September/October 2000

CONTENTS Back to Cover About Cattails TeleHealth brings specialists to outlying centers Study evaluates need to repair groin hernias Positive discipline maintains children's self-esteem Marshfield researchers helped map human genome, now seek disease-causing genes Gamma Knife a new treatment for brain tumors New Marshfield Clinic program assures food safety from farm to table Flu shots now practical for some people with egg allergy Saving your sight: New treatment improves macular degeneration outcomes New faces Marshfield Clinic Calendar of Events

TeleHealth brings specialists to outlying centers

TeleHealth was established two years ago and offers patients access to providers in Marshfield by eliminating the problems of traveling distances at inconvenient times for patients. Karshna was the first Park Falls resident to see a cardiologist though the TeleHealth connection at the Marshfield Clinic-Park Falls Center.

Jerry Karsha of Park Falls was as comfortable seeing his Marshfield Clinic cardiologist over the TeleHealth system as he is paddling his kayak on the Flambeau River near his home.

"Dr. McCauley can do the same thing on TV as there," Karshna said of his physician. "He scowls at me and tells me I have to lose 10 pounds."

With the aid of registered nurse Ghazala Kabani, Dr. McCauley also listened to Karshna's heart and asked questions about general health, exercise and diet.

"The only difference is the physical presence," Karshna said. "But he's looking at you and you can see him. I felt very comfortable."

Kabani said she enjoys her role as a TeleHealth nurse. "This is different from other nursing," she said. "We are helping patients get better access to their providers. It's rewarding to help them improve their health without having to travel."

Karshna serves on the Board of Flambeau Hospital, jointly owned by Ministry Health Care and Marshfield Clinic. He said programs such as TeleHealth are the very reason he supported an affiliation with Marshfield Clinic.

"I thought it would be just great that people could be seeing an expert but didn't have to leave Park Falls," he said. "This is what I envisioned would be a major benefit of our relationship. I can see in the future we will be doing more of these types of services."

TeleHealth saves providers and patients time, said Nina Antoniotti, R.N., M.B.A., the program manager of TeleHealth at Marshfield Clinic. Many times providers do go to other centers to provide outreach care, and that has its place, she said. But allowing for travel, time lost from other patients and other expenses, outreach is not always the best way to provide services to patients and allow the provider to practice medicine efficiently at the same time. Patients appreciate respect for their time as well. Instead of a day away from home, Telehealth often has them back to their routine within an hour.

"Telehealth is a tool for access," Antoniotti said. "It's not medicine, it's not nursing. It's a way to bring people together."

Providers in Marshfield recognize that their patients must travel a long way for short appointments, Antoniotti said. Therefore, they sometimes schedule checkups less frequently to compensate for the long trip. With TeleHealth, physicians can schedule visits as often as needed for good health care with little inconvenience to patients.

During winter the drive from Park Falls to Marshfield can be treacherous and patients are understandably uncomfortable making the trip, she continued. With TeleHealth, even patients who need to be seen in person can access some level of health care from their providers when the weather prevents them from traveling.

With a registered nurse in the room with the patient, components necessary for an adequate history and physical exam can be directed by the physician and carried out by the nurse.

Like Karshna, most patients rate the TeleHealth system very high, Antoniotti said. "Their No. 1 issue is they want to make sure the provider understands their condition. With a nurse in the room, communication between patient and physician is monitored so that nothing is missed."

Karshna said he would like to see more uses for Telehealth in Park Falls. "To me, it was great. I came into the waiting room and saw staff I knew. We went to the exam room and got everything set up and we were just chatting. It was relaxing."

Time before the provider arrives via television screen can be valuable, too, Kabani said. "Sometimes the patient tells us something that they don't think is important, but it can be very important to their health care. This is one way nurses help to facilitate communication, using assessment skills to know what is important in the overall clinical consult between the patient and the provider."

TeleHealth offers services in more than 15 specialties and that list will grow, Antoniotti said. "If a care provider or a patient contacts us, we will do everything we can to bring that patient and his or her provider together," she said.