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Telemedicine may improve health care in rural Ga.

The technology aims to connect EMTs to doctors who can make informed decisions and avoid an unnecessary ambulance trip to a hospital, often 50 miles away

By Maggie Lee
The Macon Telegraph

ATLANTA, Ga. — A black plastic case the size of a printer holds the future of medicine, according to a Mercer physician who’s part of a pilot project to start deploying those boxes in Hancock County.

Telehealth is “the future,” Dr. Jean Sumner, associate dean for rural health at Mercer University School of Medicine, told a group of state lawmakers Thursday afternoon.

In the $14,000 case by her side instruments were arranged for checking eyes, ears, noses, air passages, pulse, blood sugar and other vital signs, plus a tablet computer. They look like a typical doctor’s tools, except for the small power buttons that indicate they’re all online -- connected to the computer, the doctor and the hospital.

“You can hear heart and lung sounds incredibly well,” she said.

Sumner linked up to a colleague in Wrightsville and beamed his face onto a big-screen TV for the audience. He stuck an instrument in his ear and a close-up picture of the inside of his ear popped up on the screen, detailed enough to startle the uninitiated.

Georgia’s rules for doctors say telehealth exams must be equal or superior to in-person exams.

“I can do it with this,” Sumner said.

Hancock County ranks near the bottom of many measures: There are few people, little money and not a lot of job opportunities.

After 5 p.m. when the county health department closes, there is no health care. It has no full-time primary care doctor. An ambulance trip to a hospital in a neighboring county can mean up to 50 miles or more.

During off-hours, Hancock County residents have no choice except emergency rooms. Sumner said more than two-thirds of the ER visits there are for non-emergencies. Emergency rooms are costly for hospitals and tie up the few available ambulances. Many patients have no insurance and no way to pay for any or all of their care.

Many rural counties have various versions of the same problem: lack of access to emergency care.

The Hancock Healthcare Access Initiative, with Sumner as leader and facilitator, aims to start to change that.

The crux of the initiative is putting those black boxes of telemedicine equipment into the hands of first responders.

That means the doctor on the other end of the connection can see what the EMT sees and can make some decisions that may save time, money and lives.

For example, Sumner said, consider an elderly patient who lives in a nursing home and has fragile health.

Sometimes first aid followed by a visit from the doctor would be a safer choice than carrying a person in fragile health to a hospital, she said.

A doctor examining someone through telehealth could make that call.

It would take a lot of partners, but the project also has a lot of buy-in so far from hospitals, EMT services, local governments and others.

“We know it works. We know telemedicine is proven in Georgia. And we know we still have a lot of work to do,” said Paula Guy, CEO of the Georgia Partnership for TeleHealth, a nonprofit that began as part of a state agency.

Part of what Guy has done so far is count the bars on her cellphone all over Hancock County. She’s mapped some dead zones that would benefit from boosting, she said, but telemedicine can operate on 4G.

Alan Horton, the CEO of Putnam General Hospital in Eatonton, said his ER physicians and board are behind the project. They already receive many Hancock patients.

State Sen. David Lucas, D-Macon, is co-chairman of a study committee on rural health formed by Gov. Nathan Deal last year. Lucas supports the initiative.

“We don’t have the panacea, but we have a start,” he said.

Other parts of the puzzle remain: Rural hospitals are increasingly squeezed for money, and too few doctors want to practice in rural areas.

The Hancock initiative would cost about $100,000, Sumner said. The money is the next step. She’d like to roll out by June.

Eventually it could be self-sustaining, Sumner said. One example would involve offering virtual doctor visits by appointment to patients who can pay cash.

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©2015 The Macon Telegraph (Macon, Ga.)

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