Rick Wafler was skeptical before his first appointment with a nurse in Roseburg since he lives 150 miles away in Crescent City, Calif.

Instead of driving to the Roseburg Veterans Affairs Medical Center, the 59-year-old Air Force veteran drives to the Crescent City VA clinic. Once there, he sits in a private room in front of a computer.

“The first time I did this, I was a little shocked,” Wafler said. “I thought, ‘How can this work?'

Wafler is among a growing number of veterans treated through telemedicine, which connects doctors and patients, often over vast distances, through the Internet and phone.

Technology to treat patients remotely has existed for many years, and the Roseburg VA has used telemedicine to a limited degree for nearly a decade. But its use has exploded recently. The Roseburg VA this year hired a telemedicine coordinator and four technicians specializing in telemedicine. The hospital joins others nationwide that are expanding telemedicine programs.

Last year, the Roseburg VA logged nearly 900 telemedicine appointments, and the number of telemedicine patients continues to increase, said Tracy Weistreich, associate director of patient care at the Roseburg VA. About half of the appointments were for mental health patients. Telemedicine also serves heart patients and those with chronic conditions, like diabetes, she said.

Telemedicine allows patients in smaller, rural hospitals to connect with specialists. Although the Roseburg VA now only has working relationships with other VA hospitals, it hopes to form partnerships with hospitals outside the VA system.

“This will become the wave of the future,” Weistrich said. “This is going to revolutionize the way we deliver health care.”

Wafler said he doesn't even notice he's video conferencing anymore.

“Once you get past the technology, it's very personable, and it really does work,” he said. “Having this available for me here, I know has made a difference in my life.”

At Roseburg's other hospital, Mercy Medical Center, emergency room doctors communicate via video conferencing with specialists at Oregon Health & Science University Hospital in Portland.

The one-year partnership between the two hospitals gives the Roseburg hospital access to neurologists who prescribe medication to stroke victims to prevent brain damage. Mercy also consults OHSU doctors on pediatric and trauma cases.

“It's been really great for us,” said Dr. Brent Crabtree, a Mercy emergency room physician. “In some of these cases, you need an expert opinion.”

VA and Mercy officials say telemedicine also saves patients, doctors and other health care workers long trips.

“We can save so many people dollars and travel time,” said Cassandra Donlon, a mental health nurse practitioner at the Roseburg VA. “This is real time (video), good quality and convenient for everybody.”

Once a week, Donlon appears via a camera installed on top of her computer to meet with patients like Wafler, who live in far-flung parts of the Roseburg VA's coverage area. As they talk, she takes notes and looks at patient charts on her computer.

Her telemedicine patients have embraced the medium, Donlon said. Some actually talk more freely, she said.

“There's a buffer zone, so sometimes patients feel more comfortable,” Donlon said.

More convenient care

Central Point resident and Marine veteran Richard Erens would much rather travel to the Roseburg VA than to Portland for a quick appointment once every three months to check his heart defibrillator.

With the help of a Roseburg VA nurse and a technician from the manufacturer of the defibrillator, Erens was examined and cleared for another three months by a doctor at the Portland VA. The doctor, 170 miles away, could see the heart information collected in Roseburg, said Michael Newell, a Roseburg VA nurse.

The Roseburg VA has employed telemedicine for cardiac and mental health patients for nearly a decade, said Fran Sutherland, facility telehealth coordinator.

Around the same time, the hospital started sending home patients with chronic conditions, such as diabetes, with devices to monitor their health, she said.

The devices transmit information, such as blood sugar levels, to doctors at the VA, Sutherland said. This dramatically cut down on hospitalizations among patients with chronic conditions, she said.

In the past several years, the Roseburg VA also started sending images of patients' retinas and skin to doctors in Portland to examine, Sutherland said.

She said the hospital hopes to soon offer patients the option of telemedicine appointments before and after operations in Portland so they only have to travel north once.

Helping stroke victims faster

Sutherlin resident Dorothy Hitchcock, 74, and her husband, Norman, are grateful for the care she received in the emergency room at Mercy Medical Center when she had a stroke in October. Mercy doctors contacted OHSU vascular neurologist Dr. Hormozd Bozorgchami, who examined her via video feed.

“We just can't say, ‘Thank you,' enough,” Hitchcock said.

Bozorghami prescribed Hitchcock medicine that prevents brain damage before she was transferred up to OHSU to remove a blood clot. When she arrived, she could be wheeled right into surgery because he had already examined her and ordered lab tests.

Hitchcock said she's recovering nicely. She recently had a follow-up appointment with her local doctor. Norman Hitchcock said the doctor was impressed with how well she is doing.

“He said he's amazed how improved she is. How good she's done,” Norman Hitchcock said.

Bozorgchami said Dorothy Hitchcock's case is a perfect example of the benefits of telemedicine because it led to her taking clot-busting medicine early. The medicine most effectively prevents brain damage when taken within three hours of having a stroke, he said.

He said he and other OHSU neurologists get calls from 10 partner hospitals all over the state asking for their expertise.

“When the ER suspects a stroke, they call us,” he said. “We carry laptops with us at all times.”

Bozorgchami said he examines patients miles away by remotely controlling a camera on a cart in the emergency room. He also asks doctors or nurses who are with the patient to be his hands. He pulls up the patient's vital signs, lab reports and other information on his computer while performing the exam.

“It's almost like being there,” he said. “You can never replace face-to-face, but it's pretty close.”

Crabtree, the Mercy emergency room physician, said he uses the technology about once a week, mostly for stroke cases. The technology allows patients and their families to get a second opinion from a doctor in Portland, he said.

“I think it's a great thing for the community,” Crabtree said. “I gain some comfort knowing that the service is available.”

• You can reach reporter Inka Bajandas at 541-957-4202 or by email at ibajandas@nrtoday.com.