At rural hospitals, Dr. Robot will see you now

Telemedicine puts patients in rural areas in closer contact with Walla Walla docs, without the long commute.

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Heidi Hill is not a patient, but she plays one on TV.

Actually, the nursing supervisor of the Regional Medical Clinic arm of Grand Ronde Hospital is not on TV, but rather on video camera while seated on an exam table.

The doctor in front of her is slim -- quite -- and short. Clad in the traditional white of medicine, he sports accents of stainless steel.

This health-care provider, known as the "RP Lite" model, happens to be a robot of sorts and is plugged into the hospital's wall in La Grande. At the moment, it is transmitting Hill's image to Dr. Francesco D'Alessandro, seated in his office at Walla Walla Clinic, some 87 miles away.

It's called telemedicine and it's good news in rural America, experts say. In this particular case, the robot "doctor" is part of the La Grande hospital's efforts to bring to its patients specialized medicine not available in the area.

The system also allows people to stay at their home hospital, decreasing the number of transfers to larger medical centers, noted Jennifer Neisse with In Touch Health, the company that sold the Remote Presence technology to the hospital and the clinic.

"That benefits patients and their family greatly. It leads to better recovery time and decrease in cost."

The hospital has been recognized nationally for its work in improving rural medicine, according to its website.

The technology built into RP -- "Remote Presence" -- allows for video, audio and magnified still pictures to be beamed to the Tietan Street facility. The built-in cameras can pan the room, zoom in and precisely focus.

Since late summer, Walla Walla Clinic has partnered in bringing the future to that rural and sometimes isolated area of Oregon, said Craig Dreher, Chief Information Officer for the company.

The patients getting their dermatology needs met through the futuristic method are the same people who were once forced to drive nearly two hours one way to see a Walla Walla Clinic specialist for routine visits, he said.

Not so fun in winter weather, especially when coming down the infamous Cabbage Hill that drops travelers off Deadman Pass in the Blue Mountains into the Pendleton area.

But is being seen by a robot better than battling ice-covered roads?

Absolutely, agree Hill, Dreher and Doug Romer, the hospital's executive director of patient care services.

Making a dermatology appointment with RP is not really like meeting with R2-D2, they insist. Since the robot's "head" is a computer monitor, showing a life-sized image of D'Alessandro's face, patients quickly forget the Walla Walla Clinic physician is not right there with them in the room.

"It's just like having a doctor right in front of me," Hill said to the group watching on the Walla Walla end of things. "Patients tell us they actually pay more attention to the doctor this way."

And vise versa, Dreher pointed out. "The doctor is not, for example, tending to his laptop. And the patient does not recognize whatever else the doctor is doing ... maybe referencing a source or writing a prescription."

For the concept to work, the experience has to feel "real," Dreher said. "With that said, 'real' has a new definition."

A nurse from Grand Ronde stays with the patient during a visit and can take any high-resolution picture that are needed. On his end, D'Alessandro or another specialist can use a split screen on RP's monitor to show the patient a picture of what he is concerned about.

On this day, Hill is demonstrating a skin lesion, which is actually an ordinary mole in its day job.

Wearing head phones and a microphone to communicate, D'Alessandro zooms the robot's camera to the skin spot, via a small joystick mounted on the edge of his desk. The image transmitted back to him is sharp enough to count the lines of webbing in Hill's skin.

D'Alessandro asks the nurse on hand to photograph and describe the characteristics of the lesion. "Can you measure this mole here," he asked, running his computer's cursor over the picture.

Over the mountains, Hill and her crew see the same 18-megapixel image and know exactly what the dermatologist is viewing.

If Hill was truly a patient, and her mole truly a lesion, D'Alessandro would very likely have all the information he needed to diagnose the lesion and prescribe a course of treatment. Any lab work required can be done at the hospital.

After which, the patient would leave and go about her day in La Grande, while the physician would rise from his desk and go see his next patient.

No snow chains required.

Sheila Hagar can be reached at sheilahagar@wwub.com or 526-8322. Check out her blog at blogs.ublabs.org/fromthestorageroom.

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