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Howard Lincoln of White Mountain, Alaska, doesn't always hear it when people knock on his door. He's 82 and he still has a little shrapnel in his jaw from a mortar shell that nearly killed him in the Korean War 60 years ago.
"We heard it whistling, but I was the third one in line running toward the bunker," he recalls.
Wounds to his face, arm and hip laid him up in a Tokyo hospital for quite a while. But he recovered, came home to Alaska in 1955 and says he never applied for Veterans Administration (now the Department of Veterans Affairs) benefits.
The nearest VA hospital was hundreds of miles — and at least two plane rides — away. White Mountain, along the Fish River, is still pretty remote. It's a day's journey by snowmobile or dog sled to Nome or a short flight if the weather allows. But the distance to health care just got a lot shorter — virtually.
"Travel is a big burden on a veteran who may be older, not feeling well," says Susan Yeager, who directs the VA health care system for the state, "and just the sheer expense of travel. That can be a barrier to care, and that's part of what telemedecine is about."
"Telemedicine" happens over a secure computer connection between the big VA hospital in Anchorage and hundreds of small clinics across Alaska. Each clinic has a cart — picture your old desktop computer with retractable cables that connect it to everything in a doctor's little black bag — a stethoscope, an otoscope to look in ears, high-resolution cameras and an ultrasound.
Saving Time, Money And Travel
Brian Laufer, chief health officer at the Anchorage VA hospital, recalls a recent case where he showed a patient's skin lesion to the head of dermatology at the VA in Seattle, a thousand miles away.
It could have taken weeks and maybe a plane ride to get a specialist to look at the lesion in person. Instead the specialist asked — over the video link — for an immediate biopsy.
"Turned out to be a melanoma. Within three weeks it was fully excised and had surgery here and had a cure because the melanoma was caught very early," said Laufer.
Quick action like that can save lives — and lots of money on travel. The VA estimates it has saved more than 800,000 miles of travel that patients didn't have to make since the program was set up.
Vets with post-traumatic stress disorder can sit in group therapy by video. Therapists say that can be more discreet for veterans in tiny towns where everyone knows everybody's business.
Last year the VA made the distance to get care even shorter by joining with the Indian Health Service, which already has hundreds of clinics around rural Alaska and six other states. Vets, whether they are Native Americans or not, can now use the Native clinic system and the VA will pay for it.
That means vets like Howard Lincoln in White Mountain can get care near home. For Lincoln, it's just a short walk to the village clinic, or a snowmobile ride when the snow is too deep.
Aging Veterans From Vietnam And Korea
Vets from the Korean and Vietnam eras make up the large majority of those seeking care these days, as they reach an age where health complaints are common. Lincoln's sister Willa Ashenfleter helped him get signed up with the VA — and not a moment too soon. Lincoln had two minor strokes last year. Now he's monitoring his health more closely.
"There's a machine by his table that he takes his blood pressure around 8:30 every morning," says Ashenfelter, adding that the information can be beamed directly to the VA.
At 82, he's still fiercely independent, Ashenfleter says. Her brother worked hard to recover and stay active even after his strokes, she adds.
"Couple times he's been on his roof ... working on his stovepipe ... and when we tell him he shouldn't be up there, he isn't happy," she says.
Howard Lincoln was back up on his roof last winter. His sister says he doesn't like people telling him where he should or shouldn't go.