Norton S A, Floro C, Bice S D, Dever G, Mukaida L, Scott J C
Department of Dermatology, Tripler Army Medical Center, Honolulu, HI, USA.
Telemed J. 1996 Fall;2(3):225-31. doi: 10.1089/tmj.1.1996.2.225.
Distance and isolation profoundly affect the delivery of health care in the islands of Micronesia. The lack of specialty services on most of the islands has led to a costly off-island referral system that strains health care budgets. Care providers there have incorporated advances in telecommunications to create a telemedicine network amongst themselves and with a tertiary care hospital in Hawaii. They developed an interactive video conferencing system, a still-image transmission network, and a data transfer network for use principally in patient care and continuing education. Patients now receive earlier evaluation by off-island specialists as part of an effort to improve the appropriateness of off-island referrals. Regularly scheduled medical lectures are broadcast from Pohnpei, a main island, to physicians in several more remote locations. Transmission costs are kept low by using, when possible, preexisting public-service satellites, such as the PEACESAT system that serves the entire Pacific basin. The telemedicine system is evolving, and its success depends greatly on the cooperative relationships among the partners.
