The newsletter for the Midwest Rural Telemedicine Consortium - May/June, 1997

News on the wire:

The MRTC was recently featured in the Iowa Communications Network's (ICN) February issue of Fiber Optic Lines. The article overviewed the current status of telemedicine reimbursement in Iowa.

The Telemedicine Information Exchange (TIE) recently added the Medicare reimbursement article from the January/February issue of Telemedicine to their webpage. Be sure to visit the TIE webpage at

Paul Maakestad and Fred Eastman from the MRTC project office, and Joseph X. Latella, D.O., from Hamilton Hospital in Webster City, participated in panel discussions at a conference at the University of Iowa. In April, the University hosted Health Connections - Delivering Continuing Education to Rural Health Care Practitioners'.

MRTC names medical directors

In April, the MRTC appointed Burt Bottjen, M.D. and Joseph X. Latella, D.O. as medical directors for the project. The doctors will serve as MRTC's liaison to primary care physicians practicing throughout the NIMHC or MHMC rural networks respectively. More information about the new medical directors will be presented in the next issue of Telemedicine

Palo Alto County Hospital receives funding for rural clinic

Thanks to support from local, county and state organizations, patients at the Graettinger Medical Clinic will be able to take advantage of advanced telecommunications to obtain additional health care services through the MRTC. Financial support for the project was made available through grants and contributions from the Iowa Department of Public Health, River Valley Telephone Company, Graettinger Municipal Utilities, the city of Graettinger, and Palo Alto County Hospital. Darrell Vondrak, Administrator of Palo Alto County Hospital, said, "The Hospital's commitment to this program is a continuation of the commitment made five years ago to the community. That being to provide local access to high quality family health care to the people in Graettinger. In return, we have received tremendous support from the community, which makes obvious the justification for investing additional resources in the clinic."

When implemented in mid-May, the project will provide a live, real-time, two-way audio and video link between the Graettinger Clinic and other health care organizations located throughout Iowa. Patients and their primary care provider, located in Graettinger, will be able to see and speak with a medical specialist located in Emmetsburg, Mason City, or another larger community.

The telemedicine system placed at the Graettinger Clinic will be a single-monitor system with a picture-in-picture feature that allows patients to see themselves in the corner of the screen. The system will include at least one video camera to provide an image of the patients to the "remote" specialist. A second camera may be used for showing close-up images and X-rays.

For more information about the Graettinger Clinic project, please contact Kathy Merrill or Trisha Travis at 712/852-2434.

It was a dark and stormy night....

Well, sort of. It was a typical March Friday night in Algona, Iowa: a wrestling tournament at the high school, icy roads, and one unfortunate wrestler named Justin Parsons, needing a trip to the Emergency Room.

According to Denice Parsons, Justin's mother, "the weather was really bad that night. We thought they might even cancel the tournament."

According to Algona family practitioner, Burt Bottjen, M.D., a local wrestler had been slammed to the matt and as a result, "broke his humerus at the growth plate and his shoulder was displaced."

Dr. Bottjen called North Iowa Mercy to consult with Ray Emerson, M.D., an orthopaedic surgeon. "It was difficult to describe the patient's displaced shoulder," said Dr. Bottjen. "Dr. Emerson suggested using telemedicine." Using telemedicine to review the patient's x-rays and consult interactively with Dr. Bottjen, Dr. Emerson determined that surgery was not necessary, and Justin would not need to be transferred to Mason City. The patient was treated in Algona and sent home that night.

"Justin was hurting pretty bad - I don't think he would have enjoyed riding in our truck all the way to Mason City," Denice continued. "It was very convenient to be able to stay in Algona.

Dr. Emerson's colleague, Michael Crane, M.D., was able to follow-up with the patient during his regularly scheduled orthopedic clinic in Algona.

What did Justin think of telemedicine? "It was pretty cool." Justin also said that he liked being there while the doctors were talking. "I could see the x-rays pretty good and I could understand what the doctors were talking about."

On this Friday night, telemedicine saved the cost of a trip to Mason City in dangerous travel conditions, repeat x-rays and an additional Emergency Room charge.

The following articles were submitted by the co-chairs of the MRTC telepathology committee describing several telepathology applications.

Local Applications of Digital Microscopy
by Harrison W. Pratt, D.O., Pathologist, Mercy Hospital Medical Center, Principal Investigator, MRTC

Telepathology links rural Iowa hospital laboratories to references laboratories
by Steven P. Goetz, M.D., Pathologist, North Iowa Mercy Health Center

Ongoing Educational Opportunities

Grand Rounds
First and Third Tuesday of each month
Various Topics and Speakers
7:30 - 8:30 a.m.
1 hour CME Category
0.1 CEUs (1 contact hour)
offered by Mercy Hospital Medical Center, Des Moines
There is no charge for this program.

Lunch Lecture
Every Thursday
Various Topics and Speakers
12:00 - 1:00 p.m.
1 hour CME Category
0.1 CEUs (1 contact hour)
offered by Mercy Hospital Medical Center, Des Moines
There is no charge for this program.

Trauma Conference
First Wednesday of each month
7:00 - 8:00 a.m.
1 hour CME Category
0.1 CEUs (1 contact hour)
offered by Mercy Hospital Medical Center, Des Moines
There is no charge for this program.

To submit an article or for more information, please contact Tina Collins at 800/637-2994 ext. 8750 or 515/247-8750 or Brenda Epsteen at 800/433-3883 ext. 7875 or 515/424-7875.

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