When telemedicine programs reach a critical size, the programs can achieve sustainability and even experience accelerated growth. That’s happening in northern Arizona along a 340-mile-long corridor surrounding Interstate 40, between Arizona’s borders with New Mexico and California.
Many of the hospital facilities and community health centers in this large swath of Arizona are members of the Arizona Health Sciences Center’s Arizona Telemedicine Program (ATP), established in 1996 by the Arizona State Legislature to provide accessible, top-quality health care to rural Arizonans.
“The ‘Northern Arizona Telemedicine Corridor’ fulfills our highest expectations of what we could achieve via telemedicine when we started the ATP in 1996,” said Ronald S. Weinstein, MD, the ATP’s founding director. “Not only have these organizations established a ‘telehealth ecosystem,’ they are national models of health-care excellence in their own right.”
The rapid growth of northern Arizona’s telemedicine cooperating programs in recent years was reported at the Arizona Telecommunications and Information Council’s fifth annual meeting, Oct. 30, in Phoenix. Included were presentations by the Northern Arizona Behavioral Health Authority (NARBHA), North Country HealthCare (NCHC), the Northern Arizona Area Health Education Center (Northern Arizona AHEC) and Northern Arizona Healthcare (NAH). Each ATP-affiliated program is providing critically needed services using telemedicine techniques. NAH’s Flagstaff Medical Center, for example, offers telestroke and teleneurology through its collaboration with the Mayo Clinic Scottsdale and critical teleburn services through the Arizona Burn Center at Maricopa Medical Center in Phoenix.
The impact is significant. Mayo Clinic neurologists, for example, have provided remote teleneurology services for nearly 1,000 patients in Flagstaff alone. The devastating long-term effects of strokes have been averted for dozens of Arizonans, saving lives, improving quality of life, and reducing future health-care costs.
The ATP strongly supports the growth of telemedicine throughout Arizona and provides a suite of services to its member organizations, including clinical, administrative and IT (information technology) support, telemedicine training, facility design and continuing medical education (CME). The ATP has delivered thousands of hours of CME to physicians and nurses in Arizona.
Arizona Corporation Commissioner Bob Burns, who is credited with co-founding the ATP with Dr. Weinstein, said, “I always felt that Arizona was a good candidate to take advantage of telemedicine. Our large geographic area, the health-care needs of our rural populations, and the willingness of our state universities to innovate and stay on mission, all added to this prescription for success. What’s happening in northern Arizona should become a model for the rest of the state.”
Arizona Corporation Commissioner Bob Burns
In addition to co-founding the Arizona Telemedicine Program in 1996, Burns also organized and has chaired the Arizona Telemedicine Council, which meets quarterly on the Arizona capitol campus in Phoenix. He has been involved in many aspects of the strategic planning and assessment of telemedicine in Arizona, and has championed its mission. Burns has had a long interest in computers and was a machine language computer programmer at General Electric in Phoenix for 16 years early in his career.
ATP Founding Director Ronald S. Weinstein, MD
Ronald S. Weinstein, MD, is a pioneer in telemedicine and telepathology. Dr. Weinstein participated, as a resident physician, in the first multi-specialty telemedicine program at the Massachusetts General Hospital in 1968 and has been interested in telemedicine ever since. He invented, patented and commercialized telepathology, a branch of telemedicine; introduced the word “telepathology” into the English language; and is known to many as the “father of telepathology.” For his work on telemedicine he has received the Distinguished Service Award of the Arizona Medical Association and is president emeritus of the American Telemedicine Association.
Arizona Telemedicine Program
The Arizona Telemedicine Program (ATP) operates its own broadband telecommunications system, which links 160 sites in more than 70 Arizona communities. More than 60 clinical subspecialty services have been provided through the network, amounting to more than 1.3 million telemedicine cases. The ATP is home to the federally funded Southwest Telehealth Resource Center, which services New Mexico, Colorado, Utah and Nevada in addition to Arizona. The ATP has received many national awards for its innovative education and training programs.
Northern Arizona Area Health Education Center
The Northern Arizona Area Health Education Center (Northern Arizona AHEC) is part of the Arizona AHEC Program, which is comprised of five regional centers and an administering central office based at the Arizona Health Sciences Center at the University of Arizona. Each regional center coordinates and supports activities that target workforce development to meet the needs of Arizona´s medically underserved rural and urban populations. The centers collaborate with the Arizona Health Sciences Center’s five colleges (College of Medicine – Tucson, College of Medicine – Phoenix, Colleges of Nursing and Pharmacy and Mel and Enid Zuckerman College of Public Health), health-care agencies, K-12 and postsecondary education institutions, and community organizations. Northern Arizona AHEC’s service region includes Yavapai, Coconino, Apache and Navajo counties.
Northern Arizona Healthcare
Northern Arizona Healthcare (NAH) is the parent organization for Flagstaff Medical Center, Verde Valley Medical Center (VVMC) and the VVMC Sedona Campus. NAH has programs in remote monitoring of patients, in telemedicine outpatient and inpatient care, and in patient transitions planning using telemedicine. It has done extensive partnership work on clinical telemedicine delivery with health-care facilities of all scopes and sizes across northern Arizona. NAH Director of Telehealth Gisele (Gigi) Sorensen, RN, is a national leader in telemedicine and serves as vice chair of the Business and Finance Special Interest Group of the American Telemedicine Association.
Northern Arizona Regional Behavioral Health Authority
The Northern Arizona Regional Behavioral Health Authority (NARBHA) telepsychiatry program was started in 1996, the same year as the ATP. NARBHA has 100 employees and is one of the largest telepsychiatry programs in the country. Their telemental health network covers 62,000 square miles, has more than 80 member sites, and has accommodated more than 108,000 patient sessions. The network received the 2010 Award of Excellence in Health IT from the National Council for Community Behavioral Healthcare. Nancy Rowe is the director of telemedicine for NARBHA.
North Country HealthCare
North Country HealthCare (NCHC) operates a federally qualified community health center in Flagstaff and links to 14 community health centers along 340 miles of Interstate 40, from Show Low near the Arizona–New Mexico border to Kingman and Lake Havasu City on Arizona’s western border. All of these community health centers are telemedicine-enabled and NCHC operates 35 to 40 hours of telemedicine clinics each week. It also holds innovative weekly telemedicine chart rounds for physicians treating patients with hepatitis C in many rural communities. Richard A. Manch, MD, a liver disease expert at St. Joseph’s Hospital and Medical Center in Phoenix, links weekly to up to 11 rural NCHC sites simultaneously via telemedicine video conferencing for chart rounds and serves as the hepatitis C teleconsultant for northern Arizona without leaving his hospital in Phoenix.