[Congressional Record Volume 140, Number 104 (Tuesday, August 2, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 2, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                THE ROLE OF TELEMEDICINE IN HEALTH CARE

  The SPEAKER pro tempore (Mr. Mann). Under the Speaker's announced 
policy of February 11, 1994, and June 10, 1994, the gentleman from 
Idaho is recognized for 5 minutes.
  Mr. LaROCCO. Mr. Speaker, several months ago at a hospital in St. 
Maries, a small town in the northern panhandle of Idaho, emergency 
medical technicians were concerned about a boy who had been injured in 
a serious car accident. Unfortunately, a radiologist is available in 
St. Maries only twice a week, and the accident has not happened on one 
of those days.
  Instead of driving 90 minutes to the nearest radiologist, however, 
the boy was given a cervical x ray in St. Maries. The x-ray film was 
then put through a phone line digitizer and sent to the town of Couer 
D'Alene, where a radiologist accessed the image on the screen of his 
personal computer and examined it.
  The radiologist called the St. Maries hospital with good news: There 
was no fracture. What could have been a much more costly and painful 
experience for the boy was avoided through teleradiology, a combination 
of health care expertise and modern communications technology. An x-ray 
technician in St. Maries told me later, ``It was not a life or death 
situation for the boy. But it was wonderful because so much time was 
saved. And, best of all, the family was reassured.''
  This situation is not unique of Idaho--or to other rural areas in 
America. In rural America, communication can mean the difference 
between life and death. That is why it is important for Congress to 
move on this issue.
  This year, Congress has a unique opportunity to improve both the 
Nation's health care and communications infrastructures. We can then 
take emergency medical services to places that, until now, have been 
considered off the path. Doing so will require a major commitment on 
the part of businesses, educators, libraries, health care providers, 
and all levels of government.
  Mr. Speaker, Idaho's First Congressional District, which I represent, 
is the 19th largest in the country. It stretches 530 miles up the west 
side of Idaho, from Nevada to Canada. It contains the largest 
wilderness area in the lower 48 States. By some standards, it is one of 
the most rural districts in the country.
  Its rural nature lends advantages: Fertile farmland, beautiful 
landscapes, some of the best fishing, skiing and hunting in America. 
There are also disadvantages, not the least of which is impaired access 
to health care. Idaho faces an acute shortage of primary care 
physicians, a lack of health care infrastructure, and vast distances to 
overcome. The drive to a tertiary care center is often a matter of 
hours, sometimes on bumpy roads that can cause excruciating pain or 
exacerbated injuries to a patient.
  In 1994, with the advanced technology that exists to create the 
concept of long-distance telemedicine, there is no excuse for rural 
residents to keep paying for unnecessary services. There is no excuse 
for them to keep making unnecessary 100-mile treks.
  Telemedicine may not always make the difference in saving lives. But 
it will make an enormous difference in saving time and money. A 1992 
study by the international consulting firm, Arthur D. Little, estimated 
that a nationwide telecommunication infrastructure for high-speed, 
high-resolution video, image and data exchange among medical centers 
could cut the Nation's health care bill by as much as $36 billion.
  The bulk of this, about $30 billion, will be saved through electronic 
management and transport of patient information. It has been said that 
for every dollar spent for health care delivery, four are spent for 
administration. Improved access to patient information would help cut 
some of those administrative dollars.
  This would go hand-in-hand with Vice President Gore's initiative to 
create an information superhighway. But as the example of the St. 
Maries patient demonstrated, we do not have to rely on future 
technology to improve access. We can use technology that already 
exists. In constructing a rural telemedicine infrastructure, we should 
use as many off-the-shelf components as possible. We should avoid 
committing large amounts of capital to innovations that will be 
obsolete in the near future. We cannot wait for the perfect high 
technology development. We need to start trying and demonstrating now. 
We need to be building modest networks that work and fit together. We 
need to put the little pieces together right; then we need to connect 
them.
  Connecting these little pieces of rural America will lead to 
secondary benefits: First, it will keep money flowing into small, local 
hospitals and allow them to stay open. Second, physicians will be more 
willing to practice medicine in rural areas when they know they have 
increased access to backups from specialists in urban areas.
  All of these benefits will only be realized after Congress takes 
initiative. That is precisely why I introduced the Rural Telemedicine 
Development Act, which would establish three grant programs to 
encourage development of telemedicine. The first program would help 
create rural health care networks, with the goal of producing more of 
the successes that have been experienced in St. Maries, ID. The second 
program would strengthen the link between existing rural health care 
networks through interactive video consultation. The third program 
would help link more networks to fiber optic cables.
  I am working for the inclusion of these telemedicine provisions into 
the health care reform legislation we will soon be considering. If our 
goals in reforming health care are to provide increased service and 
more efficient spending, then taking advantage of existing telemedical 
facilities offers the perfect vehicle. The health of rural Americans 
depends on this. As one Idahoan told me, ``In rural and frontier areas, 
telemedicine is no longer just an option. It's a necessity.''
  Mr. Speaker, I know it will serve my constituents, and all of rural 
America, if we accept the opportunity that has presented itself and 
focus on rural health care delivery. I urge my colleagues to come 
together and create a telecommunications model for the future.

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