Challenging Times
• We have not produced enough physicians to serve the population we
have in this country. This is only going to get worse because we are not
producing enough physicians to meet the needs of the population we
have today or the baby boomers of tomorrow." Peter Fine, President and
CEO of Banner Health in Phoenix
• Rural areas will logically be the hardest hit. Fewer med school
graduates start off in rural communities due to loan debt and lower
projected earnings.
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Bad Timing
• Meanwhile, U.S. medical schools have not provided for the loss of 33
percent of the nation's physician work force.
• Evidence suggests that younger physicians are not willing to put their
lives on hold and work 80-hour weeks that include weekends, nights
and emergency department on-call duty like their predecessors, which
means it may take two younger physicians to cover the work of one
retiring physician.
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Overview of Mendocino County Medicine
• Only about 20% receive the therapy, often because physicians are
unsure if the patient is an appropriate candidate for the treatment.
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Number of full-time Neurologists in
Mendocino County:
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Areas of Deficiency in Our County
• Neurology
• Cardiology
• Pediatric Specialties
• Psychiatry
• Orthopedics
• cardiology • gynecology
• rehabilitation
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What would such a program look like?
Broadband
Broadband
UC Davis
Oakland Children’s
UCSF
Stanford
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A potential case study-A successful
outcome
• 77 year-old woman notices numbness on her left side while cleaning her
apartment, After finishing cleaning, she calls her daughter, concerned.
• Daughter calls ambulance and leaves for the hospital.
• Ambulance arrives at residence, stabilizes the patient and transports to
hospital.
• Upon arrival, ER physician notices slight facial drooping on left side.
Orders stat CT scan. It has now been 90 minutes since the incident.
• CT Scan is performed, ER physician contacts UCSF to request review
by neurologist.
• Neurologist reviews the scan. Decides that stroke protocol should be
started. Orders ER Physician to begin TPA (clot buster). It has now
been 2 hours, 15 minutes since the first symptom. Patient will return
home in 4 days.
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We already have success stories:
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Collateral Benefits of Telemedicine:
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Obstacles and Challenges:
• There will come a time when such connections will be critical to the
continuum of care.
• DS3
• Opt EMan
• GigaMAN
• SONET Ring
• Local Ethernet
• ISP-Centric Broadband
• Fiber Technologies
Each technology has advantages and disadvantages.
Some being data rate/reliability, some being price.
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Conclusions:
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