New system targets key issues -- Technology, law, reimbursement

CNY Business Journal (1996+), May 27, 1996 by Wilson, Frederick

SYRACUSE--The State University of New York Health Science Center (SUNYHSC) in Syracuse, in cooperation with NYNEX, recently sponsored the "Telemedicine Reality and Virtual Reality II" conference at the Onondaga County Convention Center. The program focused on "distributed medical intelligence" via advanced computer and communications technology. Speakers described and, in some cases, demonstrated applications of innovative technologies to specific health-care modalities, such as radiology (teleradiology) and pathology (telepathology). A commercial telemedicine-product exhibit served as an additional information resource. for participants. Neuropathologist Dr. Robert Corona, physician director of Medical Informatics and Telemedicine (CareNet) and director of Laboratory Informatics at SUNYHSC, moderated the proceedings. Mary Alice Williams of NYNEX acted as emcee for the opening evening program.

Keynote speakers included Forensic Pathologist Dr. Michael Baden, director of the Forensic Sciences Unit of the New York State Police and member of the Expert Forensic Team for the O.J. Simpson trial; Albany forensic consultant pathologist Dr. Barbara C. Wolf, also a member of the Expert Forensic Team and key investigator of the Bosnia mass graves; and Dr. Henry C. Lee, director of the Connecticut State Police Forensic Laboratory and star of "Autopsy 1 & 2" HBO specials.

Participants were welcomed by Dr. Gregory L. Eastwood, dean of the College of Medicine and president of the Health Science Center in Syracuse. Dr. Eastwood was dean of the Medical College of Georgia during the development of telemedicine in that state.

The conference featured the unveiling of the "Bridge," a medical-communication system using Internet applications, Web-based teleconferencing equipment, still-image transmitters, and database links. Bridge creators Dr. Dave Warner, neuroscientist for the Institute for Interventional Informatics in Loma Linda, Calif.--Nason fellow at the Northeast Parallel Architecture Center (NPAC) at Syracuse University (SU) and adjunct clinical assistant professor of Pathology at the HSC in Syracuse-- and David Balch, director of the East Carolina University Telemedicine Program in Greenville, N.C., demonstrated this latest initiative in medical informatics.

Launched in Syracuse during 1994, the Medical Informatics and Telemedicine Program--CareNet-is a cooperative effort involving the HSC, NPAC, corporate partners, and Rome Laboratory at the former Griffiss Air Force Base. As such, it is the first endeavor of its kind in the country, and the HSC has been named a national testbed for novel telemedicine projects. Founding partners include Rome Laboratory, NYNEX, NPAC, Eastman Kodak, Apple Computer, Cornell Theory Center, Nikon, Peirce-Phelps Integrated Communications Systems, Silicon Graphics, and Sprint.

What it is

Telemedicine refers to the use of telecommunications to transmit medical images, patient data, and medical education from one location to another. Teleradiology, telepathology, and telecardiology are among recognized specialties. This technology links medical specialists with primary-care physicians in remote areas, thus providing timely and comprehensive medical care to rural people. Dr. Corona, a neuropathologist, stated that "technology helps pathologists to practice more medicine and travel less, allowing more work per patholgist. This reduces the need for pathologists."

Pediatric Cardiologist Dr. Frank Smith has provided consultations from SUNYHSC to neonatologists at St. Luke's Hospital in Utica. From the HSC, Dr. Smith observed the live, real-time echocardiogram of a blue baby at St. Luke's and, from the transmitted image. ruled out cardiac abnormality immediately. "The echocardiogram is the backbone of pediatric cardiology," stated Dr. Smith. "The picture gives accurate information that a telephone description cannot. The image is not as good as face-to-face, but good enough to rule out cardiac problems. Five years ago, the baby would have been transferred, with the costs and risks of transfer and the family trauma of separation."

Dr. Smith also commented that telemedicine allows smaller hospitals to maintain their role as a primary-care provider and helps maintain a consistent standard of care throughout Central New York.

Conference participants witnessed a live consultation with radiologist Dr. Roger Stronell, a scheduled speaker who had been called to Tel Aviv, Israel. Dr. Stronell delivered his address from Tel Aviv to his Syracuse audience. Participants observed his slide presentation on-screen, while Dr. Stronell's TV image "spoke" from a corner of the screen. Stronell discussed the need for cost-effective solutions to medical problems, in contrast to solutions using the most recent technologies. "Methods must be based on outcome analysis rather than tradition," he stated, and pointed to the potential annual savings of $300 million by eliminating film archiving through teleradiology.

Following his address, Dr. Stronell transferred the microphone to a colleague from the Edith Wolfson Medical Center in Israel. This physician presented a work-up for a patient with a hearing problem. The work-up included a complete history, physical examination, and CT (computerized tomagraphy) images and MRI (magnetic resonance imaging) visuals. Ear, nose, and throat specialist Dr. Roger Kaufmann, neurosurgeon Dr. Robert King, and neuropathologist Dr. Corona provided on-stage consultation and diagnosis of a right acoustic neuroma.