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Personalities: Remote Access

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Stewart Ferguson, PhD, decided to pursue a career in telehealth while living in American Samoa and experiencing firsthand the healthcare challenges of a remote region. Now, as the director of telehealth for the Alaska Native Tribal Health Consortium, he works to improve access to quality healthcare for federal beneficiaries like Alaska Natives, active military personnel, and veterans through the Alaska Federal Health Care Access Network.

On the history of the AFHCAN: The goal is to improve healthcare for people living in remote areas by enabling a group of providers separated by time and distance to work together in a collaborative environment to care for patients. We started as a program under the Alaska Federal Health Care Partnership, which includes the Alaska Tribal Health System, U.S. Army, U.S. Air Force, U.S. Coast Guard, and Veteran's Administration about nine years ago. Now we are also providing solutions to community health centers in Alaska. We continue to be funded through Indian Health Services, so we have provided solutions to about 10 states to help native health corporations.

On AFHCAN's biggest achievement: Realizing the outrageous goal that was put in front of us to build a system that could meet the needs of the providers in Alaska. We have about 160 village clinics that are staffed by community health aides—often village residents who provide care in that setting. So we needed to design a system that was easy enough for them to learn and use. Yet we have very high-level specialists here in Anchorage who needed a very feature-rich information interface to be able to provide consultant care.

On continuing challenges: You have to continually provide training and support. I don't just mean people who can field questions on how to use the system. I mean helping people who come to us and want to try new technologies or clinical services like teleobstetrics or teleultrasound for cardiology. Being able to support all of this as it is growing places demands on my office—but it is a blast.

On telemedicine's role in healthcare's future: We need to do more with less. We are going to have less money. We are probably going to have less access—specialists are not going to suddenly relocate to a remote area. Simultaneously, patients are expecting healthcare delivery to come to them. We have documented that 68% of our patients seen through telehealth don't have to travel to the next level of care, and we can get specialty consults in less than 24 hours for most of our patients. We have demonstrated that there is an efficient model for this, and it is not just through videoconferencing. If you can capture data and send it, which is called store and forward, providers can look at it offline at a time that is convenient for them.

On Alaska: My favorite thing about living here is the sensory-rich environment. I travel to different regions and villages and work with Alaska Natives who are some of the greatest people in the world. They're a hard-working, dedicated, passionate people with a great sense of humor. They say the best thing about living in Anchorage is you are 10 minutes from Alaska. I am leaving to go hike up some 3,000-foot peaks tonight with snow on them and probably pass a bunch of moose on my way up there. I can't imagine anything better.

Carrie Vaughan

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