband connection away.

Marquette General Health System's Upper Michigan Telehealth Network began in 1994 to provide distance-learning opportunities to physicians spread out between five health care sites across northern Michigan. The high-speed data network now connects 25 sites, delivering health care services to rural communities throughout the UP via the Internet.

Sally Davis is director of telemedicine and program director for telehealth management and development at Marquette General Hospital, one of the larger and more advanced hospitals in the UP. Back in 1992 she joined the board of nonprofit Upper Great Lakes Educational Technologies Inc., an organization comprising school districts, colleges and universities, libraries and health care providers focused on providing high-speed transport of data, video and voice information to people in the UP. With the help of UGLETI, Davis helped jump-start the Upper Michigan Telehealth Network by seeking potential grant possibilities and methods to incorporate telehealth into her hospital's dossier.

Davis, who continues to represent the hospital consortiums for UGLETI today, first explored applications geared toward professional education for physicians. It wasn't long before she realized broadband technology would be beneficial for administrative purposes as well. “At the time there were 15 hospitals in the area that were coming together to form a formal network, which required frequent meetings,” she said. “Videoconferencing was a real natural for this.”

In September 2000, Marquette General was awarded a three-year federal grant to focus on clinical broadband applications. “Now the clinical applications have skyrocketed, and we see patients over the system,” Davis said. “We are a hospital of specialists so where there are smaller, local hospitals, we can rely on videoconferencing to do follow-up checkups with folks in the far reaches of the Upper Peninsula.”

Some doctors even have put the systems directly on their desktops. “There are good telemedicine services now for rural areas in the UP, and because Marquette General is more colonized as far as hospitals go in the area, it is able to offer a higher level of services than smaller hospitals,” said Dr. Alfred Joyal, vice president of academic affairs with Northern Michigan University and chairman of UGLETI.

Marquette General Health System's high-speed network continues to evolve from ISDN to a more dedicated IP-based wide area network. While some members of the network still maintain connections that reach a maximum speed of 128 kb/s, those on the new system typically reach speeds upwards of 768 kb/s.

Although telemedicine is becoming more of a standard practice, many applications have yet to be developed. One project Davis hopes will be funded in the near future would allow new doctors to specialize in a field of medicine that would be well-suited to rural areas, concurrently fulfilling their residency requirements at Marquette General via videoconferencing.

Telemedicine may not be quite as accessible among as many practitioners as Davis would have hoped, but Marquette General continues to do its part to stay active in pursuing grant opportunities. “If we find a new application, we will research and find the best solution,” Davis said. “What I hope for telemedicine is that it will become so routine that we don't have to talk about it as being unique.”