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RMC Celebrates 25 Years As Telemedicine Site

Living in a rural community has plenty of benefits. But, access to specialized care hasn’t always been one of them. Weather, distance and time present a number of obstacles for people in northeast Montana trying to manage their healthcare.
For the last 25 years, the Eastern Montana Telemedicine Network has worked to change that through the creation of real-time, two-way interactive video communications. The technology enables a patient in one town to see a provider at a distant site without leaving their community.
As one of the original five facilities to jump on board with the pilot program, Roosevelt Medical Center has been involved every step of the way, connecting area patients to specialized care via telemedicine technology.
RMC was recognized for their 25-year commitment to the program and presented a plaque at the annual EMTN convention held in Billings last month.
“Montana has been a national leader in telemedicine. I am proud that we had partners early on who were willing to take a risk and work hard. Together, we built a community of partners who truly impact the quality of care patients are receiving in the region,” said Thelma McClosky Armstrong, director of EMTN outreach services at Billings Clinic.
Today, Billings Clinic serves as the home office of the EMTN network and provides support to 42 partners in 29 rural and frontier communities throughout Montana, western North Dakota and northern Wyoming.
Since the beginning Vickie Grimsrud has served as the RMC facilitator who arranges the use of the network for classes, meetings and clinical consultations. “What makes the program so powerful are the connections patients establish with their specialty providers even when there are hundreds of miles between them,” Grimsrud said.
One of the earliest examples of RMC’s push to provide quality care to this side of the state is evident in a newspaper clipping dating back to September, 1993. Back then, with the help of a 17-year-old patient with an earache, Dr. Randy Steffens gave an hour-long presentation to onlookers, demonstrating telemedicine technology. A slide was transmitted through the system to Dr. Richter, an ear, nose and throat specialist, sitting in on the call in Sidney. He was then able to note a moderately perforated eardrum and move forward with a care plan. Through the telemedicine technology, Dr. Richter was able to illustrate what he was talking about by drawing on the transmitted image, similar to a television football commentator sketching a play. A lot has changed since then.
Back then, the technology to run the program was new, scarce and expensive. The first piece of equipment installed at RMC cost $65,000. Today, the cost is down and the highly reliable technology operates using a dedicated fiber optic connection that allows for higher quality resolution images, connectivity and continuous accessibility from increased bandwidth.
Funding of the program has been possible through a number of grants.
“All of this seemed so futuristic at the time,” said Grimsrud. “I recall watching a US West telecommunication commercial featuring Tom Selleck advertising the computer technology that was coming. I remember thinking how it seemed more like a Jetson’s cartoon episode than real life,” she recalled.
Over the years Grimsrud has seen first-hand the benefits patients receive from using telemedicine technology. “Patients who might not otherwise seek the care they need because of distance and expense associated with seeing an urban specialist have had tremendous success with managing their care,” she said.
Staff at RMC benefit too. They are able to access continuing education they would otherwise have to travel to receive. “It enables staff to attend more training and be a part of more collaborative discussions. It ensures they keep up with new trends in healthcare without adding huge travel costs to the facility,” said Jody Lizotte, director of nursing for RMC.
The community has benefitted with a number of lunch-and-learns and other educational opportunities made available on healthcare topics.
Collectively, the cost saving has been huge for the facilities as well, enabling EMTN members to save a total of 6 million in out-of-pocket costs for continuing education.
Roosevelt Medical Center joined the program under the administrative leadership of Walter Bush, who saw the need for an outreach program that connected the community with more specialized care. At the same time, Billings Clinic was looking to expand their services to outlying areas in the state and US West and the state’s office of rural health was on board with the joint effort.
“Back then, this really was a leap of faith we were asking our partners to take. Nemont joined us for the pilot project and we were able to secure a grant through the utility service to support the cost of running the five pilot program sites,” McClosky Armstrong said.
Locally, telemedicine provides access to specialists in behavioral health, nephrology, neurology, dermatology, cardiology and several others. “We see many patients for kidney disease and chronic health issues. For some, these consultations have helped them to keep on top of managing their condition and staying off dialysis,” Grimsrud said.
On average, Grimsrud schedules a dozen consultations each month but has scheduled as many as six in one day.
In the future, the EMTN will look into the viability of providing telemedicine services for remote home monitoring for patients suffering from chronic diseases such as diabetes and congestive heart failure. They will also look into the use of technology for virtual visits that allow providers to connect with their patients remotely.
The other four pilot sites were Glendive Medical Center, Sidney Health Center, Miles City Health Center and the Eastern Montana Community Mental Health Center in Miles City.