Let’s say you are one of the 904 or so residents of Warren, New Hampshire. Let’s say you get sick. Maybe you just started on a new prescription and are having unwanted side effects.
"Today, they have one of two options," says Shawn Tester, who runs the day-to-day operations at Ammonousuc Community Health Services, which has five primary care clinics in Grafton and Coos County.
"They either do without. Or they have to travel, oh, I don’t know, 45 miles to our Littleton office to receive that consultative service."
But now Tester can offer patients another option: telemedicine.
Doctors use a high-speed private internet connection to virtually meet with patients. They can also share medical records, x-rays and MRIs.
And this week, telemedicine in New Hampshire is getting a big boost. Something called the New England Telehealth Consortium–better known as NETC–is finally going online.
And Shawn Tester is psyched.
"We’ve been waiting for years for this and now it is finally happening, and I’m like whoa, okay!!"
Here’s what’s got Tester so excited: 400 or so health providers across Vermont, New Hampshire, and Maine are getting connected electronically.
Along with a fast way to share medical data, NETC will also give rural providers a way to connect with specialists in bigger hospitals.
And the need is there, says Doctor Sarah Pletcher with Dartmouth Hitchcock.
"We have exactly one stroke center in all of the state of New Hampshire. And in that stroke center, there is exactly one stroke-trained neurologist."
Telemedicine allows that neurologist to view CAT Scans, talk with a patient via video screen, and recommend treatment until the patient can physically meet with a specialist.
A few North County practices already do some small scale telemedicine: rather than spending hours in a car, a patient can link up with, say, a psychiatrist, through a screen at their local health center.
But this isn’t the type of upgrade most small doctors’ offices can afford on their own.
"The technology is out there, the technology works," says Tester. "We can do this stuff today. But, what you found for small, rural health providers is that it’s been cost prohibitive for us to join the party."
NETC lowers that bar by giving providers a steep discount on the hardware and fiber optic connections.
It’s funded by a $24 million grant from the Federal Communications Commission.
Jim Rogers helped launch the project in 2007.
"It’s been extremely frustrating that it’s taken so long," says Rogers. "We really thought we’d get this off the ground in two years."
The delays were caused by some fairly arduous rules and bureaucracy in Washington.
Kim Mohan with the NorthEast Telehealth Resource Center helps rural providers implement this type of technology.
She thinks this is just the beginning.
"If someone can see their psychiatrist through telemedicine, it makes them wonder, what other services can I get locally? Could I see my eye doctor? Could I check in around a primary care issue? Could I do my post-operation consultation via video instead of driving back down to Boston, from Berlin."
That saves time and money, but is there a cost if doctors and patients don’t meet face-to-face?
"I do worry about that," says Dr. Pletcher.
"There is something lost, certainly. And nothing can take the place of an in-person encounter."
But for patients in places like Warren, New Hampshire, Pletcher sees NETC as powerful new tool that can help bridge a gap in care.