May 10, 2002
Telerehab System Brings Back "House Calls"
New system being developed and tested at Houston VA Medical Center
HOUSTON, TX - Imagine the Telerehab system in development at the Houston VA Medical Center (HVAMC) as a way of beaming "House Calls" into veterans' homes.
HVAMC's technologist John Wright and rehabilitation engineer Tom Krouskop created the Telerehab system for just that purpose. They wanted to create "House Calls" without the travel for doctor or patients.
Computers are the backbone of the HVAMC Telerehab system, carrying information through the telephone wires from home to office. Cameras extend vision, transmitting pictures from home to office and back again. Speaker and cell phones let the doctor and patient talk to each other. And finally, a hand-held temperature sensor partially replaces the sense of touch for the doctor who might be miles away.
But all these gadgets don't work by themselves. HVAMC researchers are examining ways to turn the system into a valuable part of a veteran's medical care. Health science specialist Diana Rintala, Ph.D. and Rehabilitation Care Line Executive Dr. Trilok Monga are evaluating Telerehab's usefulness and determining the impact Telerehab could have on a veteran's health.
From the beginning, it was obvious which group of veterans might benefit the most from Telerehab - veterans at risk of amputation or post amputation, due to chronic unhealed wounds. These veterans attend a special clinic at the HVAMC, the Preservation-Amputation Care and Treatment Program (PACT).
Veterans in PACT face real challenges in the healing process. Conditions like diabetes and peripheral vascular disease interfere with healing. Leg wounds develop easily and heal slowly, needing multiple follow-up visits and specialized care.
Many veterans have long commutes to get to HVAMC, and fatiguing journeys are detrimental to an already difficult process of healing. Amputation wounds also need special follow-up care, requiring multiple visits.
Recently, the veterans attending the PACT clinic were asked to help test Telehab.
First, the veterans were taken into the Telerehab laboratory, where a camera and a computer were set up just as they might be in a veteran's home. Then, in another section of the hospital, a doctor would examine their wound. Talking with the patient over a speakerphone and asking a special set of questions, the medical expert would examine the patient's wound.
The same expert would then walk down the hall and into the Telerehab laboratory to inspect the wound in person, to see if his or her diagnosis matched his or her original rating.
Early results have been promising. In most cases, the diagnosis was the same. At least for wounds, the system seems to allow the examiner to judge the state of the wound without being in the same room.
For more testing, the Telerehab system was taken to a veteran's home for a trial run, to see how the system fits into a real home and how a veteran might learn to best use it at home.
All the tests went well, but many more questions remain. For now, participating veterans from the PACT program have the hope that Telerehab "House Calls" can save their energy for healing.
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Photos by HVAMC health science specialist Diana Rintala, Ph.D.
Point of Contact: VHAHOU Public Affairs04/21/04 08:25