By BEN DOBBIN
Associated Press Writer
(AP) ROCHESTER, N.Y.
Dropping off her two children at a neighborhood day care center, Marybeth Hoyt worried that her 2-year-old, Emily, who was cranky and hadn't eaten breakfast, might be coming down with an ear infection.
Ordinarily, Hoyt would skip work for a few hours to visit a family doctor. On this recent morning, with the help of computers, cameras and other telemedicine tools, she got Emily diagnosed by a University of Rochester pediatrician in just 10 minutes.
"I saw the doctor on the (day care center's) computer and he saw me and we talked back and forth," she said, still in awe over the extra layer of care offered since May at a Volunteers of America Children's Center near downtown Rochester.
A staff nurse at the center used a camera-linked stethoscope and an endoscope to examine the toddler's lungs, ear and throat. The doctor, watching from afar, concluded "there was a definite ear infection but that the chest sounded good," said Hoyt, a 27-year-old clerical worker.
"I was very happy it was just done with and we had the medicine within an hour," she said. "It's nice to be able to go to work and know my children are looked after by a credible doctor. You don't even have to be there and they'll check them."
Telemedicine has evolved over the last decade as a way to bring medical care to rural areas. Doctors can monitor patients via video screen as well as verbally directing medical procedures long-distance.
Aided by school nurses, hospitals already have telemedicine units set up at several schools in Kansas and Texas.
The project here, largely sponsored by a $330,000 federal grant, is one of the first in the country to offer "virtual house calls" at a day-care center _ this one serving 250 children ages 6 months to 12 years from mostly low-income families with little or no health insurance.
"Clearly it's where the need is greatest _ this is a logical place to start," said Dr. Kenneth McConnochie, a pediatrician at the University of Rochester's Strong Memorial Hospital and director of the telemedicine program.
"Clinicians involved find they're able to make observations that are as accurate as being there," he said, noting that a child's regular doctor is notified of each course of treatment.
Within six months, two other day care centers in this city of 217,000 will be equipped with telemedicine services and five more should be linked up by 2004, McConnochie said.
Reducing the need for costly trips to the emergency ward or after-hours doctor visits, telemedicine might serve to improve children's health and reduce health care costs, proponents say.
"This is a glimpse into the future of medicine," said McConnochie's colleague, Dr. Neil Herendeen. "Using telemedicine, we do everything we normally would except touch the child. We rely on the nurses to be our hands. ... The hope is that more children will receive the medical care they need because of the hassle-free option telemedicine provides."
The two doctors have diagnosed mostly everyday illnesses like colds, rashes, coughs, asthma, ringworm and pink eye in more than 125 children at the center and ordered in prescriptions from a pharmacy around the corner.
"Even when illness requires exclusion from child care and the parent needs to pick up the child, the need for an office or emergency department visit is often avoided," McConnochie said.
Because the digital equipment can capture high-quality images, "they once found a bead in somebody's ear _ it was in so far we couldn't see it," said the center's director, Pam Taylor.
"Sometimes the kids are not able to verbalize what their problem is. We can find out what's wrong with them now rather than wait till something really gets bad and they start tugging or pulling. It's a real bonus."
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