New connections improve rural access to specialty care

2011-07-06T00:00:00Z 2011-07-21T15:12:52Z New connections improve rural access to specialty care


Star-Tribune staff writer

Casper Star-Tribune Online

It’s a two-hour drive from Saratoga to the closest wound care specialist.

The trip can be daunting in the winter. But in a community too small for even a community hospital, a drive to Cheyenne or Casper has long been the only way to get specialty care.

Patients in Saratoga now have another option. They can be examined by out-of-town specialists via a secure video connection at Saratoga’s lone medical clinic.

Telemedicine has already saved two nursing home residents from traveling to Cheyenne to see a wound care specialist, said Dr. Dean Bartholomew, a physician at the clinic. In the future, doctors will be able to remotely listen to a patient’s heartbeat using a digital stethoscope.

“I think (telemedicine) is going to be a huge player in upcoming years,” Bartholomew said.

The Saratoga clinic is one of 37 sites in Wyoming that received high-speed Internet connections last winter as part of a statewide effort to boost rural access to health care. The University of Wyoming’s Center for Rural Health Research and Education sponsored the project through a grant from the Federal Communications Commission.

Most small towns in Wyoming don’t have practicing cardiologists or psychiatrists. Telemedicine can help address those gaps in the state’s health care system, said rural health center Director Rex Gantenbein.

“Because of the high speed connection, it’s like you are seeing them face to face,” he said.

The high-speed connections transmit more than just video and sound. Doctors can also send and receive medical data that can be analyzed remotely.

The connections also have safeguards to protect patient confidentiality.

Five years ago, few providers were taking advantage of video connections to deliver care, Gantenbein said. Some hospitals had video conferencing equipment, but lacked the bandwidth to make good use of it.

Now, some doctors are beginning to use it regularly.

“It’s really starting to take off in the state,” Gantenbein said.

The video system installed at Central Wyoming Counseling Center in Casper allow psychiatrist Frank Del Real to perform medication management visits with patients in Lander and Riverton.

Del Real began experimenting with telemedicine about a year ago. At first, it had some glitches, but those problems have been worked out, he said.

“Over the course of time, it really has improved to the point that I feel really comfortable that the patients are getting their needs met,” he said. “I was able to communicate with them properly. They are able to communicate with me properly.”

Del Real still conducts his evaluations in person in order to pick up on subtle behavioral cues. But performing medication management visits cuts down on the number of trips he makes to Fremont County.

He predicts more Wyoming doctors will use telemedicine to connect with patients in rural communities.

“Some of these places are really begging for somebody to provide for their people,” he said.

Contact Joshua Wolfson at 307-266-0582 or at Visit to read his blog. Follow him on Twitter @joshwolfson.

Copyright 2015 Casper Star-Tribune Online. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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