By Dr. Carl J. Getto, Dean and Provost, SIU School of Medicine

A patient suffering from severe foot ulcers appears in the office of a primary care physician in southern Illinois. The ulcerations and serious complications brought on by diabetes make this a case that probably needs the opinion of a specialist. That once required sending the patient off to a major medical center. But traveling hundreds of miles for a consultation, away from hometown medical and family support, may soon become the exception.

Dr. Carl J. Getto

Working with Ameritech, SIU School of Medicine has initiated the Ameritech-SIU Telemedicine Network, a project that uses advanced communication technology to enhance rural health care and medical education. The network connects medical and educational facilities in Springfield and Carbondale, providing real-time two-way communication with voice, image and data capabilities.

The program's primary focus is to develop a system for long-distance medical consultation and patient diagnosis. Rural Illinois physicians struggle with the distance that isolates them and their patients. But through telemedicine, physicians and patients will have expanded access to specialized medical care.

SIU sites in both Springfield and Carbondale are equipped with television monitors to display local and remote images, including those from scanners, still and video cameras, X-ray viewers, and slide and video machines. There is also audio capability for biomedical sounds such as those from an electronic stethoscope. The faculty physicians who have tested the equipment are impressed with the exact and precise readings that are transmitted so, for example, they can see details of a suspicious skin lesion or hear a possible abnormality in a heartbeat.

The initial months of the program were spent dealing with many expected (and unexpected) technology hurdles. Our faculty has started using the equipment in less patient-sensitive situations such as teaching medical students, conducting medical grand rounds (a form of teaching discussion) for residents, and consulting on psychiatric treatment plans.

As an institution that has led the country in innovative approaches to medical education, SIU wanted to develop this exciting technology here in Illinois, both for patients and the students we teach. But because of the high cost and technological complexities, it took a business-education partnership to get things started. The network is implemented under Ameritech's Advantage Illinois infrastructure plan. The company provided equipment and expertise and is waiving telecommunications line charges for this first year, for a package valued at more than $1 million. SIU is providing space, design expertise, and project management and administration.

In addition to finding the best ways for doctors to use this new technology, we must also find permanent funding for it, particularly as our state resources continue to shrink. When fully operational, the network will also help expand our continuing education program for practicing physicians downstate.

Again this year, I'm pleased to report that the percent of graduating seniors nationally who selected primary care for their residency training increased. I'm very proud that SIU continues to be one on the few schools ahead of the national curve with 65 percent of our class of 1996 choosing primary care.

But while more physicians are entering primary care, the challenge is distributing well-trained primary care providers to areas where they're needed the most. SIU is working hard to train the state's next generation of physicians. Telemedicine may be a technology that can help us to provide quality health care for all of Illinois.

Dr. Carl J. Getto was named dean and provost of Southern Illinois School of Medicine in 1993. He says that national leaders concerned about training enough primary care physicians for the future need only look to SIU, which has been consistently writing the right prescription for the problem.

4 ILLINOIS COUNTRY LIVING • MAY 1996