Convenience, Cost-Saving, and Connections for North Dakota Patients

SCOTTSDALE, Ariz. (March 15, 2010) — Minot State University is the home to the North Dakota Center for Persons with Disabilities
(NDCPD), a national leader in innovation for people with developmental challenges. Part of a network of similar programs at universities around the United States, the NDCPD conducts a wide range of projects that assist disabled individuals with education/early intervention, employment, improved health and better overall quality of life.

Among the more creative efforts recently initiated by the NDCPD are the North Dakota Distance Audiology and Connections Projects. These programs extend the power of professional hearing and speech therapy into rural communities. In a state the size of North Dakota, where residents often live hundreds of miles from the nearest audiologist or speech pathologist, diagnosing and treating hearing, speech or psychological problems can be nearly impossible. The situation is especially unfortunate when great distances prevent young rural families from getting early diagnosis for their infants or young children, when intervention can be most productive. Older individuals suffering from progressive hearing loss lose out as well, since they are usually unable to travel.

“Our therapists do their best to reach out. However, a lot of windshield time is invested in assessing and treating patients living in rural areas. This stretches resources and limits the number of individuals who can be served,” said Steve Peterson, Online Disability Services Coordinator for the NDCPD. “Specialists sometimes spend two hours driving each way for a session that lasts only an hour. Our hope was that there would be a way for therapists, audiologists and psychologists to conduct their sessions remotely, using the power of technology.”

GlobalMed Provides Telemedicine Solution
With the help of a four-year grant from the U.S. Department of Education, the NDCPC created the North Dakota Distance Audiology Project to make a telemedicine solution possible. Among the first purchases the Center made for the new project were cameras and echo-cancelling microphones from GlobalMed.
“GlobalMed’s ClearMic Duo microphone and K2r camera were good choices,” Peterson said. “They’re reliable, high quality— and especially in the case of the ClearMic Duo, the echo-cancelling capability is superb.”

GlobalMed’s iREZ K2r camera fits conveniently atop a computer monitor or screen, enabling TV-quality imaging of patients on location. The ClearMic Duo, an all-in-one audio solution incorporating microphone and speaker, suppresses both echoes and feedback. A mute button allows attendees to have confidential conversations, while an external speaker port and USB connection support headphone use for individuals undergoing testing.

Initially, the project team used a conventional videoconferencing application from a third-party vendor to remotely connect its therapists and pathologists with clients. When that company went out of business, however, the team decided to look for an upgrade.

“Obviously, many other videoconferencing solutions are out there. But telehealth has some unique demands,” Peterson commented. “It’s important for the professional to be able to take command of the client’s PC as part of the assessment. With young children, for example, you might show a barnyard on the screen and tell them, ‘Now put the cow into the barn.’ That takes software with a collaborative component—and to use such software, you have to be able to navigate firewalls on the client’s PC. Our previous software wasn’t able to do that.”

Around that time the project team first learned about GlobalMed’s EasyShare VC video conferencing software. “We were pleased to learn that EasyShare existed. It was an excellent fit for our program,” Peterson said.
EasyShare VC, a browser-based application, creates a complete communications interface between a host and any number of guests. Hosts can size the 640 × 480, high resolution video screen to make room for secondary applications, place pictures within a picture, and access directories or data sources during conferences as needed. A white board and three different presentation skins allow users to accommodate various presentation requirements.

“EasyShare allows us to navigate any firewall on the client’s end, which solves a major problem for us. But we also like its multipoint conferencing capability,” stated Peterson. “Sometimes we need to have a parent or a consultant sit in from another location. With EasyShare it’s no problem to link in specialists from remote locations.”

Easy to Use, Cost-Effective Technology
EasyShare VC, along with GlobalMed’s cameras and ClearMic Duo speaker/mic product, has created the powerful interface the NDCPD desired for the North Dakota Distance Audiology Project. “Even for experienced audiologists, conducting sessions over a VoIP [Voice over Internet Protocol] connection has been excellent. We’re surprised at the audio quality,” Peterson said. “The video is better than with other solutions we’ve used, and it doesn’t require a lot of bandwidth.” He noted that while a paraprofessional is required on the client’s end to assist with therapy, the system is simple enough for anyone to operate.

So far, the project team has installed the equipment at a limited number of locations. The beta test, however, has been encouraging. Later this year the team hopes to expand its deployment fivefold—to perhaps as many as 100 locations by the end of 2010.

“There’s no limit to the applications as these PC-based solutions are very flexible and cost-effective. Many remote schools could benefit from having a system like this,” Peterson asserts. “It also makes a world of difference for families. In one of our test cases, a father who harvests grain for a living from Oklahoma to North Dakota was able to take his child along and maintain therapy. He set up the camera and microphone at whatever hotel the family was staying, and our pathologist was able to work with the child on schedule.”

The NDCPD has extended its initiative through a contract with the US Department of Health and Human Services (HRSA), developing technical and management protocols for pediatric audiologists in the provision of audiological testing for infants less than three months old. Said Peterson,“With this system,our people can be present virtually at any location. It’s a cost-effective solution for a very difficult problem.”