Virtual Surgeon But Real Operations, As Blue Mountains Leads The World

Sydney Morning Herald

Tuesday November 18, 2003

Natasha Wallace

The State Government has turned to the internet, setting up a ``virtual reality" unit in the emergency department of a Blue Mountains hospital to address a critical shortage of specialists.

But the Australian Medical Association, which was not consulted on the two-year pilot, said plans to extend it to births next year, and eventually to make it available to all NSW hospitals, raised serious legal and ethical concerns.

The Virtual Critical Care Unit, unveiled yesterday by the Health Minister, Morris Iemma, enabled Nepean Hospital specialists to instruct emergency medical staff at Blue Mountains District Anzac Memorial Hospital in Katoomba, 52 kilometres away.

The unit has a computer screen to monitor vital signs, two television monitors to display the patient and medical staff, a microphone and mobile cameras that can zoom in on crucial areas like wounds.

Although ``tele-medicine" specialist consultations have been seen before, this critical and emergency care service is claimed to be a world first.

The $1.7 million initiative between the CSIRO and Wentworth Area Health Service would ``potentially address the difficulties of recruiting specialist health staff to remote parts of the state", Mr Iemma said.

Patrick Cregan, director of surgery for the health service, said it it intended to connect Royal North Shore, Prince Alfred, Westmead and Prince of Wales hospitals within the next two years.

Obstetrician John Pardey, the area director of women's and children's health, said some Blue Mountains mothers due to give birth from February had agreed to his ``virtual presence". A midwife and a medical officer would deliver the baby, while he provided ``electronic decision support" from Nepean Hospital.

The NSW president of the AMA, Dr Choong-Siew Yong, sounded a cautionary note, suggesting that telemedicine was best left to ``talking head" treatments, such as psychiatry.

``I don't think it's ever going to be a substitute for actually having a specialist there," he said, adding that it threatened the intimate doctor-patient relationship, raised privacy concerns if the system was hacked into and medical indemnity issues.