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Computers Link Doctors, Rural Patients
By Mea Anderson
June 20, 2005
Missoula heart specialist Mark Sanz flashed a slide on the wall Saturday that proved his point: It was a faxed copy of an old electrocardiogram, sent to his office from Seeley Lake some months ago when a patient there was having heart trouble.
That old test, when compared with a new one, might have given Missoula doctors some clues to the patient's problems. But the old printout was faded, and the fax further rendered it unreadable and unusable.
Saturday, St. Patrick Hospital showed off newly installed technology that could be the end of unreadable, faxed, blurry, late, lost and otherwise unusable medical records, at least for heart patients. It is the first phase of a program to digitally share and archive heart tests such as those called ECGs or EKGs, making them available on the Internet to doctors and hospitals in western Montana 24 hours a day, seven days a week.
About 20 Western Montana hospitals and clinics are already linked and online; another 25 will be in the next few months, Sanz said.
Doctors also will be able to send and receive, across miles and computer lines, heart tests in real time. As the test is conducted, readouts and photographs of the working heart are sent immediately to another doctor miles away who can help interpret results and decide how to treat the patient.
The program is funded by a $300,000 grant from the Paul G. Allen Foundation, $700,000 in federal funding secured by the Montana congressional delegation from the Department of Health and Human Services, a $60,000 grant from the Dennis and Phyllis Washington Foundation, and money from St. Patrick Hospital and other health-care centers.
These "telemedicine" improvements save time, money and lives, according to Sanz and other doctors. Patients stay in their hometown; reliable medical information can be gathered and read in minutes rather than hours; and patients are given risky or expensive medical treatment only when needed.
In heart cases, "time is muscle," Sanz said. The longer a patient goes without intervention, the more heart muscle is damaged. At the same time, emergency interventions such as surgery and some drugs have their own risks, including stroke and death.
In the audience Saturday for the demonstration was Sen. Conrad Burns, R-Mont., a longtime advocate for using computers and new technology for education and medicine in sparsely populated Montana.
"We have such an aging population, and we have 14 counties that have no doctor," said Burns. "We are going to have to deliver our services in different ways."
Patient confidentiality and privacy are major issues with Internet-based medical files, all agreed Saturday. With cookies and spyware, "people can use our computers and we don't even know it," Burns said. "We've got a lot to overcome electronically."
But in this computer age, storing important medical information and tests in closed-on-weekends doctors' files or hard-to-find hospital records doesn't make sense, said Dr. Randy Seachrest, medical director of the Pain Management and Montana Spine Center at St. Patrick Hospital.
"These are life-and-death issues," he said. "I can walk in the Marriott (hotel) and swipe my card, and they know more about me than my physician."
Having easy-to-get, personal medical information in electronic databases is "not a matter of if, it's a matter of when," he said. Sexy stuff, like off-site robotics that may allow surgeons in New York to operate on battlefields thousands of miles away, sounds good, but the nuts-and-bolts, computerized information systems will make the most dramatic impact, he said.
"I can save more lives databasing these EKGs in western Montana than using robotics to operate on one person," he said.
"We've got many challenges with (developing) centrally located medical records," Burns said. "That's not to say they can't be overcome."
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