Imagine a world where you could visit with a medical specialist 350 miles away from the comfort of your own home … sounds futuristic, but it’s not that farfetched.
In several ways, Nebraska has been a leader in health care technology.
The state was a pioneer in telehealth, or health care via videoconferencing. Nebraska created its first link back in 1959: psychiatrists in Omaha used television to consult on patients in Norfolk, more than 100 miles away.
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Now, Nebraska has one of the most extensive telehealth networks in the country.
“If you were going to do a non-telehealth clinic, you’d have to go out and acquire a building … somehow, and then outfit it,” said Rod Markin, chief technology officer at the University of Nebraska Medical Center in Omaha, adding that for telehealth, all you really need is a secure room and a secure connection.
He gave the example of a UNMC geriatric psychiatrist.
“He has 50-some nursing homes that we have contracts with, where he’ll provide behavioral health (and) psychiatry consultations,” Markin said. “He can actually do it off of his iPad. It’s real-time, it’s secure, it’s high-definition and it’s portable.”
Markin said he sees telehealth expanding even further in the future.
“Eventually, what we’d like to be able to do is to provide some sort of telehealth to folks actually in their home.”
That kind of access could greatly improve quality of life for rural Nebraskans, he said.
“Now, the upside is that we actually have the technology to do it.”
The downside? Health care regulations require the receiving end of the connection to take place in a licensed facility, and Markin said that’s unlikely to change anytime soon.
Nebraska has also taken the lead health information exchanges. The Nebraska Health Information Initiative, or NeHII, is a growing statewide network of electronic medical data, pooling information from Nebraska’s health care facilities and making it available to medical personnel.
Deb Bass, the chief executive officer for NeHII, said Nebraska started developing a health information exchange back in 2005, four years before major incentive packages were passed by the federal government. As a result of Nebraska’s early efforts, Bass and her staff have helped several other states, from Wisconsin to Wyoming.
NeHII can help newly graduated physicians who start their careers in one- or two-person practices in rural Nebraska and who often feel isolated, Bass said.
“I’ve heard new physicians to communities talk about, ‘I signed an agreement for 12-months, I hope I can stick it out,’” she said. “It is that frightening.”
But if that community hospital or clinic is connected to the health information exchange, Bass said, “You’re not flying blind when someone walks into your emergency room that’s been hunting and has a gunshot wound and he’s critical, and you know nothing about the individual.”
Pharmacy records were recently added to NeHII, which will strengthen its role as a drug monitoring program. But Bass said simply developing the technology isn’t enough – health care providers need to use it.
Training future workers
TEACHING THROUGH TECHNOLOGY
Photo by Hilary Stohs-Krause,
High-definition cameras are placed in every model patient room at the simulation lab at the University of Nebraska Medical Center so that instructors can closely monitor students.
Photo by Hilary Stohs-Krause,
A UNMC faculty member demonstrates the surgery portion of one of the simulation labs.
That’s where changing curriculum at Nebraska’s medical training institutions comes in.
“We’ve added a lot more technology over the 12 years that I have been here,” said Cheryl Thompson, associate professor in the College of Nursing at UNMC in Omaha. “The classroom itself is much more technologically based.
“The other place where we’ve seen the greatest advancement is in our labs.”
Simulation labs using lifelike dummies have become a major new training tool, Thompson said – UNMC has specialized models that can mimic the symptoms of cardiac arrest, facial lacerations – some can even go through “labor” and “give birth.” Central Community College, at its campuses in Columbus and Grand Island, also makes frequent use of simulation models in their dentistry and nursing programs.
But some recent graduates say they had very little exposure to the kind of technology they now have to use for their jobs, like electronic health records.
Thompson said it’s a continual effort to stay on top of the latest advancements, whether it’s electronic health records, nanotechnology or robotics.
“Technology is exploding … and I don’t see this trend slowing down,” she said. “So facilities are always going to be purchasing the newest and latest scanner and whatnot, and health care institutions are going to have to be aware of the need for ongoing education to keep the workforce up to date on the emerging technology.”
So what’s next for Nebraska?
Eighty percent of health care facility beds should be connected to the information exchange by the end of the year, and the state’s telehealth network continues to expand. As for individual clinics and hospitals, one of the next major steps is the development of patient portals, or online, one-stop shops where patients can book appointments, check their medical records, review medications and much more, all from the comfort of their own homes.
And how knows? Perhaps one day, at least for certain kinds of treatment, patients might not even need to leave home to get their health care.