DAVID GREENE, HOST:
Yesterday on the program we heard how difficult it can be to reach or even find U.S. veterans. NPR's Quil Lawrence took us to a remote town in rural Alaska. It was just one extreme example, though truth be told many vets live in hard-to-reach places. Today we're looking at how to get them health care without making them travel hundreds of miles to a hospital. It's a problem technology is helping to solve. Quil Lawrence has today's report from a snowy village just south of the Arctic Circle.
(SOUNDBITE OF KNOCKING)
QUIL LAWRENCE, BYLINE: Howard Lincoln of White Mountain doesn't always hear it when people knock on his door. He's 82.
UNIDENTIFIED MAN #1: All right, Howard.
HOWARD LINCOLN: OK, Ryan.
UNIDENTIFIED MAN #1: These two guys are going to talk with you.
LINCOLN: Yeah, OK.
UNIDENTIFIED MAN #1: Yeah, they're really good people.
LAWRENCE: He's skinny but spry. Lincoln jumped up to say hello when his nephew showed us in. Nice to meet you.
LINCOLN: Welcome to White Mountain. This is my home.
LAWRENCE: Out the window of his home the sun is casting long shadows on the Fish River. Sun sets at midnight this time of year.
(SOUNDBITE OF SCRAPING)
LAWRENCE: When we came in, Lincoln had been sitting at his coffee table sharpening a buck knife on a piece of flint. Knives and knickknacks fill the shelves of his double-wide, also photographs of Lincoln with famous dog sled racers. He's got his Purple Heart up on a shelf too. Do you remember when you got wounded?
LINCOLN: Yeah. It was terrible.
LAWRENCE: Did you get hit by bullets or shrapnel or...
LAWRENCE: That's maybe another reason Lincoln is hard of hearing - a screaming mortar shell in Korea 60 years ago. He's still got a little metal in his jaw and scars on his arm and hip. But he recovered, came home, and says he never applied for VA benefits. Anyhow, the nearest VA hospital was hundreds of miles and at least two plane rides away. But recently that distance got shorter - virtually.
SUSAN YEAGER: Travel is a big burden on a veteran who may be older, not feeling well.
LAWRENCE: Susan Yeager directs the VA health care system for the state.
YEAGER: And just the sheer expense of travel, that can be a barrier to care. That's part of what tele-medicine's about.
LAWRENCE: Tele-medicine happens over a secure computer connection between the big VA hospital in Anchorage and hundreds of small clinics across Alaska.
BRIAN LAUFER: So this is a global media cart.
LAWRENCE: Brian Laufer is chief health officer at the Anchorage VA hospital. Each clinic has a cart. Picture your old desktop computer with retractable cables that connect it to everything in a doctor's office.
LAUFER: There's a stethoscope, there's an otoscope to look in ears, ultrasound.
LAWRENCE: In a recent case, Laufer used a high-definition webcam to show a skin lesion to the head of dermatology at the VA in Seattle, a thousand miles away.
LAUFER: Turned out to be a melanoma. Within three weeks that melanoma was fully excised and had seen surgery here and had a cure because the melanoma was caught very, very early.
LAWRENCE: Quick action like that can save lives - and lots of money on travel. Vets with PTSD can sit in group therapy by video, which turns out to be more discreet - important in a tiny town where everyone knows everybody's business. Susan Yeager of the VA says tele-health carts are all over the state.
YEAGER: We have these carts - hundreds of them now - throughout the native clinic system.
LAWRENCE: The native clinic system - that's the key. The VA doesn't have a presence everywhere. But the Indian Health Service already does. A recent deal in Alaska and six other states allows veterans to use these clinics. And that means Howard Lincoln, the Korean War vet back in White Mountain, can get care in his home village and the VA will pay for it.
WILLA ASHENFLETER: There's a machine that's by his, his table that takes his blood pressure around 8:30 every morning.
LAWRENCE: Lincoln's sister, Willa Ashenfleter, helped him get signed up with the VA, which was a good thing, since he had two minor strokes last year. But, she says, he's worked hard to recover and stay independent - too independent maybe.
ASHENFLETER: Couple times he's been working on his roof, and when we tell him he shouldn't be up there, he isn't happy with that.
LAWRENCE: Howard Lincoln, 82 years old, was back up on his roof last winter. He doesn't like people telling him where he should or shouldn't go. Quil Lawrence, NPR News.
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