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Telemedicine
Supporting the CHA/Ps in their work is the world’s largest telemedicine system. The Alaska Federal Health
Care Access Network (AFHCAN) links more than 230 clinics and hospitals across the state. Created in 2000, the network updated
and expanded a pilot project, making it possible for CHA/Ps to link up with providers hundreds of miles away—increasing their
ability to diagnose, provide care and reduce the need for patients to travel.
For example, the network allows a CHA/P to conduct an ear exam on a child by using a digital otoscope to take an
image of the inner ear, send it to a doctor in Anchorage and get back a diagnosis and course of treatment—all in minutes. Likewise,
X-rays can be taken in a village and be sent electronically to a radiologist to be read. The same with EKGs. The network can also
be used for telepharmacy, electronic health records and videoconferencing. Indeed, the network brings together more than 700
providers in primary care; ear, nose and throat; audiology; dermatology; pediatrics; cardiology; family practice; trauma registry;
and same-day surgery. In a typical year, it facilitates:
- 1 million patient encounters
- 40,000 teleradiology cases
- 20,000 telepharmacy prescriptions
- 10,000 telemedicine cases
In one dramatic case, a woman in a regional hospital required emergency surgery but could not be flown to
Anchorage because of bad weather. Fortunately, a surgeon at the Alaska Native Medical Center in Anchorage using the
videoconferencing function of the network was able to successfully guide a doctor through the procedure.
On a more day-to-day basis, patients are freed from having to travel hundreds, if not thousands of miles,
for basic procedures.
“We do significant amounts of ear, nose and throat follow-up care by telemedicine,” says Sherry. “We send
kids to Anchorage for ear tubes. They used to have to go back to see if it had healed. Now, we take a picture of the ear drum
and email it in.”
Thirty years ago, he says, these small communities did not even have phone lines. “What we can do with the
technology now, was unimaginable.” None of it, he adds, could have been done without support from the telecommunications
industry and money from the Universal Service Fund, which, he says, “has been absolutely critical in making this work.”
Challenges
The success of the system notwithstanding, adequate funding continues to be a major challenge to
maintaining and improving the Alaska Tribal Health System (as does coordination of such a massive effort involving Federal,
State, Tribal, and private entities). Aging and inadequate facilities need to be replaced. Physicians and other providers
need to be recruited. Technology needs to be upgraded. It all needs to be done to meet the needs of a growing and
increasingly elderly population, many with chronic diseases. Finally, because of the remoteness, the terrain, the weather,
and the sparse population, it all costs more in Alaska.
But none of that has stopped them so far.
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