Thursday, March 13, 2003

Ball State U. Tests Interactive System for Answering Students' Health Questions Online By SCOTT CARLSON Students who call the health center at Ball State University will soon find their questions answered in more graphic detail than they are accustomed to. Instead of asking a patient to describe a rash over the telephone, a nurse might ask the patient to look at his computer screen: Does the rash have oozing pustules, like the picture on the left? Or is it red and itchy, like the one on the right? The clinic is testing a system that will allow nurses and patients to interact not only by telephone, but also through their desktop computers. Using the system, a student who calls the health center for advice will be able to go to his or her computer and see the on-duty nurse. The nurse will not be able to see the student but will be able to present pictures, video, or documents in the student's Web browser to help discuss and diagnose the student's condition. Starting at the end of the month, Ball State will test the system in the residence halls for five weeks, until the end of the school year. If the system is successful, the university will bring it back in the fall, and will expand it to serve any student with high-speed Internet, on or off campus. The system will operate from late afternoon to late night, when the health center is closed. Jake Baggott, who is the assistant director of the student health program at Southern Illinois University at Carbondale and is a board member of the Mid-America College Health Association, says he doesn't know of any other university using such technology. "The concept sounds interesting," he says. "I could see where some technology like that would have applications." The service is sponsored by the Center for Media Design, a research facility at Ball State that promotes technology projects on the campus. Rodger Smith, the director of the media-design center, says that the interactive service will allow nurses to offer more precise information about afflictions, which could lighten the schedule of appointments during the day. It will also give the nurses an opportunity to educate students. If a student who is worried about an unprotected sexual encounter calls the clinic, the nurse could not only encourage the student to come in, but could also present information about sexually-transmitted diseases. The health center's medical staff relishes such features. "A lot of studies show that when you discuss medical information with patients, they typically absorb only 15 to 25 percent of what you're telling them," says Kent Bullis, the medical director. The interactive call-in system will allow him to present more information, he says, and in a way that makes it more likely to be absorbed. "Say we have a student who calls and says that he has hit his head on concrete," Dr. Bullis says, "and from the conversation the nurse determines that the student doesn't have to come in. She can send him an information sheet that tells him what precautions he should take and what danger signs he should watch out for." Both Mr. Smith and Dr. Bullis have considered the liability issues involved. "We're not going to be doing anything more than what the student would be doing when calling the health center," Mr. Smith says. "The only difference is that they can give you more information for you to make your own kinds of decisions. "For the last 15 years, I have answered 12 calls every night and given advice," Dr. Bullis says, adding that this is no different. "I don't think we're going too far out on a limb on this." Frances J. Mantak, director of health education at Brown University Health Services, says the interactive system sounds interesting, but it's probably not something she would adopt at her clinic. She says she would be concerned about issues of confidentiality and about limits on how much and how well information can be conveyed through the Internet. If nurses are pushing pictures at a student and asking whether his or her rash looks like any in the pictures, Ms. Mantak says, "my concern is, How well-equipped is the student to interpret what they have?" She points to Lyme disease as an example: Most people believe that the tick bite resembles a bull's-eye, "but it doesn't always show up that way." Medical professionals make diagnoses after looking for a variety of possible symptoms, and often the doctor has to see the patient to get a sense of what is going on. Dr. Bullis says he'll have to see how the system works during the tests before he passes judgment on it. But he adds that, in his experience, patients' descriptions of ills often differ from what he sees when they visit the clinic. Referring to images may help patients describe their conditions more accurately, he says. "My suspicion is that there is probably some role for sending pictures through the Internet." To set up the system, the university formed a partnership with a company that manufactures interactive television in Britain, where televised health services are becoming more common. The university paid the company around $14,000 for the system; the company gave the university a discount and free technical support. "We presume and hope that Ball State's model is something that will be attractive to other universities," Mr. Smith says. "When they want to learn how to do it, the place to come to learn will be Ball State." Easy-to-print version E-mail this article

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