Rural Iowa communities seeing their population dwindle and services move to bigger cities now another option for health care — telemedicine. Michael Kienzle is a professor of medicine at the University of Iowa who says telemedicine won’t replace a hometown family doctor. Many towns will have a primary care provider, some might have a few more specialized doctors — but for lots of specialty care, the centers and doctors are a long distance away. For elective procedures and care that’s not urgent, Kienzle says many rural residents drive to “satellite” clinics in mid-size towns so they don’t have to travel even further to a big city.He himself works at a clinic in Keosauqua, where the U-of-I sponsors a number of specialty clinics on a regular basis — but he points out he has to do a lot of driving to offer care there, and it’s unreliable when the weather’s bad. Kienzle says medical centers have been working for a while to offer remote services from medical centers at a distance. University Hospitals for years provided some home nursing services to elderly and “medically complicated” patients all over the state, through a simple computer-type webcam hooked up to a phone line. Once patients got used to the video link they accepted it, the doctor says, and found it valuable. Doctor Kienzle says those simple web-cams don’t offer the kind of high quality video that might be needed for careful viewing with a lot of detail — but Kienzle explains there will still be a doctor in charge of every case. The key is matching the level of technology with the job you’re going to do — and a lot of today’s telemedicine gear is developed for whatever job it’ll be used for. Kienzle says it’s not a tremendously high-tech kind of medicine, and it doesn’t have to be. Certain types of structured telephone care, often handled by specially-trained nurses, show very good results in management of things like blood pressure, cholesterol and even conditions like depression. Kienzle says a lot of fairly simple technologies are easy to deliver on the Internet, with help from websites set up for that service and the professionals on the other end of the line. He adds while it’ll fill a big need in rural Iowa, telemedicine will never take the place of a family doctor’s care.
