Feb. 19, 2009 – While the date isn't set in stone, Harold Wallace, administrator of the Myrah Keating Smith Community Health Center, said the telemedicine system now being completed should be up and running by mid-April.
"This is real time, not taped," Wallace said of the system.
He made his remarks at a meeting Thursday of St. John's AARP chapter. The meeting was held at the Nazareth Lutheran Church hall in Cruz Bay.
According to Wallace, patients will first be evaluated by one of the Health Center's doctors or nurses. Subsequently, the patient will have an appointment with the telemedicine doctor based at the Cleveland Clinic's Weston, Florida or Cleveland, Ohio facility.
The patient or insurance will pay only for the office visit with Myrah Keating's doctor or nurse, not the additional appointment with the telemedicine physician.
The setup at Myrah Keating and the Cleveland Clinic's physician services will cost about $100,000 for the three-year contract, Wallace said. St. John businessman Donald Sussman is funding the telemedicine contract, Wallace said, but an unspecified additional funding is expected from the Rotary Club of St. John.
Wallace said the system includes a large plasma screen and equipment that allows the Cleveland Clinic's doctor to see exactly what's happening in the examination room.
"He can see the hair in your nose," he said.
The Cleveland Clinic doctor, the Myrah Keating physician and the patient can communicate with each other.
Initially telemedicine consultations will be offered in ophthalmology, podiatry, nutrition, endocrinology, and orthopedics. Wallace said these are all specialties that treat problems related to diabetes.
"The major illness plaguing St. John is diabetes," Wallace said.
St. John's public health nurse, Jane Washburn, suggested that pediatrics be added to the list of specialists because young patients who need care are often the children of illegal immigrants. She said their parents are reluctant to take them to St. Thomas for care because they're afraid they'll be apprehended.
Wallace said that the intent is not to cut St. Thomas-based medical specialists out of the loop, but to augment what they can provide.
"There is a dermatologist on St. Thomas, but he's extremely busy and booked out for months," Wallace said.
Should the patient need further care, the relationship with the Cleveland Clinic will be already set up and the patient can fly to Florida or Ohio.
Myrah Keating will have the first such facility in the Caribbean although the Cleveland Clinic has set up a telemedicine center in the Florida Keys. Wallace said St. John will be a pilot for the Caribbean.
In providing other Health Center information, Wallace said that Myrah Keating will not provide labor and delivery services despite the clamor from many St. John residents who want their children to be born on St. John.
"Forty children a year are born from St. John. It will not pay for itself," he said.
Additionally, Myrah Keating won't provide hemodyalisis because it can't pay for itself.

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