Queen's makes connection with telemedicine
By John Duchemin
Advertiser Staff Writer
The Queen's Health Systems has set up a telemedicine clinic that connects patients in Honolulu with doctors in Virginia, who can give expert medical opinions from thousands of miles away.
Richard Ambo • The Honolulu Advertiser
The Motion Disorder Clinic held its second three-hour long-distance session last Thursday at the Queen's campus in downtown Honolulu. The monthly clinic is one of the first in Hawai'i: A service in which doctors and patients interact over digital video.
Dr. Daniel Davis of the Queen's Medical Center and Dr. Frederick Wooten collaborate via digital teleconferencing.
Dr. Frederick Wooten, chairman of the neurology department at the University of Virginia in Charlottesville, observed five patients with Parkinson's disease, tremors and other neurological conditions.
Wooten, considered a world expert on movement disorders, did so over a high-speed Internet connection, with special digital video cameras on both ends connected to television sets.
Doctors at Queen's called the clinic an example of the potential power of telemedicine, a medical field in its infancy. Hawai'i, with oceans separating much of its population from specialized medical care, is considered a leader in the field, which has blossomed in recent months as costs dropped and practical systems began to come online.
"Until now, telemedicine has been a lot of smoke, with relatively little flame," said Dr. Daniel Davis, chief of the Queen's medicine department. "But lately, as with this clinic, we're beginning to see lots of very productive uses of the technology."
The clinic is the latest of many telemedicine programs to be offered by Hawai'i hospitals.
Most of the programs have arisen in the last several years, largely thanks to a package of grants to hospitals from the nonprofit Weinberg Foundation.
Among those using telemedicine are Queen's, St. Francis Healthcare System of Hawai'i, Shriners Hospital for Children, Kapiolani Health, Tripler Army Medical Center and Straub Clinic and Hospital Inc.
The hospitals have found many ways to use the technology. St. Francis, for instance, uses telemedicine to review cases in American Samoa once a month, and holds medical education video conferences with doctors observing from hospitals around Hawai'i.
St. Francis also has started a home dialysis telemedicine program.
Medical staffers at the hospital, through a video camera hooked into a standard phone line, coach patients at home on the set-up and operation of blood-purifying machines.
The hospital has spent between $400,000 and $600,000 to buy the equipment and develop its systems, said Alan Ito, the hospital system's chief information officer.
The telemedicine set-up at the Queen's clinic cost $80,000, but is relatively simple.
A camera and microphone perch on a television set, which is connected by ISDN high-speed cable to the Internet.
The University of Virginia has a similar set-up, so people on both ends can see and hear each other.
Despite a half-second signal delay, the system works well enough that Wooten can help diagnose and suggest treatment for a tough motion-disorder case — potentially saving the patient a trip to the Mainland, said Dr. Anthony Mauro, a neurologist at Queen's.
"I'd judge this a grand success, just by the fact that we have someone on the other end of the phone who can give us an informed opinion," Mauro said.
The cameras can zoom in close enough that Wooten can see patients' pupils expand and contract, and zoom out enough to capture patients walking around the room.
Such a system is particularly good for treating motion disorders, said Dr. Edwin Cadman, dean of the John A. Burns School of Medicine at the University of Hawai'i.
"Sometimes, you can't describe a motion as well as you can observe it," Cadman said. "This technology enables you to look at something and make a diagnosis, and that makes it quite a valuable tool."
