November 17
KCH Fiber Optic Pipeline goes LIVE in January
by Dean Wells, Warren Times Observer.

Dr. Timothy Trageser slips the ends of his stethoscope into his ears and listens to the steady ba-dump, ba-dump of his patient's heartbeat. He smiles, asks a few questions, makes a couple of notes. It's your typical office visit.

Only Trageser is sitting in an office at Hamot Medical Center in Erie, while his patient is perched on the end of an examining room table in Kane 73 miles apart, as the crow flies.

Trageser hears the man's heart beat as clearly as if he was sitting a few feet away, pressing the business end of the stethoscope against his chest.

He speaks to him in real time using a video camera, microphones and a computer monitor. They can see each other, interact, hold a normal conversation.

"This is still in its infancy," Trageser said of the virtual office visit. "The one thing we can't do is touch the patient yet. But one day when the cost of medical robots goes down, we will."

It's what's known as E-medicine.

Or Tele-medicine.

Whatever the technical term, it's undeniably the future of medicine.

"For the last six or seven years, we've been marketing ourselves as city medicine in the country," says Gary Rhodes, CEO of Kane Community Hospital. "I think that's even more applicable now than ever."

Last November, Rhodes entered a multi-year deal with Zito Media Communications, a telecommunications company located in Coudersport, to provide his hospital with an ultra high speed Internet connection via the company's newly built fiber optic ring in McKean County.

Zito is currently building an identical ring in Warren County.

The hospital became a redundant "hub" on the optic ring, immediately bumping its upload speed to 50 megabytes per second.

The upload speed for a typical DSL Internet connection is around 2 megs per second.

In January, Kane's upload speed will jump to 700 times faster than a T1 line, allowing the hospital to transmit huge CAT scan files to larger hospitals for diagnosis in mere seconds a process that used to take on average of 45 minutes.

The connection is so powerful, so state of the art, it dwarfs the transmission capabilities of some of the larger hospitals in the region.

"What has been accomplished in Kane is incredible," says Steve Zwerin, Zito Media vice president. "The approach was to develop incredibly fast transmission of data and connect to major tertiary hospitals at an affordable cost. This is the most advanced transmission system on the northern tier. Kane is on the forefront. And what has been accomplished here is just the beginning."

According to Rhodes, upgrading the hospital's communication speed to the world outside of Kane was a necessity.

Rhodes said that due to the increasing shortage of radiologists, rural hospitals such as Kane traditionally send data images such as CAT scans to specialists at larger hospitals 24/7. Those complex files had became so large over the years, it often took an average of 45 minutes to transmit them a dangerous wait for certain patients.

"Heart attack victims and stroke victims need immediate diagnosis," Rhodes said. "But the files had grown so big, it delayed treatment."

Rhodes said that a stroke can be diagnosed quickly with a CAT scan, but a specialist is needed to determined how a victim should be treated.

A 45-minute delay is a long enough wait to cause permanent damage, or even death.

"Doctors must make the decision whether or not to inject a clot buster, depending on if it's a hemorrhagic or ischemic stroke," Rhodes said. "If you're bleeding, the clot buster would make it 100 times worse. There are two stroke centers in the state. All they need to do is see the CAT scan and they can say, 'Okay, it's a hemorrhagic stroke. Do A, B and C, but don't do D.'"

The Kane hospital's increased connection speed last November already cut its transmission speed down to less than 20 minutes. By January, that number will be reduced to seconds.

The fiber optic link is also allowing the hospital to have a direct connection to its various satellite facilities, including an office in Sheffield. All records are being shifted to an electronic format which can be accessed by any of the hospital's facilities.

"Say one of our doctors in Ridgway has an office full of patients and suddenly one of his other patients shows up in the ER," Rhodes said. "We will have all the records and be able to see him. What's happening now is phone calls and a drive to Kane, leaving an office full of patients."

Rhodes predicts that the hospital's new optic fiber connection will drive down costs to patients by helping to eliminate emergency helicopter flights to larger hospitals, along with drives to Erie for follow-up visits with a physician after surgery.

"In instances of head trauma, sometimes the only option is to fly a patient to Erie, only to have them discharged the next day because there was nothing wrong with them," Rhodes said. The option of a virtual examination by a trauma team in Erie while the patient is still in the ER in Kane could decrease the need for calling in a helicopter.

"This is what's going to be available down the road," said Zwerin. "You roll into the emergency room, the doctor hits a button on the wall. Within moments, they will be connected through an ultra high speed connection to a Hamot trauma team. High definition cameras come live. They can see you on the table. Microphones come on. The cameras can be remote controlled. They can zoom in, look at your wounds, look at your color. Together, (the two teams) can make a medical analysis."

"The potential is here," Rhodes said. "You can just go on and on and on with it."