Health care applications for the iPhone, text messages from physicians and even Nintendo's Wii Fit video game are versions of telemedicine, according to Jonathan Linkous, chief executive officer of the American Telemedicine Association.

They reach directly to the consumer, or patient, he said, and are different than the original concept of telemedicine, where a small rural hospital connects with a larger hospital.

Linkous spoke from Washington on Wednesday to a group of Wyoming health professionals, information technology experts and legislators at more than a dozen conference sites around the state - appropriately via teleconference.

"Congressional interest in telemedicine is at an all-time high," Linkous said.

The government expanded Medicare coverage for telemedicine services to nursing homes, dialysis centers in hospitals and community mental health facilities at a time when Congress seems to be cutting back every where else.

Congress is currently considering a bill that would expand telemedicine coverage to physical, occupational and speech therapists. Reimbursement of telemedicine services is key to making a telehealth system work, according to Catherine Britain, of the Telehealth Alliance of Oregon.

"Many physicians won't even consider it until we come up with a reimbursement system," Britain said.

States have the ability to set some of the telemedicine reimbursement schedules with Medicaid, and 35 states, including Wyoming, have some form of the program. Wyoming also began telehealth psychiatric services at the State Hospital in Evanston a few years ago.

"It will work," said Sen. John Schiffer, R-Kaycee. "We could really expand this and have it not just in psychiatry."

Because Wyoming is a rural state and has a shortage of physicians, it could benefit from telemedicine, said Dr. James Bush, state Medicaid medical director with the Wyoming Department of Health. All the hospitals in the state, with the exception of the private hospitals in Evanston and Lander, are linked and have telemedicine capability, Bush said from Cheyenne.

The health department, with assistance from the Wyoming Health Information Organization, is offering 34 hours of continuing education credit for health professionals. The courses will be based out of the Wyoming Medical Center or Cheyenne Regional Medical Center, but physicians, nurses and others can attend from anywhere in the state.

"Hospitals have to pay for the staff to hit the road, [and] they lose their services for days to get the education," Bush said.

Officials are looking at telemedicine services for diabetes patients, high-risk pregnant mothers, emergency medicine and routine care.

Bush anticipated telemedicine-related budget requests in the 2009 legislative session, but Dr. Brent Sherard, director of the health department, said funding should come from both state and private entities.

A culture shift in the way physicians and hospitals practice also needs to happen, according to Sherard.

"The change is sometimes can be difficult to get past," he said. "We're used to shaking their hands and putting our stethoscopes on their chests."

Contact health reporter Allison Rupp at (307) 266-0534 or allison.rupp@trib.com.