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Scott Parazynski of the University of Texas demonstrates a telemedicine hookup with medical staff at McMurdo Station in Antarctica.

Help for far-flung patients

Telemedicine makes advances, to ends of earth

– When the doctors at University of Texas Medical Branch are reading an ultrasound, examining an X-ray or evaluating an echocardiogram, the patient they are treating is not necessarily right in front of them.

Instead, the patient is often in one of the farthest-flung corners of the Earth: a scientific research station in Antarctica.

Using telemedicine, physicians in Galveston, Texas, provide treatment to scientists and support staff who would otherwise have access to only very basic medical care. With the help of videoconference technology and specially designed medical instruments, doctors can diagnose heart attacks, inspect a lesion or even provide psychiatric counseling to National Science Foundation workers from thousands of miles away.

“We can really be virtually looking over their shoulder,” said Scott Parazynski, director of UTMB’S Center for Polar Medical Operations.

Although telemedicine has been practiced for decades, a burst of innovation in recent years has greatly improved its quality: Higher video and image resolution help lead to more accurate diagnoses, while more efficient use of bandwidth has led to more reliable connections. And the increased adoption of electronic medical records allows documentation to be shared more easily and quickly.

The way that telemedicine technology is being applied in Antarctica offers a window into its potential to reshape health care in less remote parts of the world.

The capabilities of the health facilities at the United States’ three Antarctic research stations are limited.

“They can treat most primary care issues and some emergencies, at least in terms of initial stabilization,” said Michael Montopoli, the chief medical officer at NSF’s division of polar programs.

But they are not equipped to give CT scans or MRIs, nor do they have a surgical center or postoperative facilities.

Telemedicine can help fill the gaps. A secure video conference can allow a specialist to talk to the patient and on-site caregiver to assess symptoms. The same technology can also be used to have a specialist coach an on-site clinician through a highly skilled procedure such as an echocardiogram.

A new array of tools can also help the remote doctor work as if she is in the exam room. Stethoscopes equipped with microphones enable a far-away doctor to instantly hear a patient’s heart or lungs. Special ophthalmoscopes, which come with a light source and a camera, allow the doctor to see inside a patient’s eye in real time.

Polycom, the maker of the telemedicine products used by UTMB and NSF, has made this set of equipment fit inside a case small enough that it could be stowed in an overhead bin on an airplane.

Telemedicine capabilities have been influential in how NSF health centers deliver care.

“It’s allowed us to make critical decisions about either treating the patient there at the clinic or launching a medevac operation,” Montopoli said.

The difference between those two courses can be important, not only for a patient’s health but also for a client’s bottom line.

Leaving Antarctica can be an outright odyssey: Flights are limited because it is often so cold that airplanes cannot function. In winter, the surface of the ice runway at McMurdo Station requires special preparation to accept aircraft.

And those are just the obstacles to departing a coastal facility. Travel out of the inland South Pole station is sometimes nearly impossible.

Accordingly, Montopoli said a medical evacuation from Antarctica can cost “several hundred thousand dollars.”

In the same way telemedicine has flung open the doors for more and improved care in Antarctica, its practitioners and advocates say it could have the same power closer to home.

In America’s rural areas, it can often be difficult for residents to get access to specialist physicians. As the Affordable Care Act extends health insurance to millions of Americans who previously did not have it, experts say that shortage is likely to be felt even more acutely.

Polycom and UTMB say telemedicine could help meet the swell in demand.