(Music)
>> Gary Walker: JUST AHEAD ON
"NEED TO KNOW," THE CITY
SCHOOL DISTRICT CONTINUES TO
CHIP AWAY AT A $25 MILLION
DEFICIT.
AND IT'S NOT SCIENCE FICTION;
IT'S TELEMEDICINE --
LONG-DISTANCE DIAGNOSIS BY
VIDEO.
IT'S HERE IN ROCHESTER.
PLUS ELLEN ROSEN JOINS US FROM
THE "DEMOCRAT AND CHRONICLE"
WITH THE LATEST IN LOCAL
BUSINESS NEWS, AND WE'LL READ
YOU SOME WAR LETTERS WRITTEN
TO AND FROM ROCHESTER DURING
THE PAST 200 YEARS.
IT'S ALL NEXT ON "NEED TO
KNOW."
>> WELL, I CAN SEE CHILDREN
SOONER AND GET THEM ON
EFFECTIVE TREATMENT SOONER.
>> THIS IS "NEED TO KNOW," THE
ROCHESTER AREA'S ONLY IN-DEPTH
NEWS PROGRAM.
"NEED TO KNOW" IS A PRODUCTION
OF WXXI NEWS AND PUBLIC
AFFAIRS, COVERING ISSUES,
POLITICS, EDUCATION AND
CURRENT EVENTS.
>> "NEED TO KNOW" IS MADE
POSSIBLE BY THE DAISY MARQUIS
JONES FOUNDATION, BY DORSCHEL
LEXUS, AND THROUGH THE SUPPORT
OF VIEWERS LIKE YOU.
>> Gary: THANK YOU FOR JOINING
US.
I'M GARY WALKER.
A WEEK FROM NOW, THE ROCHESTER
CITY SCHOOL DISTRICT WILL VOTE
ON FINAL STEPS TO CLOSE ITS
$25 MILLION BUDGET GAP.
THE SCHOOL BOARD SPENT HOURS
TINKERING WITH THE BUDGET,
EVENTUALLY TRIMMING THAT
NUMBER DOWN TO 17 MILLION THIS
WEEK.
SAVINGS COULD COME FROM
LAYOFFS, AMONG OTHER MEASURES.
PLUS TWO UNIONS HAVE OFFERED
TO DEFER SALARIES BY GIVING UP
ONE PAY CHECK THIS YEAR, AS
LONG AS LAYOFFS DO NOT HAPPEN
UNTIL THE SUMMER.
SCHOOL BOARD PRESIDENT JOANNE
GIUFFRIDA SAYS PROGRESS IS
BEING MADE.
RIGHT NOW WE'RE JOINED BY WXXI
AM 1370 NEWS DIRECTOR PETER
IGLINSKI, WHO'S BEEN FOLLOWING
THIS STORY.
PETER?
WE STARTED AT 29, GOT SOME
MONEY FROM THE STATE, WERE AT
25, THEN AT 22; NOW WE'RE AT
17.
HOW ARE THEY GOING TO CLOSE A
$17 MILLION GAP?
ARE LAYOFFS STILL POSSIBLE?
>> I ASKED BOARD PRESIDENT
JOANNE GIUFFRIDA ABOUT
LAYOFFS.
THE LAST BOARD PRESIDENT,
BOLGEN VARGAS, AND CLIFFORD
JANEY, SUPERINTENDENT, HAVE
SAID THEIR HOPE AND
EXPECTATION WAS NOT TO HAVE
ANY MORE LAYOFFS.
BUT I ASKED JOANNE GIUFFRIDA
JUST TWO DAYS AGO.
SHE SAID YOU CAN'T RULE THEM
OUT AT THIS POINT.
>> Gary Walker: WHY ARE THEY
BEING SO -- I'M SPEAKING OF
THE SCHOOL BOARD AND THE
SUPERINTENDENT.
WHY IS IT SO HUSH-HUSH AS TO
WHAT THEY'RE LOOKING AT RIGHT
NOW?
THEY'VE GOT A WEEK.
>> THEY'VE GOT A WEEK.
THEY CERTAINLY HAVE BEEN
WORKING ALL THROUGH THIS, AND
THEY'VE GOT A LOT OF IDEAS ON
THEIR TABLE.
WE HAVE HEARD -- DIFFERENT
THINGS HAVE LEAKED OUT, SUCH
AS THE POSSIBLE CLOSING OF
FRANKLIN.
I CAN'T TELL YOU HOW SERIOUS
THAT PROPOSAL IS, BUT IT'S
HARD TO NEGOTIATE IN PUBLIC.
THEY'RE STILL GETTING A LOT OF
PUBLIC INPUT.
THEY HAVE A TELEPHONE LINE SET
UP TO GET COMMENTS FROM THE
PUBLIC.
THEY'VE BEEN GETTING A LOT OF
INPUT DURING THEIR BOARD
MEETINGS FROM THE PUBLIC, AND
SO THEY'RE GETTING THAT, BUT
IT'S HARD TO NEGOTIATE IN
PUBLIC.
>> Gary Walker: HAVE YOU HEARD
ANYTHING ABOUT THE POSSIBILITY
OF ASKING THE CITY TO RAISE
TAXES?
>> NO.
AS YOU KNOW, THE CITY HAS GOT
ITS OWN BUDGET DEFICIT TO COPE
WITH, SO THAT'S A NIX FOR
THEM, BUT THERE'S NO TALK
ABOUT THE EFFECT ON PROPERTY
TAXES.
>> Gary Walker: LET ME ASK YOU
THIS: Dr. CLIFFORD JANEY, HIS
JOB PERFORMANCE.
HAVE YOU HEARD ANYTHING FROM
THE SCHOOL BOARD?
WE'VE HEARD SOME RUMORS OUT
THERE THAT THERE'S SOME
DISPLEASURE WITH THE JOB HE'S
DOING.
WHAT HAVE YOU HEARD?
>> WELL, YOU AND I HAVE GONE
THROUGH A LOT OF STORIES IN
THE PAST -- IN THE PAST BLANK
NUMBER OF YEARS INVOLVING
FINANCIAL DIFFICULTIES, AND
RUMORS ARE ALWAYS RAMPANT.
AMONG THE ADMINISTRATION,
AMONG THE BOARD, THERE'S NO
SERIOUS TALK ABOUT ANY BAD
FEELINGS TOWARDS JANEY AND HIS
PERFORMANCE.
>> Gary Walker: OKAY.
PETER IGLINSKI, THE NEWS
DIRECTOR OF WXXI AM 1370.
PETER, WE'LL BE HEARING ABOUT
THIS ON "MORNING EDITION" AND
"ALL THINGS CONSIDERED"
ALL NEXT WEEK.
MAKE SURE YOU TUNE IN, AM
1370, "ALL THINGS CONSIDERED"
AND "MORNING EDITION."
THANKS, PETER.
NOW, ROCHESTER'S HEALTH CARE
COMMUNITY RECENTLY TOOK A
TECHNOLOGICAL LEAP FORWARD
WITH THE INTRODUCTION OF THE
TELEHEALTH NETWORK TO PROVIDE
PEDIATRIC CARE TO CHILDREN AT
THREE LOCAL DAY CARE CENTERS.
THE PROGRAM IS CONDUCTED BY
STRONG CHILDREN'S HOSPITAL IN
CONJUNCTION WITH THE
VOLUNTEERS OF AMERICA, THE
DOWNTOWN "Y," AND GENERATIONS
CHILD CARE.
NURSES ON-SITE AT THE DAY CARE
FACILITIES EXAMINE CHILDREN
USING HIGH-TECH INSTRUMENTS
CONNECTED TO A COMPUTER THAT
TRANSMITS THE IMAGES TO
PEDIATRICIANS AT STRONG WHO
ARE MILES AWAY.
THE TELEMEDICINE PROGRAM IS
ENTIRELY FUNDED BY A GRANT
FROM THE U.S. DEPARTMENT OF
COMMERCE TECHNOLOGY
OPPORTUNITIES PROGRAM, MEANING
PARTICIPATING CHILDREN RECEIVE
HEALTH CARE AT NO COST TO THE
PARENTS.
AS "NEED TO KNOW'S" MATT
CUMMINGS EXPLAINS, THE
PROGRAM'S GOAL IS TO USE
TECHNOLOGY TO PROVIDE FLEXIBLE
HEALTH CARE TO CHILDREN WHO
NEED IT THE MOST.
>> WE RULE OUT PINK EYE A LOT,
RINGWORM, EAR INFECTIONS...
THE ONLY THING WE DO NOT RULE
OUT AT THIS POINT IS STREP
THROAT.
WE LISTEN TO THE LUNGS.
WE CAN TELL IF THE CHILD IS
HAVING AN ASTHMA ATTACK.
>> Matt Cummings: FOR JOHN
ARMIENTO AND HIS DAUGHTER
MICHAELA LEHR, TELEMEDICINE
HAS MADE THIS MEDICAL EXAM
MUCH EASIER.
>> THE CONVENIENCE,
NO LOSS OF WORK TIME FOR
MYSELF OR MY WIFE.
SHE'S IN SCHOOL THE WHOLE DAY,
MAKING FRIENDS, LEARNING.
NO LOST TIME.
WE COME HERE, GET IT DONE.
IF SHE'S SICK OR NOT, THEY
CALL THE PHARMACY FOR ME.
IF THERE WAS, I PICK IT UP.
THERE'S NO LOST TIME AT ALL.
IT'S GREAT.
>> Matt Cummings: LAST SPRING,
THREE LOCAL CHILD CARE CENTERS
JOINED WITH STRONG CHILDREN'S
HOSPITAL IN A NEW PROGRAM
CALLED THE ROCHESTER CHILD
CARE TELEHEALTH ACCESS
NETWORK.
THE PROCESS FEATURES A DAY
CARE CENTER NURSE USING
HIGH-TECH EXAMINATION
EQUIPMENT TO TRANSMIT IMAGES
TO A DOCTOR, MILES AWAY AT
STRONG CHILDREN'S HOSPITAL,
WHO MAKES A DIAGNOSIS AND THEN
PRESCRIBES TREATMENT, A
DIFFICULT PROCESS MADE EASIER
BY INTERNET TECHNOLOGY.
>> I CAN SEE CHILDREN SOONER
AND GET THEM ON EFFECTIVE
TREATMENT SOONER BECAUSE, YOU
KNOW, I'M SEEING THEM AT WHAT,
FOR MANY CHILDREN IN THE
ROCHESTER AREA, IS A HOME AWAY
FROM HOME.
60% OF CHILDREN NATIONALLY ARE
IN -- PRESCHOOL CHILDREN, ARE
IN SOME FORM OF CHILD CARE
SETTING, AND THEY SPEND MUCH
OF THEIR TIME, AT LEAST FIVE
DAYS A WEEK THERE.
AND I CAN SEE THEM OFTEN AT
THE FIRST MANIFESTATIONS OF
ANY ILLNESS.
>> Matt Cummings: THE NURSING
STAFF AT THE VOLUNTEERS OF
AMERICA WILL EXAMINE BETWEEN
20 AND 30 CHILDREN ON AVERAGE
PER WEEK, MEANING THEIR
TELEMEDICINE OFFICE
PRACTICALLY BECOMES A FULLY
FUNCTIONAL DOCTOR'S OFFICE.
THE TELEMEDICINE PROGRAM HAS
PROVIDED MEDICAL TREATMENT TO
ABOUT 150 CHILDREN IN
ROCHESTER SO FAR.
ACCORDING TO PROGRAM
ORGANIZERS, MANY OF THEM LIVE
IN POVERTY AND MAY NOT
OTHERWISE RECEIVE MEDICAL
CARE.
THE PROGRAM IS DESIGNED TO
ALLOW GREATER FLEXIBILITY FOR
PARENTS WHO WOULD HAVE
DIFFICULTY GETTING OUT OF WORK
TO TAKE THEIR CHILD TO A
DOCTOR'S OFFICE.
FOR ARMIENTO, IT ALSO PROVIDES
PEACE OF MIND, KNOWING HIS
DAUGHTER IS RECEIVING QUALITY
CARE.
>> WELL, IT'S WEIRD AT FIRST.
THE FIRST TIME, AWHILE BACK,
ALL THESE GADGETS, I GUESS YOU
WANT TO CALL THEM, IT'S
AMAZING.
THEY CAN SEE; THEY CAN TELL.
THEY CAN ACTUALLY TELL YOU TO
TAKE HER TO A DOCTOR AS WELL.
THERE'S NO GUESSING AT ALL.
IF THEY CAN'T SEE IT, THEY'LL
TELL YOU THEY CAN'T TELL AND
TO GO FOR FOLLOW-UP.
IT'S AMAZING IN MY IDEA.
>> Matt Cummings:
Dr. McCONNOCHIE SAYS THE USE
OF TELEMEDICINE IS ONLY A
STARTING POINT FOR MEDICAL
CARE AND SHOULD NOT BE SEEN AS
A REPLACEMENT FOR A TRIP TO A
CHILD'S PRIMARY CARE
PHYSICIAN.
WITH THAT IN MIND, McCONNOCHIE
ALSO BELIEVES THAT THE SUCCESS
RATE IN CORRECTLY DIAGNOSING
MEDICAL PROBLEMS IN CHILDREN
LIKE CHAELA IS ON PAR WITH
IN-PERSON DOCTOR VISITS.
>> I PERSONALLY DON'T THINK
THIS TAKES THE PLACE OF A
PERSONAL DOCTOR, AND SINCE
CHAELA IS HERE WITH ME ALL THE
TIME, FIVE DAYS A WEEK, FOR ME
TO LOOK IN HER EARS -- MOST OF
THE CHILDREN WILL SEE IT AND
ALLOW US TO LOOK IN THEIR
EARS, AS OPPOSED TO A DOCTOR
THEY SEE TWICE A YEAR WHEN
THEY'RE FIGHTING AND KICKING
AND SCREAMING.
BUT SINCE SHE SEES ME EVERY
DAY, I'M DOING ROUNDS EVERY
DAY, WE'RE HUGGING AND LOVING
EACH OTHER EVERY DAY, SHE
KNOWS ME MORE PERSONALLY AND
THAT ALLOWS THE DOCTOR TO GET
AN ADEQUATE REVIEW OF HER EAR
TO DETERMINE WHETHER OR NOT
SHE HAS AN INFECTION.
>> IS THAT HARD?
CAN YOU FEEL IT'S FIRM?
>> YES.
>> SO IT'S A CALLUS AND
THERE'S KIND OF A CENTRAL CORE
THERE?
>> YES.
>> TO ME IT LOOKS LIKE SHE'S
GOT A LITTLE WART THERE.
>> Matt Cummings: FOR ALL ITS
TECHNOLOGY, THERE ARE SOME
THINGS DOCTORS SAY
TELEMEDICINE CANNOT BE USED
FOR, SUCH AS CHEST X RAYS,
DRAWING BLOOD OR GIVING I.V.
FLUIDS, AND THE MOST OBVIOUS:
CONTACT WITH THE PATIENT
DURING AN EXAM.
>> YEAH, THAT IS SOMETHING
THAT IS LOST AND, YOU KNOW, IT
FEELS A LITTLE UNCOMFORTABLE.
I WANT TO REACH OUT AND TOUCH
IT MYSELF.
THE IMAGE -- THAT IMAGE WAS SO
GOOD THAT I ALMOST FELT LIKE I
COULD.
BUT WE CERTAINLY DO RELY ON
WHAT THE CHILD AND THE
TELEMEDICINE ASSISTANT CAN
TELL US IN TERMS OF WHAT IT
FEELS LIKE.
>> Matt Cummings: WHILE
Dr. McCONNOCHIE RECOGNIZES
THOSE LIMITATIONS, HE SEES
THIS TELEMEDICINE PROGRAM
FILLING A NICHE IN THE HEALTH
CARE COMMUNITY.
>> YOU KNOW, WHAT YOU CAN DO
WITH TELEMEDICINE IS SOMEWHERE
IN BETWEEN WHAT YOU CAN DO
WITH A TELEPHONE CALL AND WHAT
YOU CAN DO IN PERSON, BUT IT'S
A LOT CLOSER TO WHAT YOU CAN
DO IN PERSON IN TERMS OF THE
PROBLEMS THAT YOU CAN IMAGE
THAN A TELEPHONE CALL.
YOU CAN DO, YOU KNOW, WELL
OVER 50%, I WOULD DARE SAY,
WELL OVER 50% OF THE KIND OF
COMMON PROBLEMS THAT YOU SEE
IN A PEDIATRIC OFFICE, AND OUR
EXPERIENCE IS THAT WE'RE
DEALING QUITE WELL, QUITE
EFFECTIVELY, WITH PROBABLY 90%
OF THE PROBLEMS THAT WE SEE IN
CHILDREN IN THE DAY CARE
CENTER.
(Music)
>> Gary Walker: JOINING US NOW
IN STUDIO ARE Dr. NEIL
HERENDENN, ONE OF THE
TELEMEDICINE PROGRAM DIRECTORS
AT STRONG CHILDREN'S HOSPITAL;
PAM TAYLOR, DIRECTOR OF
CHILDREN'S SERVICES AT THE
VOLUNTEERS OF AMERICA; JANE
GREENLAW, ATTORNEY AND
CO-DIRECTOR OF CLINICAL ETHICS
AT THE U OF R MEDICAL SCHOOL,
AND Dr. DAVID PARKER, A
MEDICAL ETHICIST AND ASSOCIATE
DIRECTOR AT THE H.M.O.
INDEPENDENT HEALTH.
THANK YOU ALL FOR JOINING US.
I'M GLAD I DON'T HAVE TO SAY
ETHICIST A LOT
BECAUSE IT DOESN'T ROLL OFF
THE TONGUE
AS EASILY AS IT USED TO.
LET'S GET RIGHT DOWN TO IT.
I THINK THE -- LOOKING AT THE
VIDEO THAT MATT PUT TOGETHER,
THE PROGRAM'S GOAL IS
LAUDABLE.
I GUESS IT'S TO PROVIDE HEALTH
CARE, MORE FLEXIBLE HEALTH
CARE TO UNDERSERVED
POPULATIONS.
>> WELL, I THINK THAT'S BEEN
THE GOAL AT STRONG FOR A LONG
TIME, TO PROVIDE CARE TO KIDS
THAT ARE VULNERABLE AND NEED
EXTRA ATTENTION.
BUT THE TECHNOLOGY IS THERE.
I THINK WHAT WE REALLY ARE
SEEING IS PEOPLE STARTING TO
RECOGNIZE PRACTICAL
APPLICATIONS OF WHAT SEEMS TO
BE FAR-OUT TECHNOLOGY.
WE HAVE HEARD ABOUT TELEHEALTH
IN THE SYSTEM OF RURAL
SETTINGS.
WE WANT TO SEE WHAT CAN WE DO
IN A PEDIATRICIAN'S OFFICE?
WHAT CAN WE DO IN THE INNER
CITY?
WHAT WE CAN DO TO MAKE HEALTH
CARE MORE ACCESSIBLE?
ACCESSIBILITY IS NOT A
DISTANCE ISSUE.
THERE'S LOTS OF REASONS KIDS
CAN'T GET INTO A HEALTH CARE
SETTING AND IT DOESN'T HAVE
ANYTHING TO DO WITH GEOGRAPHIC
DISTANCE; IT HAS TO DO WITH
TRANSPORTATION SYSTEMS, BUSING
SYSTEMS, THE THREE OTHER KIDS
AT HOME, THE WORK SITUATION.
>> Gary Walker: LET ME LOOK AT
THE -- SOMEBODY WATCHING THIS
MIGHT SAY, WELL, A VIDEO
DOCTOR, IS THAT AS QUALITY AS
SEEING A DOCTOR IN PERSON?
>> WELL, I THINK WE'RE NOT
GOING TO REPLACE YOUR ROUTINE
DOCTOR'S OFFICE VISIT FOR WELL
CARE, FOR ROUTINE THINGS, BUT
WE HAVE THAT SAME QUESTION.
WE'RE IN THE MIDDLE OF A STUDY
THAT'S DOING A HEAD-TO-HEAD
COMPARISON.
IN-PERSON DOCTOR GOES IN THE
ROOM; THE TELEHEALTH DOCTOR
DOES IT OVER THE INTERNET.
AND WHAT WE'RE LOOKING AT IS
HOW OFTEN DO WE COME UP WITH
THE SAME DIAGNOSIS AND HOW
OFTEN WOULD WE TREAT IT THE
EXACT SAME WAY?
SO WE'RE IN THE MIDDLE OF
EVALUATING JUST THAT BECAUSE
NO ONE HAS LOOKED AT IT FOR
LITTLE KIDS.
>> Gary Walker: OKAY.
LET'S LOOK OVER TO OUR MEDICAL
ETHICIST AND ASK, IS THERE --
SOME PEOPLE WOULD SAY,
"INSTEAD OF TAKING VIDEO TO
CHILDREN, LET'S TAKE CHILDREN
TO DOCTORS; LET'S FIND A
BETTER WAY TO DO IT."
IS THERE ANY CONCERN AT ALL
THAT THIS COULD BECOME THE
BASELINE QUALITY OF CARE FOR
CHILDREN WHO CAN'T AFFORD TO
SEE A REAL DOCTOR?
SO IN OTHER WORDS, IF YOU CAN
AFFORD IT, YOU GET TO SEE A
DOCTOR IN PERSON;
IF YOU CAN'T, IT'S THE VIDEO.
>> I THINK YOU HAVE TO
SEPARATE THE TWO ISSUES.
FOR THESE CHILDREN THAT WOULD
HAVE DIFFICULTY GETTING TO SEE
A DOCTOR AT ALL, OFFERING THE
OPPORTUNITY TO HAVE THE VIDEO
CONSULTATION WITH A COMPETENT
NURSE ON-SITE AS THE
INTERPRETER AND THE
GO-BETWEEN, IT MAY ACTUALLY BE
BETTER.
YOU'RE NOT INTERRUPTING THE
CARE FOR THE OTHER THREE
CHILDREN IN THE HOME; YOU'RE
NOT INTERRUPTING THE NEEDS OF
THE FAMILY TO GET OTHER THINGS
DONE, AND THE OPTION IS ALWAYS
THERE THROUGH THE PROTOCOLS
THAT THEY USE AND THE RULES
THAT ARE SET UP AHEAD OF TIME
TO SEND A SERIOUSLY ILL CHILD
OR POTENTIALLY SERIOUSLY ILL
CHILD RIGHT TO THE OFFICE OR
EMERGENCY ROOM.
>> Gary Walker: SO YOU DON'T
SEE ANY POSSIBILITY THAT AS IT
DEVELOPS WE COULD HAVE A
TWO-TIERED SYSTEM OF DIAGNOSIS
FOR CHILDREN?
>> THERE MAY BE A TWO-TIERED
SYSTEM, BUT IT WON'T BE
DEPENDENT ON THE VIDEO
SYSTEMS.
>> Gary Walker: LET'S TURN TO
OUR ATTORNEY.
ANY LEGAL ISSUES INVOLVED
HERE?
IT SEEMS TO ME THAT RIGHT NOW
IT'S NOT COSTING CHILDREN
ANYTHING, OR PARENTS ANYTHING,
BUT ARE THERE LEGAL
RAMIFICATIONS TO A DIAGNOSIS
OR MISDIAGNOSIS?
MALPRACTICE IS AN UGLY WORD
FOR DOCTORS, BUT IS THERE
TELEMALPRACTICE IN THE FUTURE?
>> WELL, MAYBE, BUT I THINK
THE MOST IMPORTANT ISSUE IS
THIS PROJECT IS POTENTIALLY A
WIN/WIN SITUATION FROM THE
POINT OF VIEW OF THE
INDIVIDUAL CHILD AND THAT
CHILD'S FAMILY GETTING, AS
Dr. PARKER SAID, NECESSARY
TREATMENT FOR THAT CHILD.
BUT ALSO IN THE AGGREGATE,
FROM A PUBLIC HEALTH POINT OF
VIEW, THIS PROVIDES SERVICE
FOR A CATEGORY OF PEOPLE FOR
WHOM IT WOULD BE DIFFICULT;
THERE ARE OBSTACLES TO
RECEIVING THE CARE.
SO I THINK THAT -- WE CAN
THINK OF IT MAYBE ANALOGOUSLY
TO THE EDUCATION SYSTEM, THAT
SOME PEOPLE WHO HAVE HIGH
INCOMES CAN AFFORD TO PROVIDE
PRIVATE SCHOOL EDUCATIONS FOR
THEIR CHILDREN, BUT WE PROVIDE
A BASIC MINIMUM OF EDUCATION
FOR EVERY CHILD.
AND THIS IS A WAY TO ENSURE
THAT CHILDREN FOR WHOM THERE
ARE OBSTACLES TO RECEIVE BASIC
KIND OF CARE WILL RECEIVE IT.
SO I THINK THOSE ETHICAL
ISSUES AT LEAST AT THE
BEGINNING OF THIS PROJECT ARE
MUCH MORE INTERESTING THAN THE
POTENTIAL LEGAL ISSUES, AND
THE OPPORTUNITY FOR THE
PHYSICIAN TO HAVE BETTER
INFORMATION THAN THE PHYSICIAN
WOULD GET VIA PHONE CALL,
WHICH IS ACTUALLY FROM A
PRACTICAL POINT OF VIEW THE
WAY THE INFORMATION WOULD
NORMALLY BE CONVEYED, SO THIS
IS PROBABLY A BETTER SITUATION
THAN WHAT THE CHILD WOULD BE
IN WITHOUT THE TELEMEDICINE.
>> Gary Walker: YOU'RE IN THE
ETHICS DEPARTMENT AT THE
SCHOOL.
WHAT INTERESTING ETHICAL
PROBLEMS DO YOU SEE COMING OUT
OF THIS?
>> WELL, I THINK THE ETHICAL
ISSUES ARE THE INDIVIDUAL ONE
THAT I JUST MENTIONED: IS THE
CHILD WORSE OFF THAN THE CHILD
WOULD BE BY RECEIVING THE
ATTENTION IN THIS MANNER?
I THINK NOT.
AT LEAST -- WE'LL LEARN MORE,
BUT THE EVIDENCE SO FAR
SUGGESTS THAT ISN'T TRUE.
BUT THEN FROM THE PUBLIC
POLICY, PUBLIC HEALTH, IT'S IN
THE ETHICS' CATEGORY OF
JUSTICE, DISTRIBUTION OF
RESOURCES.
THIS IS GOING TO INCREASE THE
ACCESS OF A CATEGORY OF
PATIENTS TO GET BETTER CARE.
>> Gary Walker: DO YOU SEE
THIS -- RIGHT NOW YOU HAVE
THIS AT YOUR FACILITY, HAVE
CHILDREN IN YOUR FACILITY
USING IT ALL THE TIME.
DO YOU SEE IT GROWING TO
CHILDREN AND THEIR PARENTS?
WOULD THAT BE A GOAL OF YOURS?
>> I DON'T KNOW.
RIGHT NOW IT'S WORKING VERY
WELL IN THE APPLICATION WE'RE
USING IT: THE CHILDREN WHO
HAVE EAR INFECTIONS AND PINK
EYE AND WOULD PROBABLY BE SENT
HOME BECAUSE THEY HAVE A FEVER
OR WE'RE NOT SURE WHAT IT IS
DON'T HAVE TO GO HOME ANY
LONGER.
EAR INFECTIONS ARE NOT
CONTAGIOUS.
THE DOCTORS CALL A
PRESCRIPTION IN; THEY LET THE
CHILD'S REGULAR PEDIATRICIAN
KNOW WHAT'S GOING ON.
GOING FORWARD, I DON'T KNOW IF
IT WOULD BE A DROP-IN PLACE
PEOPLE COULD GO FOR THEMSELVES
OR THEIR OTHER CHILDREN
THAT AREN'T IN THE PROGRAM.
I SUPPOSE THAT WOULD BE
SOMETHING WE COULD CERTAINLY
EXPLORE GOING FORWARD.
>> Gary Walker: DOCTOR, WHERE
DO YOU SEE THIS PROGRAM GOING?
DO YOU SEE THIS -- I IMAGINE
EXPANDING TO THE DAY CARE
CENTER, BUT DO YOU SEE THIS
GROWING TO SERVE THE ADULT
POPULATION AS WELL?
>> I THINK IT'S GOING TO GROW
INTO MANY PLACES AND THE
TRIAGE PHONE CALLS THAT EVERY
DOCTOR'S OFFICE TAKES, IT'S
GOING TO BE A VERY SHORT
WINDOW OF THREE TO FIVE YEARS
THAT YOU'LL HAVE THAT
TELECONFERENCING ABILITY
ATTACHED TO YOUR PHONE SO
YOU'LL BE ABLE TO SEE.
IN MEDICINE, A PICTURE IS
WORTH A THOUSAND WORDS.
>> Gary Walker: RIGHT.
IF YOU CALL YOUR DOCTOR FROM
HOME AND HE SAYS, "PUT THE
PROBE IN YOUR EAR AND WE'LL
TAKE A LOOK," RIGHT?
>> I THINK THERE'S MANY
COMPANIES LOOKING AT THE
PRACTICAL APPLICATION: CAN
YOU DEVELOP A LITTLE
ATTACHMENT TO YOUR HOME
COMPUTER THAT WOULD GIVE YOU A
STETHOSCOPE TO LISTEN TO
LUNGS, WOULD GIVE YOU A LITTLE
CAMERA THAT LOOKS IN EARS AND
MOUTH...
AND HOW MUCH OF THAT CAN YOU
DO WITHOUT HAVING TO TRACK IN
TO THE DOCTOR'S OFFICE?
SO FOR THE ELDERLY POPULATION
WHO CAN'T GET OUT OF THEIR
HOMES AS EASILY OR THE
CHRONICALLY ILL, YOU REALLY
NEED TO TALK TO YOUR DOCTOR
ALMOST ON A WEEKLY IF NOT
DAILY BASIS, THESE
ATTACHMENTS, THESE PERIPHERAL
COMPUTER DEVICES, ARE GOING TO
OPEN UP A WHOLE NEW WORLD FOR
THE WAY THAT DOCTORS
COMMUNICATE WITH PATIENTS.
>> Gary Walker: OKAY.
BUT IS THERE ANY POSSIBILITY
-- AS THIS THING GROWS, I
IMAGINE IT WILL BE A LOT MORE
COST EFFECTIVE.
I IMAGINE H.M.O.s ARE GOING TO
WANT TO DO A LOT OF THIS.
STILL DO YOU NOT SEE THE
POSSIBILITY THAT IT COULD
BECOME THE STANDARD QUALITY OF
CARE AND, YOU KNOW, HOW DO
DOCTORS FEEL ABOUT THAT?
WHO'S GOING TO BE ON THE OTHER
END OF THAT COMPUTER ALL THE
TIME?
IS IT ALWAYS GOING TO BE
DOCTORS, OR AS COSTS KEEP
DRIVING MEDICAL CARE, COULD
THIS BECOME THE STANDARD
DIAGNOSTIC CARE FOR ALL OF US?
>> IT MAY VERY WELL BE A GOOD
THING.
FIRST, EVERY OFFICE HAS 10% OF
ITS PATIENTS THAT ARE VERY
SICK AT HOME.
YOU CAN TAILOR THE INSTRUMENTS
THAT ARE SENT TO THAT HOME AND
HOW THE INFORMATION IS
DELIVERED BACK SO THAT THERE'S
NO DELAY IN HAVING A PARENT
COME HOME AND DISCOVER A SICK
CHILD.
IN THIS CASE, YOU HAVE TAKEN
THAT AWAY; YOU'VE SHORTENED
THE TIME TO DIAGNOSIS AND
TREATMENT.
>> Gary Walker: BRIEFLY, IF
SOMEONE WANTED TO GET SOME
MORE INFORMATION ON THIS, DO
THEY CALL STRONG?
>> THEY CAN CALL STRONG RIGHT
NOW AND ASK FOR Dr. TIM
McCONNOCHIE OR MYSELF,
Dr. HERENDENN.
>> Gary Walker: OKAY.
THAT'S IT.
UNFORTUNATELY, THAT'S ALL THE
TIME WE HAVE FOR THIS
DISCUSSION.
FOR MORE INFORMATION ON
TELEMEDICINE, PLEASE LOG ON TO
OUR WEB SITE AT wxxi.org/ntk.
WHILE YOU'RE THERE, YOU CAN
ALSO TAKE PART IN OUR WEEKLY
SURVEY QUESTION, AND FOR
COMPREHENSIVE DAILY COVERAGE
OF STATE ISSUES AND NEWS, IT'S
nycitizens.org.
NOW IT'S TIME FOR THIS WEEK'S
EDITION OF "THE BUSINESS
SECTION" WITH THE "DEMOCRAT
AND CHRONICLE."
(Music)
>> Gary Walker: JOINING US NOW
IN STUDIO IS ELLEN ROSEN, THE
BUSINESS EDITOR FOR "THE
DEMOCRAT
AND CHRONICLE."
ELLEN, THANKS AGAIN FOR
JOINING US THIS WEEK.
I REMEMBER WE HAD A TALK ABOUT
THE BIG STORIES OF LAST YEAR
AND YOU HAD SAID THAT LOW
AIRFARE TRANSIT WITH JetBlue
WAS A BIG STORY.
NOW THE PAPER HAD A STORY
ABOUT AirTran COMING TO
ROCHESTER NOW.
>> Ellen Rosen: THAT WAS BIG
NEWS BECAUSE THE BIGGER
CONGLOMERATION YOU CAN GET OF
LOW-FARE CARRIERS IN YOUR
COMMUNITY, BOTH THE BETTER
SERVICE YOU CAN GET FOR PEOPLE
AND IT ALSO FORCES THE BIG
GUYS TO TAKE IT SERIOUSLY AND
START LOWERING SOME OF THEIR
FARES.
YOU REALLY GET SOME
COMPETITION BECAUSE THAT'S
WHAT ROCHESTER SUFFERED FROM,
A LACK OF COMPETITION IN
AIRFARE.
NOW WHETHER OR NOT -- LOUISE
SLAUGHTER SAYS SHE'S ALSO
TALKING TO SOUTHWEST.
NOW, IF WE COULD GET THEM
HERE, THEY'RE THE NUMBER ONE
COMPANY.
AirTran IS THE NUMBER TWO
LOW-FARE CARRIER.
IF WE COULD GET ALL OF THEM IN
HERE, I REALLY THINK WE'D BE
DOING VERY WELL.
>> Gary Walker: WE WOULD BE
VERY COMPETITIVE.
>> Ellen Rose: WE'D BE VERY
COMPETITIVE.
>> Gary Walker: HEY, IT'S
JANUARY.
IT'S THAT TIME OF YEAR, AND
EVERYONE IS WAITING FOR
FOURTH-QUARTER EARNINGS.
WHEN IS THAT HAPPENING?
>> Ellen Rosen: IT'S EARNINGS
SEASON AND THEY HAVE BEEN
COMING OUT ALL WEEK, AND
THEY'LL CONTINUE TO COME OUT
FOR THE NEXT COUPLE OF WEEKS.
DELPHI, FOR INSTANCE, THIS
MORNING ANNOUNCED A LOSS.
A LOT OF THE NEWS HASN'T BEEN
GOOD AND WALL STREET HAS BEEN
NERVOUS, AS YOU CAN TELL BY
THE WAY THE MARKET HAS BEEN
BEHAVING THIS WEEK.
THE BIG ONES WE'RE LOOKING
TOWARD ARE COMING NEXT WEEK,
BOTH NEXT THURSDAY.
BOTH KODAK AND BAUSCH & LOMB
WILL ANNOUNCE THEIR EARNINGS.
AND THE FOLLOWING MONDAY,
XEROX WILL ANNOUNCE THEIRS.
>> Gary Walker: ARE WE BRACING
FOR BAD NEWS?
>> Ellen Rosen: WELL, THE
NEWS WON'T BE REALLY THAT GOOD
FOR ANY OF THE COMPANIES.
KODAK, FOR INSTANCE, IS
EXPECTING ITS EARNINGS TO BE
DOWN TO SOMETHING LIKE 12
CENTS A SHARE, WHICH IS LIKE
AN 82% DROP FROM WHERE THEY
WERE A YEAR AGO, AND ACTUALLY
FOR THE FULL YEAR, KODAK IS ON
TRACK TO HAVE THE WORST
FINANCIAL YEAR SINCE 1984.
>> Gary Walker: AS A GENRE,
YOU BUSINESS FOLKS ARE LIKE
"FOURTH QUARTER EARNINGS ARE
COMING..." BUT IS THERE
SOMETHING BEYOND, OTHER THAN
THE FACT THAT WE LOST MONEY OR
GAINED MONEY FOR A COMPANY
THAT YOU'RE LOOKING AT THE
FOURTH-QUARTER NUMBERS?
>> Ellen Rosen: WELL, IT
REALLY TELLS YOU ABOUT -- IT'S
NOT JUST THE FOURTH QUARTER;
IT'S THE YEAR END.
YOU LOOK AT EVERY QUARTER, BUT
THEN YOU LOOK AT THE YEAR END.
IT GIVES YOU AN IDEA OF THE
HEALTH OF THE COMPANY.
OBVIOUSLY, INVESTORS MAKE
DECISIONS BASED ON WHERE THEY
THINK A COMPANY IS GOING. AND
COMPANIES NEED INVESTMENT;
THEY NEED THEIR SHARES TO SELL
BECAUSE THEY NEED THE CAPITAL.
IT ALSO TELLS YOU WHETHER OR
NOT, IF YOU'RE AN EMPLOYEE,
WHERE YOUR COMPANY IS GOING,
IF THE BUSINESS PLAN IS
WORKING OR VIABLE.
I MEAN, FOR INSTANCE NOW, WALL
STREET CONFIDENCE IS A REALLY
BIG THING FOR KEEPING THE
SHARE PRICE UP THERE, WHICH
MEANS PEOPLE WILL BUY YOUR
SHARE AND HANG ON TO YOUR
STOCK.
IN KODAK'S CASE, THEY'RE
TEAMING THEIR ANNOUNCEMENT OF
THEIR EARNINGS WITH AN
INVESTOR CONFERENCE IN NEW
YORK CITY WITH WALL STREET
ANALYSTS NEXT THURSDAY AT THE
SAME TIME, WHICH WILL REALLY
GIVE THEM A CHANCE TO TELL
THEIR STORY AND TRY TO SELL
WALL STREET ON WHAT THE
COMPANY'S PLAN IS FOR 2002.
WE'RE GOING TO HAVE OUR
REPORTER, BEN RAND, DOWN THERE
LIVE, HAVE UPDATES ON OUR WEB
SITE.
>> Gary Walker: ARE THEY GOING
TO HAVE ANYTHING POSITIVE TO
REPORT TO WALL STREET WHEN
THEY GIVE THE NUMBERS OUT?
>> Ellen Rosen: WELL,
ACTUALLY THEY'RE LOOKING --
THEY'RE SORT OF CLOSING THE
BOOK ON 2001.
THEY HAD A LOT OF DIFFICULTIES
THIS YEAR; SOME WERE MISSTEPS
OF THEIR OWN, PARTICULARLY IN
THEIR HEALTH IMAGING UNIT,
WHICH IS THEIR SECOND LARGEST
UNIT; THE INCURSION OF DIGITAL
INTO THEIR TRADITIONAL CASH
COW, WHICH HAS BEEN STALE AND
THE MARGINS ARE DOWN.
KODAK HAS TO LEARN TO DO
BUSINESS A LITTLE DIFFERENTLY.
BUT THEY'RE OPTIMISTIC ABOUT
2002; THEY'RE LOOKING AT THEIR
OWN GROWTH IN DIGITAL.
FOR INSTANCE, IN NOVEMBER,
KODAK HAS SLOWLY BEEN INCHING
UP IN DIGITAL CAMERA SALES,
AND IN NOVEMBER THEY WERE
ACTUALLY THE NUMBER ONE CAMERA
SELLER IN THE UNITED STATES.
THEY DROPPED BACK DOWN TO
NUMBER TWO
-- SONY REGAINED THE NUMBER
ONE POSITION IN DECEMBER, BUT
BY A VERY, VERY SMALL MARGIN,
A FRACTION OF A PERCENTAGE
POINT.
>> Gary Walker: SO KODAK BEING
COMPETITIVE ON THE OPEN MARKET
WITH SONY, THAT'S PRETTY
HEARTENING NEWS.
>> Ellen Rosen: THAT IS, BUT
THAT'S ACTUALLY ONE OF THE
ISSUES FOR KODAK.
THEY HAVE A LOT MORE PEOPLE
COMPETING WITH THEM.
WE HAVE A STORY ON SUNDAY THAT
TALKS ABOUT -- IN THE BUSINESS
PAGE, THAT TALKS ABOUT THEIR
HEALTH IMAGING UNIT.
KODAK REALLY INVENTED HEALTH
IMAGING, X RAYS AND ALL THAT
STUFF.
WELL, NOW YOU'VE GOT SIEMENS
AND ALL THESE OTHER COMPANIES,
GENERAL ELECTRIC, ALL THESE
OTHER COMPANIES THAT HAVE COME
IN WITH DIGITAL X RAY
MACHINES, SO THE COMPETITION
FOR KODAK HAS JUST GOTTEN
ENORMOUS.
>> Gary Walker: WELL, THE
FOURTH QUARTER NUMBERS ARE
COMING NEXT THURSDAY.
WHAT CAN WE EXPECT FROM "THE
DEMOCRAT AND CHRONICLE" ON
THAT NOW?
>> WELL, WE'LL HAVE BEN DOWN
IN NEW YORK CITY AND WE WILL
HAVE EARNINGS POSTED AS SOON
AS THEY COME OUT,
WHICH IS USUALLY BETWEEN 7 AND
8 IN THE MORNING.
WE'LL HAVE BEN DOWN IN NEW
YORK; WE'LL HAVE UPDATES ALL
DAY LONG ON OUR WEB SITE,
WHICH IS
democratandchronicle.com.
AND WE'LL HAVE A FULL STORY
THE NEXT DAY.
SAME FOR BAUSCH & LOMB,
WHICH ALSO COMES OUT THAT DAY.
>> Gary Walker: GREAT.
WE WON'T BE SEEING YOU NEXT
WEEK; WE'RE OFF THE AIR.
BUT WE'LL READ ABOUT IT IN
"THE DEMOCRAT AND CHRONICLE."
ELLEN ROSEN, THANK YOU VERY
MUCH FOR THIS WEEK'S REPORT.
NOW, YOU MAY HAVE SEEN THE PBS
SPECIAL "WAR LETTERS."
RECENTLY WXXI TV CREATED ITS
OWN VERSION WITH A LOCAL SPIN.
"WAR LETTERS, ROCHESTER WRITES
HOME," FEATURES CORRESPONDENCE
TO AND FROM LOCAL SOLDIERS WHO
SERVED IN EVERY CONFLICT
AMERICA HAS ENTERED.
HERE'S A LOOK...
(Music)
>> JANUARY 30th, 1944.
DEAR TONY, IT WAS SUCH A
BEAUTIFUL MORNING WITH A
BRAND-NEW WINTER BLUE SKY THAT
WAS DUSTED HERE AND THERE WITH
FLUFFY WHITE CLOUDS, A SKY
PERFECT FOR FLYING.
YOU WOULD HAVE LOVED IT.
FATHER WAS SAYING THAT HE MET
YOUR DAD QUITE BY ACCIDENT IN
A GROCERY STORE YESTERDAY
AFTERNOON.
I ASKED FATHER IF HE HAD HEARD
ANY NEWS ABOUT YOU.
IT WAS THEN THAT HE SAID
QUICKLY "YES, THEY SAY HE IS
MISSING."
(Music)
I WAS LOOKING STRAIGHT AHEAD.
THE WINDSHIELD WAS MISTY AND
THE SKY HAD TURNED SUDDENLY
INTO A SEA OF BLUE.
MISSING...
I FIXED MY GAZE UPON A CLOUD
UNTIL I COULDN'T SEE IT
ANYMORE.
I WAS NOT GOING TO BOW MY
HEAD.
NO, LET THE TEARS COME.
YOU WERE MISSING.
COULDN'T EVERYONE UNDERSTAND?
YOU WERE MISSING.
I LOOKED DOWN AT THE TURQUOISE
BRACELET YOU SENT ME FROM SAN
JUAN.
I LOOKED AT THE MINIATURE SUNS
CARVED ON IT,
TWO OF THEM, ONE ON EITHER
SIDE OF THE TURQUOISE.
I LOOKED AT IT AND EVERYTHING
YOU EVER MEANT TO ME WELLED UP
IN A GREAT BLUR THAT HURT SO
MUCH.
TEARS FELL ON THE SUN, TONY,
BUT IT HAS NOT STOPPED
SHINING.
YOU WILL ALWAYS BE WRITING TO
ME, MY DARLING, ALWAYS...
FRANCES.
(Music)
>> APRIL 20th, 1945.
DEAR KATHY, DADDY IS FINALLY
GETTING AROUND TO ANSWERING
YOUR SWEET LITTLE LETTER, THE
ONE YOU WROTE SO LONG AGO.
IT SEEMS SUCH A LONG TIME AGO
AND YET IT'S EVEN LONGER SINCE
I LAST SAW MY LITTLE GIRL.
MOMMY SENDS ME YOUR PICTURES
ALL THE TIME AND I CAN SEE
THAT YOU'RE GETTING TO BE A
BIG GIRL.
PRETTY, TOO.
DADDY LOVES YOU VERY MUCH.
ALL I EVER THINK ABOUT IS
WANTING TO SEE YOU, WONDERING
WHAT YOU WILL SAY AND DO WHEN
YOU SEE ME.
WAIT UNTIL I COME HOME.
WE ARE GOING FOR LOTS OF TRAIN
RIDES, CAR RIDES, TOO, JUST
MOMMY, YOU AND I.
WE WILL GO ALL OVER AND MAKE
UP FOR ALL THE FUN WE'VE
MISSED SINCE I HAVE BEEN AWAY.
MOMMY TELLS ME THAT YOU ARE A
SPOILED BABY, BUT I DON'T
BELIEVE HER.
DON'T TELL HER I SAID THAT OR
SHE WILL BE MAD AT ME.
IF I WERE HOME, I WOULD ROCK
YOU TO SLEEP EVERY NIGHT, AND
I WOULDN'T LET HER STOP ME.
IT WOULD BE SWELL TO HEAR YOU
SAY "DADDY, TAKE YOUR BABY."
DON'T FORGET TO BE A GOOD
LITTLE GIRL ALWAYS.
I MISS YOU VERY MUCH AND I
CAN'T WAIT UNTIL I SEE YOU.
ALL MY LOVE AND KISSES, DADDY.
(Music)
>> Gary Walker: FOR MORE
INFORMATION ON "WAR
LETTERS"
AND THIS WEEK'S EDITION OF
"NEED TO KNOW," OR TO DISCUSS
ANY OF THESE TOPICS, JUST LOG
ON TO wxxi.org/ntk.
THAT'S ALL FOR TODAY.
WE'RE OFF NEXT WEEK SO WE MAY
INTRODUCE YOU TO A NEW PBS
SERIES CALLED "AMERICAN
FAMILY."
WE'LL SEE YOU IN TWO WEEKS.
(Music)