Section 1: Alaska Federal Health Care Access Network (AFHCAN)\ job -- director \ Alaska Native Tribal Health Consortium (ANTHC)\ AFHCAN -- mission\ AFHCAN -- beneficiaries\ agencies -- federal\ Native\ education\ college degree -- electrical engineering\ mathematics\ graduate degree -- biomedical engineering\ engineering -- medical applications\ Samoa -- work experience\ work -- computer network\ telecommunications\ telemedicine -- rural benefits\ Alaska -- coming to\ telehealth -- interest in\ AFHCAN -- employment\ AFHCAN -- startup date\ Alaska -- reasons for\ National Library of Medicine (NLM) -- project\ NLM project -- precursor to AFHCAN\ NLM -- funding source|

Section 2: National Library of Medicine (NLM) -- background\ telehealth -- federal funding\ telehealth -- studies of\ NLM -- study\ Village Telemedicine Testbed Project\ Village Telemedicine Testbed Project -- purpose of\ University of Alaska Anchorage (UAA) -- project management\ Pearce, Fred -- principal investigator\ Alaska Native Health Board (ANHB) -- contract with\ ANHB -- role\ telehealth system -- first\ Native regional health corporations -- proposals\ Native regional health corporations -- participation\ Native regional health corporations -- selection\ Ninilchik Traditional Council\ Bristol Bay Area Health Corporation\ Norton Sound Health Corporation\ Yukon-Kuskokwim Health Corporation\ telehealth system -- implementation\ telehealth system -- design\ telehealth system -- locations\ villages -- number involved\ NLM project -- outcomes\ NLM project -- expansion of|

Section 3: National Institute of Health (NIH)\ Village Telemedicine Testbed Project\ Alaska Native Health Board (ANHB) -- role\ telehealth system -- design \ telehealth system -- implementation\ telehealth system -- evaluation\ University of Alaska Anchorage (UAA)\ Pearce, Dr. Fred \ evaluation -- guidelines\ isolation -- reduction of\ cost\ evaluation guidelines -- key areas\ health care -- satisfaction\ telehealth -- customer satisfaction\ evaluation -- method\ method -- questionnaire\ method -- effectiveness\ evaluation -- results of\ health aide -- recognition\health aides -- skills\ telehealth -- use of\ use -- example\ injury -- wound\ suturing -- need for\ health aide -- lack of training\ doctor-- communication with\ images -- sending\ doctor -- response from\ fax machine -- use of\ telecommunications -- benefits\ Village Telemedicine Testbed Project -- focus\ focus -- ear disease \ tools\ scopes -- Ear Nose Throat (ENT) \ digital camera\ digital camera -- benefits of\ digital camera -- medical uses\ trauma\ wound management\ care -- chronic\ dermatology -- diagnosis\ diagnosis -- difficulty\ skin disease -- outbreak\ dermatologist -- lack of\ Alaska Native Medical Center\ dermatologist -- employment|

Section 4: telehealth systems -- use of\ use -- frequency\ use -- study of\ Kotzebue\ Maniilaq Association\ clinic -- village\ tools -- use of\ tools -- video otoscope\ tools -- digital camera\ data -- comparison\ tools -- preferences\ telehealth -- applications\ applications -- local control\ teleheath tools -- access\ access -- health aides\ health aides -- technological issues\ generations -- differences\ health aides -- surprises\ expectations\ health aides -- case study\ case study -- efficacy of technology\ case study -- outcome\ health aides -- longevity\ telehealth -- reaction to\ health aides -- feedback\ electrocardiogram (EKG) -- examination\ EKG -- training\ EKG -- tools\ EKG tools -- request\ telehealth -- response to\ technology -- response to|

Section 5: videoconferencing -- comparisons with\ Alaska Federal Health Care Access Network (AFHCAN) system -- comparisons with\ videoconferencing -- description of\ videoconferencing -- system requirements\ connectivity -- broadband T1\ videoconferencing -- scheduling\ videoconferencing -- challenges\ videoconferencing -- locations\ videoconferencing -- impractical\ connectivity -- limits of\ Alaska\ AFHCAN system -- logistics\ AFHCAN system -- design\ technology -- store and forward\ AFHCAN system -- description\ technology -- bandwidth\ bandwidth -- low\ AFHCAN system -- efficiency\ AFHCAN system -- asynchronous\ AFHCAN system -- evolution\ National Library of Medicine (NLM)\ AFHCAN system -- recognition\ recognition -- worldwide\ AFHCAN system -- advances in\ video -- emergence of\ AFHCAN system -- applicability\ telehealth -- cases\ cases -- types of\ cases -- response to\ cases -- non-urgent\ cases -- trauma\ cases -- urgent\ patient -- evacuation\ data -- sending\ case -- follow-up\ case -- decision|

Section 6: National Library of Medicine (NLM) telehealth project -- timeline\ Alaska Federal Health Care Access Network (AFHCAN) -- timeline\ AFHCAN -- organizational structure\ Alaska Federal Health Care Partnership (AFHCP) -- description of\ AFHCP --involvement\ AFHCP -- partnerships\ AFHCP -- proposal\ AFHCP -- management\ Alaska Native Tribal Health Consortium (ANTHC)\ ANTHC -- organizational structure\ AFHCP -- reorganization\ ANTHC -- management\ ANTHC -- collaboration|

Section 7: Alaska Federal Health Care Access Network (AFHCAN) -- funding\ funding -- history\ funding -- federal\ Indian Health Service (IHS)\ Department of Defense\ Veterans Administration\ Department of Transportation\ Health and Human Services\ funding -- management of\ Alaska Native Tribal Health Consortium (ANTHC)\ funding -- primary source|

Section 8: telehealth\ people -- key\ Pearce, Fred\ Alaska Telemedicine Project (ATP) -- development\ Eussen, Lori \ Patricoski, Chris\ telehealth -- history\ telehealth system -- challenges\ telehealth system -- connectivity\ telehealth system -- partnerships\ cohesiveness \ technology -- advances\ telehealth system -- organization\ organization -- changes\ Alaska Native Medical Center -- Ear, Nose, Throat (ENT) Department\ ENT Department -- support from\ AFHCAN -- changes\ partnerships -- evolving|

Section 9: National Library of Medicine (NLM) telehealth project\ lessons -- learned\ Stotts(?), Denise\ interviews -- health aides\ health aides -- suggestions\ telehealth system -- usage\ usage -- variation\ telehealth system -- future\ future -- goals\ ownership\ training --development\ curriculum\ distance education\ regional health corporations -- staff\ staff -- trained\ telehealth system -- integration\ telerad system -- radiology\ data -- compiling\ data -- outcome\ studies\ case studies -- development of\ telehealth -- multi-disciplinary\ images -- variety\ telehealth -- emergence of\ information -- transferring of\ information -- integration of\ AFHCAN\ electronic health records -- integration of\ Picture Archiving Communication Systems -- integration of\ data -- movement\ integration -- issues with|

Section 10: technology -- integration\ electronic health records\ Native health corporations\ data -- exchange\ health record -- access to\ data -- movement\ data -- access\ format -- standardization\ standard -- Health Level 7 (HL7)\ standard -- open\ lexicon -- variability\ funding\ Indian Health Service (IHS)\ telehealth -- solutions\ solutions -- Alaska\ solutions -- national\ Washington\ Arizona\ Tennessee\ electronic health record -- national\ data -- commonality\ records -- management\ forms -- paper\ forms -- faxing\ record management -- electronic|

Section 11: data -- electronic\ record management -- electronic\ health aides -- effect on\ health aides -- consultation with\ telehealth system -- use of\ village -- visit\ use -- observation of\ telephone -- similarity\ data -- capture\ data -- send\ telehealth system -- importance of\ clinic -- fire\ telehealth cart -- rescue of\ telehealth system -- shortcomings\ clinics -- lack of use\ timeframe -- limited\ technology -- acceptance of\ connectivity -- limit of\ system -- unusable\ users -- training\ use -- increase\ training -- timing\ training -- Information Technology staff\ cart -- building\ AFHCAN -- training group\ Constantine, Mandy\ trainers -- nurses\ curriculum -- “train the trainer”\ Native health corporations -- staff\ training -- on-site\ training -- length of\ training -- content\ staff -- empowerment\ training -- success\ Maniilaq Corporation\ Yukon-Kuskokwim Health Corporation\ US Coast Guard|

Section 12: telehealth -- cart\ cart -- description\ cart -- equipment\ computer\ monitor\ computer -- touchscreen\ telehealth case -- creation of\ cart -- standard\ carts -- number of\ digital camera\ otoscope\ scanner\ ECG\ cart -- decisions\ committee -- clinical\ committee -- membership\ regional health corporations -- clinical directors\ cart -- original\ cart -- redesign\ cart -- upgrade\ cart -- equipment\ cart -- set-up\ set-up -- easy\ cart -- size\ size -- standard\ cart -- deployment|

Section 13: Equipment -- description of\ timpenometry\ ear drum -- fluid\ ear pressure -- measuring\ ear problems -- treatment\ image -- limits of\ reflex response -- measurement of\ audiometry\ screening\ hearing loss -- measurement of\ writing spenometry\ pulmonary function -- testing of\ asthma -- diagnosis of\ stethoscopsy\ heart -- sound\ lung -- sound\ stethoscopsy -- challenges\ stethoscope -- placement\ placement -- importance of\ heart beat -- fetal\ dental care -- camera\ dental health aide program\ videoconferencing\ webcam\ camera -- zoom\ camera -- operation\ operation -- remote\ technology -- store and forward\ technology -- interactive\ monitors -- vital signs\ blood pressure -- measuring\ temperature -- measuring\ blood -- oxygen levels\ monitoring -- simultaneous\ data entry -- lack of\ typing -- lack of\ error -- removal of\ devices -- external\ devices -- plug-in|

Section 14: telehealth cart -- upgrade\ cart -- design\ cart -- size\ cart -- small case\ case -- prototype\ case -- briefcase\ case -- equipment\ case -- standard\ case -- transportable\ house calls -- use for\ field treatment -- use for\ Coast Guard -- interest from\ Air Force -- interest from\ case -- waterproof\ case -- dustproof\ case -- request for\ Navajo Nation\ elder -- home visit\ electricity -- lack of\ conditions -- dusty\ power -- battery\ cart mobility -- solution|

Section 15: telehealth system -- cart\ cart -- touchscreen\ software -- design\ touchscreen -- buttons\ buttons -- size\ buttons -- color\ language -- simple\ use -- ease of\ telehealth case -- creation of\ telehealth system -- logging in\ telehealth -- choices\ case -- new\ case -- already sent\ case -- archived\ case -- respond\ choices -- limited\ colors -- consistent\ case -- creation\ creation -- method\ data -- adding\ images -- use of\ order -- flexibility\ information -- advance\ EKG -- interpretive\ patient -- age\ patient -- gender\ case -- practice\ case -- real\ case -- management\ evaluation\ answers -- stored\ data -- assessment\ case creator -- question to\ questions -- examples of\ satisfaction -- patient\ satisfaction -- job\ problems\ consultant -- question to\ travel -- patient\ travel -- effect on\ responses -- number of\ patient travel -- amount of\ telehealth -- success of\ expectations\ patient travel -- reduction\ Alaska Native Medical Center (ANMC)\ patient travel -- increase\ disease -- catching\ health care -- improvement|

Section 16: health aides -- duties\ duties -- number of\ health aides -- appreciation for\ health aides -- primary care\ health statistics -- Alaska\ death -- rate\ death -- trauma\ trauma -- villages\ accidents\ health care -- basic\ death -- premature\ disease -- heart\ disease -- diabetes\ health -- problems\ health aides -- care from\ health aides -- training\ training -- level of\ training -- continued\ telehealth system -- benefits\ health care -- effect on\ telehealth system -- reliance on\ AFHCAN -- open house\ health aides -- visit\ telehealth system -- response to\ telehealth system -- reliance on\ telehealth system -- use\ use -- expansion of\ expansion -- efforts\ health aide program -- support from\ community health aide manual (CHAM) -- telehealth section\ demonstrations\ training\ meetings -- statewide\ health aides -- involvement with\ training -- trainers|

Section 17: telehealth -- future\ telehealth -- routine\ data -- capture\ data -- movement\ data -- requirement\ physicians\ Alaska Native Medical Center\ Anchorage\ telehealth -- cases\ telehealth cases -- requirement\ telehealth -- expectations\ technology -- expectations\ information -- expectations\ provider -- needs\ needs -- meeting\ simple\ accessibility\ training\ system -- support\ technology -- advancement\ technology -- changes\ connectivity -- changes\ video -- access to\ telehealth systems -- advances\ priorities\ telehealth -- promotion of\ promoters -- health aides\ telehealth -- difficulties\ consultants -- support from\ support -- changes in\ telehealth -- acceptance of\ expectations -- meeting\ technology -- abilities of\ technology -- limits of\ technology -- advances\ resources -- limits of\ possibilities -- prioritization\ cost -- effectiveness\ demands -- reasonable\ staff -- shortage\ requests -- filling|

Section 18: need -- unmet\ mental health services\ video -- live\ Adler, Ron\ Alaska Psychiatric Institute (API)\ telehealth -- use of\ telehealth -- promotion of\ user -- needs\ needs -- meeting\ cooperation\ funding\ University of Alaska\ Alaska Primary Care Association\ health centers -- community\ work -- collaborative\ collaboration -- emphasis on\ technology -- limits\ limits -- lack of\ technology -- expectations\ mental health services -- reliance on telehealth\ psychiatrist\ patients -- see in person\ mental health services -- local\ patients -- monitor\ travel -- decisions about\ medication -- adjustment\ telehealth -- international\ telehealth -- standard\ videoconferencing -- use of\ videoconferencing -- Alaska\ regional health corporations\ Southeast Alaska Regional Health Consortium (SEARHC)\ technology -- overcoming\ connectivity -- broad\ mental health aides -- supporting\ telehealth -- creative uses\ families -- talk with\ live video -- use of\ pregnant women -- Anchorage\ care -- hospice\ family -- involvement\ telehealth -- possibilities\ telehealth -- public\ hospital -- consulting room\ clinics -- new\ room -- videoconferencing\ room -- private|

Section 19: telecommunications\ connectivity -- Universal Services Fund (USF)\ telephone -- fees\ connectivity -- subsidized\ connectivity -- remote area\ connectivity -- access\ corporation\ connectivity -- price of\ connectivity -- paying for\ connectivity -- equal access\ Anchorage\ village -- connectivity\ school -- connectivity\ lines -- sharing|

Section 20: telehealth -- Alaska\ telehealth system -- development\ people -- involved\ National Library of Medicine (NLM) project\ Pearce, Fred\ Hall, Rich\ Alaska Native Medical Center\ Sherry, Paul\ Alaska Native Health Board (ANHB)\ ANHB -- partnership\ Alaska Native Tribal Health Consortium (ANTHC) -- involvement\ AFHCAN -- management of\ health corporation -- leadership\ leadership -- support from\ Kashevaroff, Don\ ANTHC -- Board of Directors\ AFHCAN -- steering committee\ Stevens, Senator Ted\ Canal(?), Liz\ funding -- availability\ project -- stabilization\ funding -- Indian Health Service (IHS)\ requests -- meeting\ requests -- national\ Carroll, Mark\ IHS -- national coordinator\ telehealth -- model\ telehealth -- promotion\ opportunities\ systems -- integration\ systems -- effectiveness|

Section 21: Alaska Telehealth Advisory Council (ATAC) -- formation of\ ATAC -- purpose of\ telehealth -- statewide issues\ telecommunication -- companies\ hospitals\ Mental Health Trust Authority\ Nicewinder, Tom\ ATAC -- facilitator\ ATAC -- reporting to\ ATAC -- importance of\ State -- health commissioner\ Medicaid -- regulations\ regulations -- changes\ telehealth -- paying for\ insurance -- reimbursement\ leadership -- State\ telehealth systems -- additional\ Providence Hospital\ Boucha, Kathe\ teleradiology\ Sivits, Herb\ Alaska Clinical Engineering Services\ AFHCAN -- regional partners\ local -- needs\ systems -- local\ systems -- development\ corporations -- individual efforts\ telehealth -- acceptance of|

Section 22: telehealth -- response\ physicians -- response\ response -- variability\ telehealth -- struggles\ physicians -- support from\ physicians -- working with\ physicians -- encouragement\ telehealth system -- demonstration\ hospital -- administration\ telehealth -- adoption of\ telehealth case -- first\ excitement\ apprehension\ telehealth -- usefulness\ email -- use of\ system -- comfort level\ system -- convenience\ system -- easy|

Section 23: email -- security\ telehealth -- security\ security -- healthcare\ security -- regulations\ regulations -- Health Information Portability Accountability Act (HIPA)\ security\ privacy\ health care -- data\ data -- movement\ data -- protection\ data -- encryption\ signature -- electronic\ recipient -- verification\ data -- validation\ email -- encryption\ email -- image\ image -- control of\ virus -- presence of\ email -- storage\ server\ personal computer\ telehealth system -- security\ security -- electronic\ security -- procedures\ telehealth -- servers\ servers -- security\ security -- importance of\ confidentiality -- changes in\ radio -- uses of\ information -- knowledge about\ village -- concerns\ health care -- importance of\ security -- lack of interest\ telehealth case -- encryption\ data -- protection\ data -- backup\ server -- ownership\ control -- local\ data -- ownership|

Section 24: health corporation -- empowerment\ control -- local\ telehealth -- success\ training -- success\ lessons -- learned\ telehealth -- users\ training -- needs\ training -- constant\ health aides -- training\ training -- desire for\ staff -- shortage\ training -- distance\ training -- increase\ telehealth system -- future\ telehealth system -- standard\ training -- importance of\ regional health corporations\ data -- management\ training -- users\ training -- cart builders\ training -- software managers\ training -- server managers\ training -- improvement of|

Section 25: telehealth -- personal influence\ career -- satisfaction\ job -- quality\ staff -- quality\ dedication\ passionate\ technology -- cutting edge\ job -- fulfillment\ travel -- village\ health aides -- working with\ work -- importance of\ NLM project -- staff\ Rawls, Rob\ Stotts, Denise\ telehealth system -- design\ telehealth -- software\ telehealth -- cart\ cart -- building\ work -- hands-on\ AFHCAN -- growth\ villages -- consultation with\ staff -- hiring\ staff -- improvement\ system -- improvement|