VA branch rolls out first of 5 telemedicine carts

The New England branch of the Department of Veterans Affairs has developed a compact telemedicine cart that doctors can use to consult with medical specialists, saving patients time and trouble.

Many veterans venture across a state or states to consult with specialists such as dermatologists or ophthalmologists. But the cart— which includes a 13-inch monitor, speakers, a camera and medical instruments— will allow veterans to visit their local VA clinic and consult via a teleconference with specialists based at larger VA medical centers.

Doctors will begin using the first telemedicine cart this week at a VA outpatient clinic in Burlington, Vt., with four more carts being deployed later this year throughout New England.

"We're looking to deploy more telemedicine services in the field to reach out and get to more veterans with specialists that otherwise wouldn't be available to them," said Kevin Hope, the VA computer specialist who designed the telemedicine carts that will be deployed at the New England VA clinics.

Physicians can use the cart's medical equipment, which includes an endoscope, an ophthalmoscope and an otoscope, to let a specialist on the other end of a teleconference examine the patient remotely.

A hardware/software unit developed by PictureTel Corp. lies at the heart of the telemedicine cart, compressing and decompressing video images sent from clinic to specialist. Sound and video images travel from the cart and to the specialist's screen via an Integrated Services Digital Network line, which also allows parties at both ends to converse normally during an examination.

One of the cart's advantages is its compact design. The cart stands 4 feet tall and measures about 20 inches wide, which allows it to take up precious little space in clinic rooms already crowded with medical equipment and people.

"Basically, I decided we needed something smaller than anything on the market," Hope said. "If you were to take a unit that had a 32-inch monitor...on a broad-based stand into this room with you and the doctor, it would be a bit crowded."

Chris Ferrenz, PictureTel's account manager for the VA, said some value-added resellers take telemedicine equipment— including monitors, image compressors and medical instruments— and create compact telemedicine systems. But he said what Hope has created may be more friendly to its intended users.

Ferrenz said equipment outlets are near the front of the cart, and the design doesn't leave users guessing which device plugs into which slot, making the cart easy to use. "[Hope's] emphasis was making it user-friendly for the medical staff," Ferrenz said.

Dr. Doug Perednia, president of the Association of Telemedicine Service Providers, said the carts definitely can fill a need in clinics where small spaces make it hard to find room for a full-scale telemedicine outfit. He said smaller, portable carts also may be useful for health care organizations that need to share telemedicine equipment with several other clinics.

Demand for such systems may grow as more people become aware of the travel, time and resources that telemedicine can save, Perednia said. "Telemedicine is very important because it's addressing the issue of geographic mis-match."

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