Requested by:  Dr. Eliz Albritton-MacDonald and Dr. David Kappenman

Total Cost:  $39,278          Installed:  March 2016

Thanks to a generous donation from the Hillsdale Fund, the RHF was able to equip both clinics with a Telemedicine System.  Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that are not consistently available


Peter Gallagher from the Hillsdale Fund and Jeanne Brown, RHF Executive Director

in rural communities. Once telemedicine is installed,
a rural clinic can obtain real time feedback from experts in burn care, cardiology, oncology, neurology, psychiatric and mental health care, and stroke, to name just a few examples.

The Sublette County Rural Health Care District has two clinics: one in Pinedale, WY and one approximately 40 miles away in Marbleton, WY. These clinics were located to provide reasonable access to health care for Sublette County’s 10,247 citizens from both ends of the nearly 5,000 square mile county. Pinedale is located 100 miles from Rock Springs, WY and 77 miles from Jackson, WY and Marbleton is 70 miles from Kemmerer, WY and 91 miles from Jackson, WY where the nearest hospitals exist. The further distance a patient must travel means time delay and increased risk.  Sublette County is the only county in Wyoming without a hospital resulting in a limited available level of care at the clinics. All other counties in Wyoming have either a District Hospital or a Critical Access Hospital.

The Census Bureau’s current estimates indicate that since 2010 the number of people in Sublette County from 25 to 44 years of age decreased by 4.8 percent, and the number of people from 55 to 64 years of age has increased by 1.9 percent.  This aging population has unique needs for health care services that could be provided through telemedicine. It is not practical to hire onsite physicians with expertise in all areas. Telemedicine is an effective way to improve diagnosis and treatment for patients requiring fast and accurate response.   Telemedicine systems provide interactive services that enable real-time communications between patient and provider. A stroke patient needs administration of medication within 2 hours of symptom onset to avoid permanent damage or fatality and telemedicine could reduce the response time considerably.

RHF obtained enough funding to purchase 2 complete telemedicine systems, one for the Marbleton/Big Piney Clinic and one for the Pinedale Clinic.  The Polycom Real Presence 500 & GlobalMedia i8300 Cart is a system appropriately scaled to meet the needs of rural clinics. Its main components include:

  • Portable power & network cart w/32” display
  • Video conferencing system w/zooming, high resolution camera
  • Remote controller
  • Hewlett Packard PC w/software
  • Port switch to allow for connectivity to more than one device

Partnering with knowledgeable and competent partners is important to telemedicine. This unit can be easily interfaced with both the University of Utah Hospital in Salt Lake City and Eastern Idaho Regional Medical Center in Idaho Falls. These locations have expertise in areas of health care that complement local staff. Telemedicine is changing the way medical care is delivered. Patients are embracing it, the cost savings are increasing, and its efficacy has been proven. Just one telemedicine diagnosis allowing for local treatment could eliminate a $30,000 to $70,000 helicopter or airplane trip to a hospital. Telemedicine in Sublette County clinics will certainly save lives as well as relieve some of the burden on the nation’s health care costs.

This system includes 3 years of maintenance and warranty coverage. It is imperative that the equipment is in excellent working order and calibrated at all times ready for that stroke patient who comes through the emergency door. 3 years of initial coverage would allow time to set up the systems and begin billing for telemedicine services. Telemedicine supports ongoing maintenance and warranty fees through Medicare, Medicaid and private insurance cost reimbursements.